On A POZitive Note : "Undetectable" - The New Catch Phrase

Is it worth it to live on HIV meds even when you’re healthy without them?

To pill-pop or not to pill-pop, that is the question. Whether tis nobler in the mind to suffer the nightmarish dreams that come with a once-a-day dose of ATRIPLA, or take arms against the constant fear that your T-cells aren’t high enough to combat Swine Flu?

One friend told me, “I started on meds as soon as I found out I was HIV positive. Now I’m living with the virus undetectable in my body.”

“But what are the side effects of taking the medications” I asked.

“None really” he replied, “just one pill a day and some really wild dreams for the first few weeks while the virus is being killed in your body.”

It sounded too easy, like early silicone implants which leaked causing cancer in some patients, or all the new sugar substitutes we’re now using that might do the same. How do we know there aren’t long-term effects of putting ANYTHING synthetic in our bodies?

My doctor at Callen-Lorde told me, “Since you are newly diagnosed and your blood work results look good, I’d wait a while to start on treatment and see how the virus settles in your body. The more you know about how you react naturally to HIV, the better.”

“I stayed off the meds for ten years,” said another friend “until I got full blown AIDS, and now I’m on for life. The toll on my body might have been worse if I’d taken the amount of AZT the doctors prescribed for me when I was first diagnosed in the early 90’s. That stuff was poison back then, but it was all we had. Waiting until I was sick probably saved my life.”

“I had a treatment regimen for several years” said a date of mine, “Then I slowly weaned myself off. You don’t have to keep taking meds if your body can keep the virus under control by itself.”

"There are so many opinions" I said to my date, "Just last week someone else told me, 'Once you start on the meds, you can't ever stop.' So who do I believe?"

“There was a time the prevailing mindset in the medical community was to start everyone on treatment as early as possible,” said Tim Horn, Editor-in-Chief of AIDSmeds.com, “Then we saw problems with side effects, adherence and drug resistance with older meds, resulting in recommendations to delay treatment for as long as possible. Now, given that newer meds are easier to take and less toxic, we’re moving back toward early treatment. Plus we’re discovering more about the long-term effects of HIV on other parts of our bodies in people who aren’t on treatment, even with high T-cell counts, so the focus is now on preventive care.”

As alluring as the new catch phrase “undetectable” is, I’m still having trouble with the idea of taking drugs everyday if I don’t have to. Would it make me feel more secure knowing the virus is completely under control, or less secure wondering if the drugs are going to damage my liver and kidneys? It almost feels like I’m giving my personal power away to a drug company.

One man in my discussion group told me, “Oh you’ll want to get on meds immediately.”

“Well, I’m still trying to figure it all out” I said.

“You young guys are foolish. I’m 56. I watched all my friends die. The ones who took the drugs lived longer like me, the ones who waited are all dead.”

“Well thanks for the words of comfort” I wanted to say, but settled on “I’ll ask my doctor about it again in a couple months after my next blood tests.”

I know I’m new at this, having only been diagnosed POZ in January, but I’ve tried to avoid most medications - especially Penicillin - my entire adult life. Now I’m faced with the choice of self-medicating merely to get my viral load below 50 (instead at 29 thousand which it was last week) and my t-cells to 7 or 8 hundred, instead of 500 - which some say is the borderline of when you should start treatment.

As long as I’m getting flooded by suggestions, what do you think I should do?

(Photo: Getty Images)

[Editor's note: Any information provided by readers should not be used for diagnosing or treating health problems or diseases. It is not a substitute for professional care. If you have or suspect you may have health problems, please consult your health care provider.]

Comments

[Jim]

If your seeing a guy who's poz. and you take precautions, and they tell you they're undetectable, but they're afraid of infecting you, what's the best thing to do?

[Steve]

I stayed off drugs for 5 years and had a CD4 count of 560 but I started catching things that people in full blown AIDS catch, like fungus on the eyelids, back, and arm, thrush and walking pneumonia. Took me by total surprise. If you do decide to stay off the medications make sure you know what to look for as warning signs that you may need them, other than the CD4 count.

[michael]

I have been positive since '96. I tried different drugs for the last 8 years, going on and off because of the side effects. My cd4 count got down to 6 and although never sick, I decided to start and I am on Atripla, and it is a God send. I have not suffered one side affect and I am undetectable after my viral load being off the charts. And my cd4 count is now 550. I had 1700 in '96 when I was diagnosed. If you get tested without fail, every 6 months, and you do come up positive, begin meds right away, the side affects are so minimal these days and if you do it right away, there may not be a need for you to be on meds for life.

