The HIV Behind That Smile

My son and one of his friends were watching something on TV when a commercial came on. I was nearby, on the computer and doing my thing when I overheard it all.

The ad was about HIV. The people in it were saying one after another, "I have HIV."

"Man, that's so stupid," Xavier's friend said. "Why would anyone announce on TV they have HIV?"

"Yeah," my son agreed, "but they're probably actors. No one would be that stupid."

I looked up and feigned innocence. "What's so stupid about it?"

I swear to God, this is what his homeboy answered: "None of the shorties would want to get with you."

"Oh, I see," I replied dryly. "If you had HIV and met a girl, you wouldn't tell her."

It was an ah-ha, I gotcha moment. I caught the truth and both of them looked away. Too late; I saw it in their eyes and they knew it.

I glared at my son. "What about you? Is that a secret you'd keep?"

He shrugged, possibly to help his homie save face, or maybe he really feels that way.

"I use condoms most of the time," he said. "You know that 'cause you buy them for me when I'm broke."

"Yeah, I use them too," said his friend.

"Y'all are still trifling," I said, "letting your balls tug on your brains like this. If the girls you mess with think the same way, one day one of y'all might get burned. Won't be pretty."

They looked uncomfortable. Good. I returned to my computer so they could chew on that shit. Notice that I hadn't said jack like "what about the girl if you're infected?"

This is because appeals of compassion are less effective than appeals to self-interest.

This is how, my sistahs and brothas, it gets played out and we get infected, so much so that HIV is the #1 cause of death for young black women, and after homicide, #2 for young black men in America.

Before my non-black readers get too comfortable and feel safe, White America is only around 20 years behind us and always has been, from losing virginity at a younger age, getting married less, teen pregnancies and having out-of-wedlock children, and sinking into working class status. Blacks only get hit with the bad first because we're the test subjects for how far greedy corporations and inadequate social policies will screw us all.

Now, allow me to give you another spin on the HIV situation.

The most powerful appetite is the one for food, and except for children and the elderly, the second strongest is for sex.

A lot of men will laugh and say, nah, I'd skip a meal for sex. Yeah, but if they hadn't eaten in a week, they'd opt for the plate... followed by the sex. Go ahead and chuckle, you know I'm telling the truth.

We are prisoners to our sexual urges, which is why total abstinence for the unmarried is an impossibility for most. It is for this reason that I don't rush to judgment and label people as necessarily selfish by not telling if they have HIV as long as they use condoms, although if they know they have it and don't use them 100% of the time, they are selfish, cruel, and worthy of being placed before a firing squad.

My own son was tested about two years ago and was fine. I know 'cause I dragged his azz to the doctor after he became sick as a dog, couldn't get out of bed and was having nightsweats. Turned out to be mononucleosis. Even though he was relieved, I had to drag him kicking and screaming for a follow up just to make sure.

He didn't want to know. He had been careless a few times between relationships and didn't know those girls well. He was relieved when he passed, and like many people when they test negative, vowed to use protection in the future.

I can't speak for his friend, but I know that Xavier hasn't been 100% consistent in the past. He has a nice girlfriend now and wants to marry her one day. Neither are promiscuous, but for them, condoms are for protecting against pregnancy, not HIV.

It's not hard to understand why. The world is an F'ed up place with so many mind-boggling problems that the ordinary person can't solve. Every time you turn on the news, you see a Chicken Little newscaster screaming about how the sky is falling:

"Terrorism! Iraq! Iran! War! Global warming! Melting ice caps! Floods! Wildfires! Racism! Murder! AIDS! Food shortages! Mortgage meltdowns! Economy dying! End times!"

In our communities, every bad thing there is only a microcosm of the larger world.


Young adults and teens were bottle-fed on bad news and many have become desensitized to it. They're not oblivious to it, but the negative information over-load has become like the sun. You know it's there but you don't look directly at it because it hurts your eyes.

I first read about HIV in 1981. They called it GRID - Gay Related Immune Disorder and didn't even have a test for it until early 1986. There was a small story in the Washington Post about a puzzling new disease that had claimed the lives of a few dozen gay men in New York and L.A. I read it to my best friend at the time, a gay guy who was also my co-worker.

"This doesn't sound good," I said. "Maybe it's a virus. If only the gay guys have it, it could be an STD. You'd better be careful."

"Pffft," he replied dismissively. "It's probably nothing."

That same year, he met a guy while partying in New York City. He fell for him like a ton of bricks and was going there every weekend.

"He's got the greatest smile," he'd tell me. "I'm so in love!"

Then one day at work, he was rubbing his throat. He said, "That's odd. My lymph nodes keep swelling as though I'm sick with a cold or flu, and I keep waiting for the sore throat to happen, but it doesn't."

There was something about that moment and his intensity that was unforgettable. Neither of us suspected he had contracted HIV - hell, it was a back page news story - but he had. He died in early 1986.



I ran into one a mutual friend at his service. I hadn't seen him since high school and didn't realize at the time he was gay. He told me he became 100% abstinent because he, too, suspected AIDS was caused by a sexually transmitted virus. A year later he was dead. So was a nice man who my late friend/co-worker dated after the New York love affair bombed.

By the mid-80's, I was fairly new social worker and not long out of grad school. One of our first agency cases became mine in 1988. A grandmother brought her adult daughter and two young grandkids to my office. The young woman, I'll call her Debbie, was thin and weak. She'd gotten strung out on crack and had sex with the wrong person or people. She kept her head on the table while I worked with her mother to get her approved for Relative Foster Care payments. Every now and then she would look up.

