Cocktail Hours

The latest AIDS medications give life to the dying--but what kind of life?

Three weeks later, Warner felt feverish and chilled, his head pounding with pain. When his symptoms didn't abate after five days, he went to the doctor, who suggested he might have HIV. Testing later confirmed his suspicions: Warner's viral load was soaring at a million; his T-cell count was down to 150.

While his numbers looked as though he had full-blown AIDS, he was suffering from acute retroviral syndrome (ARS), which occurs when the body goes from negative to positive. Although ARS typically resolves itself after a few weeks, with T-cells rising and viral loads falling, research suggests that if the virus is attacked before it can lodge in the harder-to-reach sanctuary sites, there is a better chance of staying healthier longer. People can live with HIV for an average of 10 years before their immune systems become seriously impaired.

Because Warner carries no health insurance, his doctor enrolled him in a clinical trial that provides him with free medicine for 18 months. He now takes an adherence-friendly cocktail--three tablets once a day--that would make pill-fatigued long-termers such as Neal Shaffer envious. Warner's prognosis is not unlike many of the newly infected. Assuming he adheres strictly to his regimen, doesn't develop drug resistances and the meds he uses aren't later discovered to cause any long-term toxicity, he should live a normal life. "So far, my side effects have been minimal," he says. "I do get really fatigued, and my stomach gets upset if I eat fatty foods, but I can live with that."

Melissa Grove, the executive director of Legacy Counseling Center, the largest provider of HIV counseling services in Dallas, says that "HIV puts a magnifying glass on every other problem you have, bringing out existing issues and adding another layer of stress to them."
Mark Graham
Melissa Grove, the executive director of Legacy Counseling Center, the largest provider of HIV counseling services in Dallas, says that "HIV puts a magnifying glass on every other problem you have, bringing out existing issues and adding another layer of stress to them."
Dr. Louis Sloan, a Dallas HIV specialist, says that approximately 30 percent of patients do not take their cocktails with the discipline that the medications and the disease require. "It will catch up with them," he says. "But you can't convince them that five years from now they might have a problem."
Mark Graham
Dr. Louis Sloan, a Dallas HIV specialist, says that approximately 30 percent of patients do not take their cocktails with the discipline that the medications and the disease require. "It will catch up with them," he says. "But you can't convince them that five years from now they might have a problem."

After the initial shock of his illness subsided, he met with friends at Starbucks and told them about his status. They were furious with Gary, but in true 12-step fashion, Warner took full responsibility for his risky behavior. He even went to dinner with Gary, who acted upset, claiming he just assumed Warner was also positive. Why else would he have put himself in that situation?

Not only did Warner forgive Gary, they also began to date. Warner felt a level of comfort and intimacy that came from their both being positive. There was no fear of the rejection that full disclosure might bring. They spent a lot of time together and grew closer, more trusting. With Gary, Warner felt he didn't have to worry about spreading the virus; there was a certain relief in knowing they were just two positives having unprotected sex.

Then a friend told Warner to log onto a Web site called barebackcity.com. He needed to check out the personals section, which included a posting from Gary. Next to his photograph, Gary wrote a description of himself, saying that he enjoyed bareback sex and was HIV-negative.

"I broke up with him after that," Warner says. "I knew he had infected other people."

The Supermoms

He was a big hulk of a man who played football at the Los Angeles junior college they both attended. She had never been with anyone else, and she thought she would be with him forever. But when Shalonda Henderson (her real name) turned up pregnant, he wanted nothing to do with her, and she decided to have the baby on her own. Six months into the pregnancy, her doctor ran some tests and questioned her about the father, who was African-American, the same as her. Was he an IV drug user? Absolutely not. Could he have been gay or bisexual? She didn't think so. Did she know anyone who had pneumonia? She paused and said yes, the father; he'd been hospitalized with pneumonia a month earlier. The doctor said it was likely the father had HIV and had infected her as well.

Two years later she ran into him--she wanted him to admit what he had done. He only copped to being sick, said his new girlfriend and their baby also had the disease, claimed it was some kind of genetic blood disorder. "What kind of fool did he think I was?" she says. Since then, she has met many women who were infected by men, and "found out later that they were bisexual, which is probably what happened to me."

The problem of male-to-female heterosexual transmission is particularly daunting in the black community, and most notably in the South. People of color--African-Americans and Latinos--continue to fuel the epidemic, accounting for 70 percent of all new infections between July 1999 and June 2000, according to the Centers for Disease Control. The disease is also the leading cause of death for black women between the ages of 25 and 34.

"Let's cut to the chase," says Don Sneed, executive director of Renaissance III, a Dallas AIDS service agency primarily targeting black men. "There's a lot of internalized homophobia, guilt and shame revolving around same-sex behavior in the African-American community. It can be traced to the black church and culture, which treats homosexuality like the greatest sin since blasphemy. It keeps folks in denial, makes people less likely to test or seek treatment until they wind up in the emergency room."

"Men on the down-low," those who do not "self-identify" as gays or bisexuals but who secretly enjoy sex with other men, "comprise the majority of HIV transmissions to African-American women," says Sneed, who is also a member of the Presidential Advisory Council on HIV and AIDS. "Homosexuality and AIDS are still a very uncomfortable conversation in the black community in 2003. We would prefer to talk about women and children with AIDS; it's more pleasant because there's a true victim."

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