At first, AIDS was history. Then, about 10 months ago, HIV became a part of my daily life. I started dating Julie, who was, at that time, fairly recently diagnosed. Back then, her T cells were booming, and HIV was still more of a topic of discussion than a cause for concern. Julie’s status didn’t change the way we had sex. She didn’t feel sick. We were as normal as any two trannies living in Brooklyn could be, and I figured we had the HIV stuff under control.
That isn’t to say that I didn’t deal with negative effects, but they were mostly social. For instance, the only arguments Julie and I have ever gotten in have been because I get frustrated when I think she doesn’t take care of herself. One of our first dates involved me dragging her to the food stamps office and then sitting outside on the sidewalk for several hours while she worked her way through the red tape upstairs. (I occupied myself reading Catch-22.) After a couple months, my sister met Julie, loved her, but ever since seeing our video about connecting with other HIV+/- couples, refuses to speak to me. (Other family members insist that AIDS panic isn’t the cause for this, but I am pretty sure it is.)
I feel stupid even bringing up the “negative” effects because they seem pretty minor in comparison to actually, say, being sick, and mentioning my family weirdness makes me feel oddly selfish. Luckily thing, then, that all the heady fun times when HIV was just a theory are all the the past.
One afternoon a few weeks ago, I got a chat message from Julie and suddenly her face popped up and the webcam engaged. She looked worried. She sounded nervous, almost guilty, like she was in trouble.
“I guess it’s that time.” she said.
I confess that I had no idea what she could be talking about. It wasn’t her birthday. I was reasonably sure we didn’t have plans that night. A second or two later my heart sank, and I remembered why she had left my house in the first place–a doctor’s appointment. I knew that she had to mean that her doctor had recommended that she start on ARVs–a process we both had been hoping would be put off as long as possible, considering her housing/job/life situation is in near-constant flux and very stressful. She is prone to depressive bouts and without my gregarious habit of inviting swarms of friends over several times per week, might be happy to lock herself up alone for months and put any responsibilities of taking care of herself out of her mind.
“You’re going to start?” I asked.
Her T-cells had dropped just under 400 and her viral load was breaching 75k (we refer to them fondly as “seventy-five thousand of your closest friends per milliliter”). I wish I could say “for the first time, it was actually real” about this moment, but the truth is that I keep having those moments, as HIV leaves the realm of zines and books and old VHS transfers and becomes this thing that is in my life and changing this person I love. But in the past, as my understanding of HIV grew I might have felt curious or confused, now I finally felt worried. I was going through this transition with my partner, who had previously been essentially a person with a diagnosis and was becoming a person with a prescription and side effects.
We found out that Julie would be starting on Atripla, an ARV that seems to have a good reputation for beating the snot out of HIV. She has an old version of HIV (one-point-oh, I imagine) and I am under the impression that the ARVs will have a good chance of zeroing her viral load. Atripla’s other reputation is for having extremely common psychological side effects. The package insert is a 55-page 16,000-word document printed on a single elephant-sized sheet in a flea-sized font. The first warning: The medication can cause psychiatric problems, including anxiety, depression, aggressiveness, and suicidal thoughts or behavior. Tell your healthcare provider immediately if you are experiencing any psychiatric Atripla side effects.
The online reviews written by other consumers of Atripla reveal a panoply of first-person narratives of terrifying side effects including vivid dreams coupled with insomnia, dizziness, being unable to see (strangely never described as “blindness”) and even at least one who complained that their “ears swelled almost completely shut.” At first I chuckled at this last symptom and thought, I’d like to see that, but then I considered it and decided, no, I probably wouldn’t.
That was six weeks ago.
Today her T-cells are holding steady above 300; our little friends have increased the party by about 10k per ml.
Tonight, at around 11, Julie took her first Atripla pill. It’s the only pill container I’ve ever seen that has branding on the bottle. I asked her if I could take a picture of her swallowing it but she told me No in a way that encouraged me not to press the issue further. The moment brought back memories of all those times I’ve been with friends who are taking their first shot of testosterone, one of those few medical moments of true joy. Those first shots are recorded on video and polaroids, in livejournal posts and self-important essays. But tonight, I was the only witness, and the moment passed without pomp, without circumstance.
It’s 1am now. I’ve got her framed in my periphery. I don’t want her to know I’m paying too close attention, waiting for something, anything, maybe for her ears to swell shut.
“I feel weird” Julie told me a few minutes ago. I asked her to elaborate. “I just feel weird.” she said.
“Does it feel like anything you’ve ever experienced before?”
“Yeah. Like drugs.”
And so, it begins.