Alex: “You are still worthy of love, you still deserve love and you are still loved”

Alex can you tell our readers a little bit about yourself and what you’re up to right now? Where are you based? What is it that you do?

I live in Sheffield at the moment, I’m a medical microbiologist. I’m a PhD student at the university of Sheffield.

That’s great, I believe you’ve just got yourself a distinction in your masters too which is phenomenal! How did you celebrate?

I did. I studied medical microbiology at the university of Manchester! I have had a friend visiting for the weekend, so I’ve basically just been drinking a lot. I went to see the new Harry Potter movie and I am going on a date tonight. Basically lots of not checking my bank balance for a few days.

That’s good to hear, it’s not everyday you get a distinction in your masters so we’d happily condone you splashing out! We’re speaking with you today because we’d like to get an opinion on HIV stigma from somebody with a medical background. Would you mind if we ask what your status is?

Of course! I’m HIV negative, I was last tested at the end of October using a home kit. I think they’re great. Absolutely, fire away!

I remember seeing you post a link out on social media for these self testing kits and I ordered one myself! They’re great and very easy to use, ideal for somebody like myself who has a severe phobia of needles. I’d like to ask what is your overall opinion on what HIV is today in comparison to what is was 30 years ago in terms of treatment?

I think it’s important to address that question in two ways, first of all. Obviously our understanding of HIV/AIDS has changed dramatically in the past 30 years and so have our attitudes.

I think that in order to have successful treatment then we need successful education, so in that respect I think things are coming along brilliantly. Unfortunately with regards to the more binary and scientific vein of though regarding ART and vaccine candidates etc. we have come up against the same old obstacle that we always do with viral infections. They are very tricky to treat, and prevention is the best chance we have. HIV is a very tricky virus and it was very poignant and sad in a way seeing Françoise Barré-Sinoussi one of the co-discovers of HIV retire last year without having seen a cure.

Drug resistance is also becoming a problem as it inevitably always will when treating infectious diseases. Losing antibiotics, drugs that we use to treat bacterial infections would be a huge blow to how we treat and manage HIV/AIDS patients.

We are better than we have ever been in diagnostics and therapeutics but reaching those that are most in need and educating those whom are most in need remains a huge problem. Tackling stigma even in resource rich settings like in the UK is also a big barrier and that is reflected in the published statistics on HIV, which is why I think your work is so important.

So the race is on really to prevent better, treat better and educate better and keep funding research!

Incredible answer! You’ve actually already answered what my next question would have been as it would have been based around stigma. Staying on stigma, what are your thoughts on those that face unnecessary rejection in the dating world?

I think that the stigma is spectral, across society but I think rejecting and vilifying people because of their status is a tremendously ignorant betrayal first and foremost. If someone feels like they are going to be made into pariahs then they are less likely to get tested, they are therefore more likely to unwittingly infect others. They are also not going to be able to get access to treatment which really has transformed HIV very much from an invariably fatal cassette of syndromes to something that people can live with and lead perfectly normal lives. I find it very difficult to think outside of that philosophy, including in the realms of dating.

I am completely open minded and open hearted and I think as a gay man, in the LGBT community adjusting our attitudes just personally can have far reaching positive consequences for HIV/AIDS globally. “It starts with me” is so profound, it really does start with you and we are much more powerful than we imagine against HIV/AIDS. It’s not just stuffy scientists working in labs issuing the occasional press release. It’s something we can all tackle together. I’m very conscious of that privilege though as a white cis sexual gay male. It’s really not that simple for the majority of people that struggle with HIV/AIDS, knowingly or unknowingly.

It’s interesting you just mentioned the LGBT community. Many just simply assume that many of us are already educated, would you think that’s a fair statement to make?