[david]

I was diagnosed poz in 1989. My doctor and I did the treatments discussion, and strangely for that time, decided to stay away. I remained healthy and with CD4 counts above 600 until December 2008. Nineteen and a half years! My CD4 nosedived to 53, and my viral load around 200,000. Onto to current meds and 5 months later, my CD4 is 500 and viral load undetectable. That 19.5 years was the best decision I ever made.

[Infatuation junkie]

The noblest thing would have been to avoid infection of others and of self. "An ounce of prevention is worth a pound of cure."
I understand this is an article about "what now?" but given the gay.com audience, a reality check is in order.

Granted "stupidity happens" (especially in the heat of the moment), but a total lack of consciousness about prevention and personal responsibility promotes a destructive mindset in my community.

GAWD, I hate this virus, and how it co-mingles with gay selfish and self-destructive behaviors (which themselves are promoted by being men and growing up gay in a gay-bashing society)

Now that you are POZ, good luck with that. Once it happens, I can understand a need to "embrace" it, but I do wish members of "my community" were less cavalier about getting infected and infecting others.

I'd offer my sympathies, but I feel like I'm more sorry about your infection than you are. Sincerely, good luck with your life long treatments.

[Ha!]

So far I'm reading the total opposite to whats true. Early detection early treatment prevents full blown aids. If you people want to die go ahead and listen to the morons on here.

[Arthur Graves]

Maybe if your healthly you should start on low dose HIV meds. That way the can see how they'll effect you. So when you start to loss T's cell they can have a better game plan for you.

[Ha!]

Been poz and undetectable for 15 years. I've been on meds since the early 90's. I can have children and live a normal life. My CD4 count was last 1450. Above normal. Take your vitamins take care of yourself and you wont have to worry. If you go on and off meds like a childish baby the chances of the virus mutating is high. Get on one medication and stick with it unless you find its not working. The government release a gag order trying to get people on Drug Holidays well all those people are dead today. You have to do the research and not believe everything the doctors says. All they do is trial and error. 9 times out 10 you get some quack that doesn't know what he's talking about. Thats when you tell him you want to talk to the REAL doctor and watch how his story changes. These dumbasses just memorize a dialog because they don't speak english. These damn dot heads think they can handle medicine they way the stold our computer jobs from us. Just do your research and don't listen to ever dumb dot head practicing medicine. The last dot head I spoke to gave me 6 months to live. I'm here 15 years later.

[zig]

The trend these days is towards starting meds earlier. This is largely due to the fact that the meds have gotten a lot better and we have more and more research that shows potential benefit from the standpoint of both AIDS and non AIDS related illnesses. We really have come such a long way from the days of 12 norvir per day. Atripla is certainly more well tolerated.

Between 2006 and 2008 the guidelines were revised so that the new recommendation was to start meds at a CD4 greater than 350 (formerly 200). This was based on observational data that suggested that people who started medications at a lower CD4 count did worse. More recently, the New England Journal of Medicine published an article that suggested that there was even benefit if you started your medications at a CD4 count greater than 500. You have to keep in mind that the research is not perfect. You also have to keep in mind that everyone has got a different immune system as well. At the same time, we don't know all of the long term side effects and these may come to light in the upcoming years.

I'm of the mind that starting early is not a bad thing. The most important thing is that you have to be ready mentally and prepare for it to become a small but significant part of your life. You will have to take the medication every day otherwise you could get resistance. You should know what to expect in terms of side effects and you may or may not have any number of them.

At a CD4 count of 700-800, you certainly have time to make an informed and educated decision. So collect your information, I think you will be just fine.

[Ha!]

This comment is by a dumbass that has no clue and is going to die because he wants the virus to mutate into a super strain. The medications are just a form of birth control for the disease. You allow the virus to breed its going to mutate. Chances are this guy still has unprotected sex and wont admit if even if he was at gun point. Do youself a favor take your meds as soon as possible find a regimine you can handle and stick with it for the rest of your life. This is not a cure its just a way the drug companies can profit off of your suffering but you will still be alive. Take it from someone thats been on meds for 15 years and yes I hated the side effects. You see me today and you wont even know that I was infected. I hope I save your life because I don't see these idiots giving you any answers
************************************
Take your B Vitamins (Time Released formula) and a mulitvitamin with antioxidents and minerals Folic acid
CO Q10 (CoEnzyme Q10)and your HIV meds. Eat Healthy and stick with it don't miss a dose and you will never get sick.
************************************
“I had a treatment regimen for several years” said a date of mine, “Then I slowly weaned myself off. You don’t have to keep taking meds if your body can keep the virus under control by itself.”

