jbaumeister

I'm HIV+ as well. Since I contracted, sero-converted, and was diagnosed over a very short period of time, I had very little time to ease into the notion and it hit me like a ton of bricks. My biggest concern at diagnosis was that I wouldn't live a full life. My biggest concern now is the various forms of stigma or pity that I have to endure upon telling someone of my status. Ignorance I can handle, but pity is a lot tougher. I tend to get frustrated when people suddenly either seem to want to saint me (all I did was have unprotected sex, contract a disease, and express a desire to continue living a relatively normal life! I'm not a hero.) or treat me as if I'm a fragile object (the only thing that's fragile is my patience...) How do you deal with the pity?

My worst nightmare, too. That says something positive about your character, I think.

I've discovered there are people out there (likely including the person who infected me) who know they're positive and don't disclose, or lie, or (very rarely) actively seek out negative partners.

I think dogma unintentionally works, too. I grew up in a conservative evangelical denomination (same one as a certain Congresswoman from Minnesota) and they pretty much failed the compassion test when it came to HIV/AIDS and the ideas they promoted about it. I actually heard from teachers at the affiliated private school I was sent to about how AIDS was God's curse on homosexuals. They also told us in health class that condoms don't stop the spread of HIV. That was a bald-faced lie, of course. But it served their particular agenda.

I can't answer for the UK, but in the USA, the primary standard for an AIDS diagnosis remains based on the number of CD4 cells per unit (microliter, I believe) of blood. Below 200 garners an AIDS diagnosis. (Having an "AIDS-defining" medical condition can also trigger the diagnosis but this is much less commonly used and generally only happens at low CD4 counts, anyways.) There's on-going debate as to whether or not diagnostic criteria for AIDS are medically or socially useful in any meaningful way anymore.

With adequate health care available for HIV+ persons, this becomes less relevant for health outcomes, as modern anti-retroviral drugs can take a person from the brink of death and a single-digit CD4 count back up to where a normal immune system would be in a matter of months. Yet once diagnosed with AIDS, an otherwise healthy person will retain that diagnosis no matter how high their CD4 counts rise.

Without adequate access to anti-retroviral treatments, an AIDS diagnosis is a death sentence and an eventual given in almost all HIV+ persons who remain untreated.

One of the primary reasons people with HIV in the US and other developed nations still progress to AIDS is that not everyone gets tested regularly for STDs. Thus, some may go for years with untreated HIV because they were unaware they had it. In fact, an estimated 1 in 4 people in the US with HIV are unaware that they have the virus.

There are obviously other factors that contribute to HIV progression, such as ease of access to care, adherence to medication, individual choices, economic conditions, cost of care, employment, housing stability, and mental health. I would still wager my entire Science Fiction & Fantasy hardcover collection that the single largest factor in progression to AIDS is people who have never received anti-retroviral treatment for HIV, whether through circumstance or ignorance of their HIV status.

Because this.