No, not at all. There’s no room for complacency. I think it would actually be more accurate to say that if anything as a community we are becoming more complacent. I might even go as far as to say that we think we know more than we actually do. I think we’ve all been in a situation whereby we or a friend has had high risk sex and is trying to weigh up how likely they are to have caught a sexually transmitted disease or infection. Drugs and alcohol also play a big part, I think. It’s well known that they increase the propensity of an individual to engage in high risk sexual behaviour. I’m a huge advocate for PrEP but a knock on effect of PrEP and even PEP to an extent is that people throw caution to the wind because they think they’re protected against HIV and not much else matters. Like I already said, it’s a complicated social issue that touches on so many different sociological and scientific areas. HIV/AIDS isn’t in its own vacuum. It’s very much linked to social and behavioural patterns, as I’m sure you know.

We are educated, and I think more so than people outside of the LGBT community but a lot of people tend to just think that they know all there is to know and put it to the back of their minds. It should always be in the front of our minds and we should always keep our fingers on the pulse staying abreast of new information and data as it comes out.

I’ve noticed that in the LGBT community recreational drug use is becoming more serious, especially with ‘slamming’ which can also increase your chances of contracting HIV and Hep C through sharing needles. What are your thoughts on this?

It’s quite shocking really. Off of the top of my head I couldn’t tell you about the prevalence of HCV in the LGBT community but other sexually transmitted diseases and infections are increasing as a result of drug use and high risk sexual behaviour. There are a number of ongoing syphilis outbreaks in the UK at the moment, the epidemiology of lymphogranuloma venereum (an infection caused by certain serotypes of Chlamydia trachomatis) is changing, sexually transmitted shigellosis, multidrug resistat gonorrhoea… They are all on the increase and I think chemsex definitely plays a role in that.

Some of my best friends use hard drugs and I’m totally comfortable with it. It’s your body, it’s your life, as long as it stays that way and doesn’t harm anyone else then I’m a bit of a crazy liberal in that sense. We all have our vices. Yes, it’s a very clever little customer. Gonorrhoea is a bacterial infection caused by Neisseria gonorrhoeae and we are kind of down to our last few antibiotics to treat it, ceftriaxone and azithromycin. The problem is that now we are losing the efficacy of those two precious drugs and there are already circulating strains that we don’t have any real treatment options for. Gonorrhoea is usually limited to urogenital disease, but it can also spread from those sites and cause more widespread systemic infections like septic arthritis, meningitis and osteomyelitis. We’re very used to being able to treat these infections, but now that we are losing that ability, the more serious complications are making a bit of a comeback.

It’s sounds pretty scary! I asked a sexual health advisor in my local clinic about this last month and she re-iterated the same information. I’d like to ask if you have any advice to give to those are who are newly diagnosed with HIV. Many newly diagnosed HIV+ people, particularly LGBT youth are afraid that they will be defined by their new medical condition. Do you have any reassuring words for them?

Some of the most inspiring and empowering words that I have heard have come from the veterans of the LGBT community. Survivors of the emergence of HIV/AIDS and those who have lost their friends, their families and their communities. The fundamental running theme is love. You are still worthy of love, you still deserve love and you are still loved. You do not have to be defined by HIV/AIDS, or you may wish to use your new diagnosis as a platform to help others as so many have done in the past. There is such a lot of support out there, both professional and more casual.

We are an incredible resilient community, we are strong and although at times I believe we falter, we are powerful and we are a family. That runs deep and I believe that. You’re not alone. Reach out, speak out and remember that irrespective of your social circumstance or how you came to be HIV positive, you can expect to live a fulfilling and happy life. Don’t let your status form the basis for self abuse, don’t let others abuse you because of your status. Have hope, give yourself time and live your life.

Beautiful words! Thank you so much for taking the time to speak with us and most importantly thank you for contributing to an everlasting fight against HIV stigma, is there anything else you would like to say?

I would like to wish everyone a mindful and healing trans day of remembrance and to take a few minutes to think about the trans people that lost their lives this year. Stay safe and look out for one another. Thank you for speaking with me!

Want to take part in our #STIGMAWARRIOR campaign? Have your say on HIV stigma and get in touch: stigmawarrior@destigmatizehiv.com