[brontomancer]

For those that were exposed to HIV before the times of VERY precise education and standards of "safer sex" practices or afterwards due to TOTAL ignorance, I wish you all the best and hope you can contend with this very difficult question. For those that disregarded totally available information or threw caution to the win and are now contending with this nightmare...I sure hate it for you.

[K]

I noticed you got rid of the comment about the 56 year old being an old geezer or something to that effect.

[Joel]

It was 1993 when I sero-converted. I knew I had done something I shouldn't have and I tested several times that year until the test that showed I was "reactive". My Cd4 count then was 1556. I was told then that I had to take care of myself AND I was told by a doctor that I had to guard against REinfection. In 1998 I started on the meds because although I had a Cd4 count of 1100, my viral load was 300,000. I stayed on the meds for 4 years solid until it was suggested by new doctor that I go on a "drug holiday". I was scared to death to do it, but my Cd4 count was 1400 and I was told it might be worth the risk...fast forward to today:Going off the meds was the best thing I ever did. But only because I had a high Cd4 count. Too many people went off the meds when they shouldn't have. 5 years later my Cd4 count is 983. My viral load is high at times and I take the meds for a month or so until the virus gets down to nothing again and I have gone off of them. Maybe that isn't a good idea but I have been doing it for 5 years now and the trizivir has continued to work when I take it. I still get my blood work done every 3 months. If my Cd4 counts were diving it would be a different story...
I still guard against reinfection and I am always disturbed as to how so many Hiv-ers think they can practice unbridled, unsafe sex as long as they are doing it with another Hiv infected person. I am seeing many newly infected people with Cd4 counts lower than 500...the proof is in the pudding...
This is the 16th year for me now...I am healthy as any man has a right to be. I know at some point I will have to return to the meds, but I plan to wait until I am down to at least 600 Cd4 before I make any decisions...

[Raggedy Trans-Am Faggy]

i have had friends pop up as positive all around me almost every single day. i stopped making friends because of it, but realized how wrong i was to do such.

they allow themselves to get into these positions because of their baser sexual instinct which is pretty much going without the rubber or latex.

i think all that guys want is a load of white dick foam in their hole like they just got pregnant. plus all those gang-bang orgies you hear about very rarely that you wish you were a part of, involving 12 black guys and a token british guy for the sexual humor, among 4 other white guys or something like that.

realistically, there is no sense in holding back the information these people need which is to practice safer sex without thinking. if they knew a friend who popped up positive one day, that is usually enough to scare them probably into thinking they have it and to practice safer sex.

one day, there will be a cure, but until then, maybe this goddamn network should start promoting it more!

[david]

The one thing I get from here is that still isn't a right answer. Current wisdom is to get on drugs early, but the wisdom changes.

Discussion also isn't helped by people like Ha! who insist we do our research, and then say if we don't immediately go on meds they we're morons and going to die.

I don't think so!!

[Roman]

So, after reading all of the comments on here, and obviously people having MANY opinions on what you should or should not do, my response is to wait and see what happens in the next year. Some men are long-term non-progressors, and they don't need to meds for a LONG time. Some men are in need of immediate treatment to keep themselves healthy. I know friends on both sides of the spectrum, and the only thing that remains consistent is their trust in their HIV internalist. Know your doctor, trust your doctor, and make sure that your doctor knows your lifestyle (your real one, not the one you post online). I believe that the longer you can go without the meds, the better (and you would seem to agree with that, based on your article). For people to talk about their personal experiences as a basis of decision is ironic, as they are the only source of how their affect has been with them. None of us are doctors, and some doctors aren't worth a damn. Know as much as you can about your circumstance, and then take the best approach you are comfortable with. I hope that my little insight is helpful, but that you still find your own answers that are best for you. All the best to you, as I hope that you will still be here for another commentary in 2050.

