What a Long, Strange Trip It's Been: 30 Years of HIV tests

It’s a sunny but cold morning in New York City’s Chelsea neighborhood. I’ve arrived at 8:30 a.m. sharp at the Callen-Lorde center, a sexual health services clinic named for a Broadway choreographer and a poet. Callen-Lorde is a quintessential safe space for the local LGBTQ community with gay staffers galore, a sliding fee scale based on income, racks of educational pamphlets and bowls filled with condoms. On Saturdays no appointment is needed; first come, first served.

In the waiting room I watch a corny video on the political correctness of gender labeling – never assume! – before being taken to a small sunlit consulting room. A nice young man puts on rubber gloves and pricks my finger to squeeze a drop of blood into a slender glass straw. He adds the blood to a small vial of solution and does some other bartending over a tiny plastic dish the size of a contact lens case.

Like scryers from days of yore, we turn our attention to the tiny bowl to see what my future holds. A single blue dot has formed to indicate the test has a viable mix for an accurate reading. We’re now going to wait to see if a second dot appears indicating the presence of HIV antibodies in my blood.

What do you expect the result to be, he asks me.

Negative, I say.

If it came back positive do you think you might harm yourself, he asks.

I look at him for a second and smile. No, I say.

It occurs to me that this is my 30th year of taking HIV tests. Thirty years living in the shadow of HIV/AIDS. Thirty years of doing postmortems after every new sexual encounter to assess whether transmission may have occurred. Three decades of tests: heart pounding fear as you wonder if this is the day your luck runs out; a rush of joy when you’ve been spared. “Thank you Jesus! I’ll never have gay sex again!” Thirty years of reading everything you can find about HIV/AIDS with the keen interest of someone with skin in the game. Thirty years … as the Grateful Dead lyric goes, what a long, strange trip it’s been.

In 1987 I am 28 years old and working as a reporter for the local paper in El Paso, Texas. I am dating girls and having furtive encounters with men. For several years I’ve been following news reports of a gay plague in New York and San Francisco. AIDS is definitely on my radar. Rock Hudson has died in 1985. Ryan White, an Indiana teen who acquired HIV in a blood transfusion, is in the news after his school barred him from attending.

Journalist David M. Hancock seen here in 1986-87, standing on a hill in Ciudad Juarez with downtown El Paso, Texas, in the background

But AIDS isn’t real to me, in terms of my life. It is something happening elsewhere, not in El Paso, Texas. In 1987, the message about using condoms for anal (and oral) is getting out there. But I am not using condoms with either sex.

Then I fall in love.

I meet a handsome Mexican American man and … Zing! go my heart strings. The stars fall on Alabama. I fall hard; I’m all shook up. It’s like a heat wave. I can’t help myself. I’m shot through the heart. Insert your favorite love-metaphor-lyric here …

After several weeks of having unsafe sex in all directions, I decide that we can’t go forward as a new couple unless we have tests for this gay disease. I’m acting out the fuzzy discrimination that is still rampant today. We’ll armor up and sleep with strangers and hope for the best. But for matters of the heart we don’t want to engage with the afflicted. I wrote an essay about this knee-jerk regressive attitude for Poz.com.

Here’s how it goes down in El Paso, Texas, in 1987. We make separate appointments under assumed names at the one hospital that is doing tests. I use the name of a reporter in San Antonio that I’ve never met. My friend (and future partner) has a very generic Mexican name. It’s not Joe Garcia, but pretty close. So he comes up with the more exotic moniker Jose Luis Escarciga.

I think it was $75 for the test. I pay in cash so they can’t trace it back to me. The nurse has a slight smirk as she draws a large vial of blood. I know what you are. Two weeks later we come back under our assumed names and get the green light for what turns into a five-year relationship.

I think back now and try to remember what was going through my mind in 1987. I hadn’t been worried about AIDS enough to change my behavior. But the act of taking the test brought the possibility into frightening focus. Skeletal men with blotches on their faces, violent diarrhea and deadly pneumonia. If my future partner had turned up positive I think I would have been a supportive friend. But it would have been the end of us as a couple. It was just too scary in 1987. Not like today, where the facts about transmission are much clearer. Back then people were still asking if you could get it from a sneeze or drinking from someone’s glass.

Skip forward to 1992 and I’m now living in Miami. My relationship has ended and I’m back on the market. With one big difference. In 1987, safer sex practices were not part of my game. In 1992, I now understand condoms must be used for all things anal. My relationship has given me a five-year window of shelter during a murky time. Sometimes you get lucky with the timing in life.

It occurs to me that this is my 30th year of taking HIV tests. Thirty years living in the shadow of HIV/AIDS. Thirty years of doing postmortems after every new sexual encounter to assess whether transmission may have occurred.

In Miami 1990s, AIDS is a real thing. It isn’t some war raging in a faraway gay enclave. I have known my first person to die of AIDS, a young black reporter at The Miami Herald. An eager guy trying to rise up the ranks and then he’s gone. Goes into the hospital for a couple days and dies. There are other deaths on the staff that seem suspicious. Back then you can appear fine to the world even with a miniscule T-cell count ― and then a tough case of pneumonia comes along and you slip away fast.