[Joel]

post to Jim: Even though your poz partner is considered "undectable" that still does not mean you couldn't be infected with the virus if you are the recipient of his poz load of cum. "undectable" means it is not detected by the current methods available. If you think you are "safe" because he is on the meds then you should think again...if your partner is afraid of infecting you then you better heed what he says. If you sero-convert you won't like it very much and you will "blame" your poz partner. He will feel terrible for you. If you think you will both become lovers forever and ever since you are both poz now, you are also living in lala land...it usually doesn't happen. I have many Hiv-ers who are just as incapable of having a relationship as they were BEFORE they became infected...

[omg]

o

m

g

I dont want hiv/aids

[matt]

I'm on Atripla and have had no side effects at all. It's like taking aspirin once a day, really. The results were fantastic in just a few months. And with the progress they make I would imagine we will soon see a once-a-week pill coming soon. I'd definitely go for it sooner than later.

[POZboy]

The reality is, get an HIV doctor, and LISTEN TO HIM. Do not go off other peoples experiences, nor take the advise of untrained uneducated people. Everybody has a different experience with HIV. Some people naturally maintain low viral loads without meds, some people do not. Everyone is an individual, and their systems react differently to HIV. The same goes for everyone reacting differently to the meds. One thing is true of everyone, you will benefit from a healthy lifestyle.

[POZboy]

oh, and the commentator needs to delete all the postings by Ha! This guy is obviously a RACIST MORON! Dot heads? Really? I think Ha! suffers from neuro AIDS, and has lost his fracking marbles!

[Aaron Zolen]

Anybody reading or commenting on this article should also visit:

http://www.aliveandwell.org
http://www.rethinkingaids.com/
http://www.healaids.com/

Important information!

[Michael Z]

There is also some interesting research being done internationaly with Monolaurin (a short chain fatty acid that comes from coconuts) they are having some success using it as a medication. The theory behind it is that it disolves the protective viral envelope protecting it from the immune system. The research is being done by a Dr. Dayrit (I believe) from the University of the Philippines.

[J B]

Wow I wasn't even familiar with the concept of "undetectable" HIV. Makes me wonder how many people are walking around with small enough amounts of HIV to keep testing negative...

[Tri racer guy]

Here is a resource. Becon Clinic in Boulder Co is a great place to ask questions and recieve treatment. Bcap (Boulder County Aids Project is also amazing.) If your looking to donate money, Bcap is a great place to write a check to.

[Pat]

I been poz for 25 years, didn't start any meds until 2001, when I was diagnosed with AIDS. Only then did I began talking various combos, each having their special signature side effect, which I still deal with daily.

Those comments about undetectable sends the wrong message. Sure most ID docs say undetectable any viral load under 50, because the ultra sensitive test cost $5K vs the <50 cost $2000.

Atripla is not for everyone, as the drug works well with certain mutations and not others. I know three guys that participated in the Atripla drug trials, two of them died because of kidney failure, so this drug is not all that is being advertised, besides, Donald Rumsfeld owns the patents to Atripla.

Once you start drug therapy, stopping is very foolish, as the virus will develop a resistances quick.

People will do whatever they want, I take my meds like clockwork because I choose to live.

I look at CD4 counts more as how I feel versus the number, which presently I am at 327, only because of a recent bout with PCP which caused them to drop from 404, the highest since 01.

Take your meds and listen to your doctor, they are trained in HIV/AIDS and not us.

[Tom]

For God's sake get on the med's now - they're safer than ever. And things are only going to improve. The new med's are going to be better, but get on the current ones now. They're safe enough - and considering you're risk... you don't want to wait for AIDS symptoms!

[Scott]

I feel for the fellas that have HIV. It's a sad choice to have unprotected sex. I've had it with fellas before that didn't tell me they were positive, but so far I have remained negative.
I have lost good, fun friends to the virus, I wish they were still with me today.
When I log onto gay.com at night and chat with guys that want to get into my pants, I wonder, Is this guy lying to me too?
I think we should practice universal precautions, condoms, safer sex, better judgment, and in the end, HIV meds and side effects will not be the primary topic of discussion.
I am a typical gay man with a strong sexual desire, I do not wish to be a causality because of it.

[david]

Please do not confuse undetectable viral loads with not being able to tell you're HIV+ The antibody test will still show you as poz with an undetectable load.

They are two very different things. Also, don't believe that if you have an undetectable viral load that you can't infect someone. You definitely can, and it's been the subject of several legal cases. In a recent one, a man who had been undetectable for several years infected someone, and attempted to use the defence that he believed that with an undetectable viral load, he couldn't infect someone. That defence was rejected.

Everybody's case is different. Don't accept the generic approach. I agree with the 'speak to your internest' but make sure that he has a broad range of experience as well, otherwise he'll only look at the common wisdom. Your case is special - everyone's is. Take everything into account, and three things you must do -

1. Make a decision that is comfortable for you
2. Understand the consequences of that decision.
3. Monitor, monitor, monitor. Your health, the latest information and your internests advice.

Live long and prosper.

[PozWest]

Definitely find a Dr that specializes in HIV, although it was very strange for me as they monitored me for a year, as my viral count went up and up, and then my CD4 count went down and finally hit that new, accepted, magic number to start me on meds. I was never ill from anything in the meantime, but it felt like a game with my health, while it was actually the AIDS Medical Community that decided this new number was a good indicator. I started Atripla and my viral count went from 100,000 to "undetectable" (or under 50) in only 1 month and have remained there. My CD4 counts have not really improved much over a year, but I have been reassured that sometimes it can take 3-5 years before they build back up. Still have very vivid dreams at times, but nothing has ever been nightmarish, and I have always had bizarre dreams.

I think all in all, like many have said, everyone is different and you need to find a doctor you can trust that know his stuff who will monitor you - on or off meds. Mine happens to teach the subject at a med school, so I know he is up on all the latest.

Hope this helps.

[Ben]

There are so many viewpoints on HIV/AIDS and when to start treatment. It affects everyone differently. I don't believe there is a right or wrong answer.
Find an HIV specialist that you can trust and feel comfortable with. Make sure he knows what he is talking about and has a lot of experience. Discuss everything with him and also do your own research. Then make the decisions that are right for YOU. Discuss your lifestyle and daily routine with your doctor and start treatment when you are ready. Even the medication affects people differently. Know the side effects of the medication and find what works best for you. The viewpoints of even the professionals change as they learn more about the disease. Obviously there are people alive today that started treatment early and those that waited. Some are in better health than others. They are all posting comments and expressing their viewpoints. It's their individual experience with HIV, their knowledge and how it affected them. Do what feels right for you. Take good care of yourself, and eat a healthy diet. I wish everyone the very best!!!!!

[Ignorance]

Wow I wasn't even familiar with the concept of "undetectable" HIV. Makes me wonder how many people are walking around with small enough amounts of HIV to keep testing negative...

Posted by: J B | May 10, 2009 at 04:14 PM

************************************
I have been saying this for years and years now. Until your body decides to show antibodies you may never show poz on any HIV test it don't matter how sensitive it is. The other issue is that people are infected have the symptoms but don't have enough virus in their body for the Doctor to start treatment. My friend went on like this for 5 years and now he is full blown. The doctors wouldn't treat him because he didn't have enough infection in his body and they follow government protcols. I keep telling everyon I'm clost to that everyone has it. Whether your body decides to show poz is going to determine when you are going to be able to recieve treatment. Doctors wont treat you if you don't have enough infection and by then its too late. I'm very supportive to my best friend that went for years knowing he was poz but was unable to get treatment because he didn't have enough virus to develop antibodies so the doctors would constantly ignore him and make him think it was all in his head. He is full blown now. I know he always practiced safe sex. It wasn't until he met his monster X that he started getting these symptoms and not he's full blown. The only thing I can do for him is be there when he needs love and attention.

[Scott]

I was diagnosed on february 23rd of this year, a week later I was in with a specialist to have my labs drawn. I spoke with my doctor a month later after she had gotten all of the results back. My CD 4 count at that point was 475 and my viral load was 9,500.

My doctor gave me all of the current recommendations on when to start meds and advised me of what new studies are showing. She told me that the newer studies are showing that starting when your CD 4 count is in the 450 to 500 range that patients have a better outcome.

My doctor asked me what I thought about starting meds. Knowing how I am, I wanted to go ahead and start meds while I was still scared. I explained that I thought I would have better adherence and take it more seriously if I started them while I was still not used to the idea of being positive.

My doctor said she wanted to wait a month and re-draw my labs before we started meds. I went back a month later, and my CD 4 had dropped to 350 and my viral load tripled to 35,000.