In Dade County they are taking HIV/AIDS testing to the streets in mobile vans. You sneak inside hoping no one saw you going in. And you still have to come back a week or two later for results. Days spent on edge, with an axe hanging over your head. They won’t give results on the phone, for fear you will hang up and go jump off a building into Biscayne Bay.

I remember driving my car past one of those vans on Washington Avenue in Miami Beach. The door opens and a man in black leather pants staggers out into the glaring afternoon sun. He has a ghastly look on his face, as if he’s just gotten a death sentence – which in the 1990s he very likely has.

I put it all on the line in the 1990s. I have seen that using condoms for all things anal has kept me negative. But there is no guarantee that will hold up. Each HIV test is a moment of truth. You just don’t know – particularly about performing oral sex. The health pamphlets back then tell you to use condoms for oral sex – which is a no-go for me and most every other gay guy.

One of my favorite bars in Miami Beach is a two-story semi-dive called Twist. One night at Twist I chat with a sad young man in a white shirt and a pink bow tie. He tells me he attended the funeral of a friend that day who had died of AIDS. And that he isn’t well himself.

I take him home. When we undress, his pale body is covered like a Dalmatian with red and purple bruises. We kiss and he performs oral sex on me. I slip on a condom and gently enter him. I remember repeating to myself my mantra from that era: “If this isn’t safe, I would have gotten it by now.”

I look at that last paragraph and ask myself why did you do that? Why would you have sex with someone with full-blown AIDS? On one level, I was touched by this sad young man who was going to die. I wanted to give comfort.

But decades later, it also seems to me an act of defiance. Either safer sex worked or it didn’t. I couldn’t live my sexual life in constant fear. But during every test, in the back of your mind there was always doubt. Is this the day?

In the mid ‘90s I found a doctor I felt comfortable confiding in. I had my first HIV/AIDS test that was part of an annual checkup. During the first test in his office, his nurse’s hands shook when she drew my blood.

I’ve done pretty much every test as the technology evolved. In the 2000s I used a $79 kit where you squeezed a drop of blood onto a paper bullseye and mailed it off. You waited a week before calling in with a code number for your results. Usually you got a recorded message saying you were negative but it didn’t include exposure in the last three months. One time the machine transferred me to a live operator. I died a thousand deaths until she told me I was fine and it had been a glitch in their telephone system.

A few years ago I bought an environmentally unfriendly home saliva test kit, which cleared the hurdle of giving you immediate results. You swabbed the side of your mouth and got your results in 20 minutes. It was $39 and came in a clunky 8-inch-wide plastic tray with laminated instruction tabs like an old style rolodex.

That’s it, says the nice man at Callen-Lorde. It’s negative.

And again, even with all my experience, I feel relieved. You never know.

From there, I proceed to have the most thorough STD exam I’ve ever had. My throat is swabbed, I swab my sphincter, I pee in a cup for chlamydia and give more blood for syphilis. Finally I meet with a doctor to show her the real reason I am there, a weird crusty sore on my lower abdomen. Could it be … a chancre?!?

I take him home. When we undress, his pale body is covered like a Dalmatian with red and purple bruises. We kiss and he performs oral sex on me. I slip on a condom and gently enter him. I remember repeating to myself my mantra from that era: “If this isn’t safe, I would have gotten it by now.”

She examines it with her gloved hands and promptly diagnoses it as folliculitis, AKA a boil. Which turns out to be true a few days later when all the STD tests come back clear.

I felt a little silly, then, to have gone to all that trouble over an inflamed pore. But in truth, it wasn’t that much bother. I was done in less than two hours, my insurance paid for it. I walked out with a feeling of confidence and power. I had taken my nagging doubts and worries and inverted them 180 degrees into positive action. I treated myself to a donut.

I hope you’ve enjoyed this stroll down my memory lane on HIV testing. Just as it’s been a journey to become comfortable in my skin as a gay man, it’s been a process to take control of my sexual health. It’s exciting to see the improvements of the last ten years in HIV/AIDS treatment and prevention. What was once a death sentence is now manageable. And there’s even a pill that has shown an amazing ability to protect from HIV transmission.

Two modest points:

  • In this new age of Truvada, it’s also still possible to remain HIV negative with the use of condoms and common sense, i.e. never drinking or drugging so much that you lose control
  • It’s important for sexual health services to have the support of government and their communities

Just as I was afraid to be seen going into mobile testing vans, many people have to screw up their courage to visit a facility for contraceptives or STD testing. There remains in this country a strong Calvinistic streak that discourages people from acknowledging sex and making plans for it.

I feel sad to see beautiful organizations like Planned Parenthood under fire in the current political climate. We need more places like Planned Parenthood and Callen-Lorde – safe spaces where men and women can obtain sexual health services.

David Hancock is an NYC-based writer who has worked for CBS News and The Miami Herald. He is the author of two books: “Tricks Gone Bad” and “The Man Who Lost His Gayness”. More at davidmhancock.com.

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