I have started meds now, Truvada and Isentress, and am hoping that these meds will bring my CD 4 count back up as well as help me feel better. In the last my month it feels like my body has been succumbing to the virus. I have had no energy, minor wounds have taken excessively long to heal, and I have had problems with wounds getting infected.

So I guess what I am saying is, if you are not ready to start meds, feel good, and are comfortable with your numbers, don't start meds. Follow your gut instincts and educate yourself.

What it comes down to is, you know what is best for you.

[Jim]

I am not sure I believe the last post that a person can naturally remain with no detectable anti-bodies but still get full blown Aids? That would mean you go for a HIV test and you're negative, then the next day you've got full blown Aids. No, nonsense.

Once someone is told they're negative why on earth would they want to enroll in the anti-virals? You assume you're negative, And why would any doctor proscribe these pils. Sorry but you're barmy.

[Jared]

I was Diagnosed with HTLV III (HIV) in 1982, I made a decesion to wait until my T-Cells were 200 before I started meds. I believe had I started the high dose AZT regimens that were being prescribed at the time, I would be dead now. When to start the medications in a personal choice you must make for yourself. My kidneys and liver are fine after all these years and God willing will stay that way. If pressed for advice I say start the medications and monitor your labs and live a healthy and safe lifestyle. Wish you all the luck on your descision.

[jeff]

oh man I just feel so sorry for the guys out there that have been infected. Life must be horrible. But let it be a lesson to the negative guys...practice safe sex and you will lead a long healthy life.
:)

[Billy]

You have to love the fact that almost everyone has said to you educate yourself. We're taking it for granted that the writer of the article can read and has comprehension skills! I was infected in the early 90's, and by the mid-90's I had PCP. I spent a week in the hospital and have been on HIV meds every since. At the time I had 6 CD4's and a viral load too high to count. My last blood work showed me with a 550 CD4 and undectable viral load. It took over 10 years to get my levels to a "decent" level.

My questions are, Why in 2009, are there still people getting infected! Why has there not been more education on this! Why do these people still think their frickin Superman and won't get infected! Screw this idea of people thinking "Oh there's a cocktail out there where I can live a normal life." It's a bunch of crap, and these newly infected people and bug chasers don't realize the other consequences!! My health insurance just changed, it went from only being $230 a month to $550!!! So much for this gay man's "disposable" income.

If you're serious about writing another article, why not write it about the cost of being infected. Not just from a finanical stand point, but from a social stand point as well! Try living in a small town, and trying to date someone, when you are "suppose" to tell your partner you're positive. It's not easy, it's frustrating, and then I have to become a teacher and try to educate some negitive potential partners. Education is the key and Obama & the CDC need to put a greater effort into it!!

[Vicomet]

If you are treated at Collen-Lorde - Just listen to your Dr. Every person is different and those here who tell you, based on their experience, do this or that, are fools!

I was diagnosed Feb 24th of this year
since I had 3 blood test - the CD4 count was - 712/682/722 and viral load 454/452/256. Considering my acute was probably at the end of Jan, those were the times that I was to be most infectious. My Dr. at the clinic is strongly against someone like me getting on Med's and suggest i keep follow on my blood results.

And to all those know it all - a swiss study has proven that undetectable was not infectious and it was accepted at court.

[Frédéric]

Hi there,
I think deciding whether to take or not medication is not only a matter of us.
As naive pacient, being diagnosed feb 09, i've been educated by my health care professional that our goals nowadays are take the Viral load to undetectable and remain it like that, and increase the T-cell number if it's necessary.
I decided not only start treatment because of me, i also did it because of the fact that i'm a 22 years old guy who will continue having partners (positive or even negative) and the fact of remaining undetectable would be a plus combined to protected sexual intercourse in case something fails. As everyone knows to infect somebody it's necessary a certain level of viral load, therefore the higher your viral load is the riskier sexual intercourse becomes.
There was another article on this website about what would i do to stop HIV/AIDS. In my opinion there are still lot of guys who don't know they are positive and they don't take the corresponding careful beliving they are healthy, i don't blame them at all. From my experience i ve always had protected anal sex being the top guy but i have to admit i ve never had protected oral sex, finally i was moving to a different country and before leaving i test myself because i wanted to be sure everything was ok. The exam's results came back positive.
Firstly we have to stop scaring people because if we keep on doing it nobody will be brave enough to get tested and once each one of who tested positive know their status they should assume their responsability in front of their mates and keep enjoying life.
My greetings from Paris. Ciao!