I said, "You look awfully familiar."

"I was thinking the same thing about you," she answered.

We did quick exchange of the schools we attended. Bam! Fifth and sixth grades at Catholic school. I remembered her well. We were so cute in our uniforms. She loved to jump rope. It broke my heart to see her come to this.


A college friend of mine was encountering the same thing. He's a doctor, and his first HIV patient was priest whom he'd known for years.

He later had another patient who was also a friend. This guy was successful and in his 30s and often cheated on his wife. He caught HIV and refused to tell her because he didn't want to deal with her anger over the adultery or her pain if she was infected.

"Can't you tell her?", I asked.

"No, it's client privilege, even in cases like this. It's unbelievable. I guess he'll keep right on fucking her until death do them part."

He also had female patient who tested HIV positive. She messed around even though she lived with her boyfriend. Rather than tell him, she moved.

In 1989, I began working as a therapist and saw a fair number of gay teens. Until the late 90's, we weren't instructed to give them info about HIV, but to focus on family and individual therapy. I did anyway, for the straights and the gay kids, and boy am I glad.

One kid, a 16 year old who had become sexually active, told me a few stories which blew my mind. He had met a 21 year old through this guy's cousin, a girl who was his classmate, at a party. Later, he and the man decided to have sex.

"Something about his dick didn't look right," he said.

"He had sores?", I asked.

"No," he said thoughtfully. "I don't know what it was. Maybe it looked fine, but something didn't feel right. I had one of the condoms you gave me and at the last minute, told him to put it on."

"That's good," I offered, "but you should always do that anyway."

He nodded, still lost in thought. "We had sex. It was just okay. Then afterwards I noticed all these medicine bottles in his bathroom. I called my girl friend later and asked her if he had AIDS. She said yeah. I couldn't believe she didn't tell me this because she knew I was gonna go out with him."

Oh shit, I thought. That's fucking treacherous. With friends like that, you absolutely don't need enemies.

I asked him if he confronted either one about it. He said no, he couldn't. He was too hurt. He wouldn't give me the man's name so I couldn't report him. That's not uncommon.

I ran into him 15 years later at a mall. He was 30, fat, healthy, happy, employed, and driving an SUV. He treated me to lunch and thanked me for saving him. I thanked him for saving himself.

Amen!

On the flip side, I worked with another teen about eight years ago who had an emerging personality disorder. This kid was as narcissistic as they come. The world was all about him. He was also one the brightest kids I ever met and had the IQ to prove it, but extremely damaged from growing up in a household where his mother and uncle were anti-social and dirt poor. His father sounded functional but lived across the country and rarely saw him. He didn't want custody. My teen recalls how he watched gay porn when he was little with his uncle and straight porn with his father as a teen. At 15, he was well on his way to a promiscuous lifestyle.

When I gave him HIV education mixed in with therapy, he was adamant that if he ever got infected, he'd do his best to spread it around. I made sure he always walked out of my office with condoms, which I routinely picked up on my own time from the Health Department.

One day he walked into my office and gave me a story that made me wonder why some people try to pass for human. He was at the train station, which has theaters and a bangin' eatery. A handsome, young adult male around 20 years old gave him a great smile and patted the seat next to him. He didn't waste any time.

"Wanna fuck?"

"Yeah, okay," my client answered.

He'd never done anonymous sex and the prospect of it turned him on. He was game for anything and thought this guy was hot. They went to the mens room and into a stall.

"Pull your pants down and turn around," the guy said.

He did, and at the last minute, the kid says, "Um, do you have a condom?"

The man sounded irritated when he said yes. He put it on, and performed anal sex on him.

"Did you have a condom with you, in case he didn't?", I asked.

"Uh-huh," he replied.

"Why do you think he sounded annoyed when you asked if he had one?"

"I don't know."

"Use your imagination."

"He doesn't like the way they feel?"

"You said he was grown. Don't you think that by now he knows that anal sex is the #1 one way HIV is caught, or transmitted, or was he a retard?"

"I don't fuck retards," he said indignantly.

"So what else might motivate a grown man to have unprotected sex with a teenager in public restroom five minutes after meeting him?"

He sat quietly. I let the silence build. His face turned stormy.

My narcissistic 15 year old client almost yelled, "No one would dare to that to me!"

"Because you're dazzlingly beautiful, brilliant, and hot, right?"

"Yes!"

"Bet he thought like you, too, when he was 15," I snapped. "I'll be blunt. I think you had an encounter with the kind of person you could become one day - infected, vengeful, and dangerous. What are you gonna do to be different?"

He was so pissed that he walked out of my office.

He kept his appointment next week and every week like clockwork for many months. His mother, by the way, refused to come to therapy. I watched him yo-yo back and forth in our sessions. One week he said he'd infect the world, the following week he'd cry and ask how others could be so cruel. He finally got tested and was negative. He was overjoyed. After that he wrote a paper on HIV and gave an oral presentation to his class.

"Nice way of protecting your classmates," I said.

He waved off the compliment. "Oh, it was nothing."

But it was.

I don't know how his life turned out. He always carried condoms, but his prognosis is what mental health professionals call guarded. He had a lot of baggage: moodiness, narcissism, entitlement, sexual addiction, drama addiction, and a tendency toward emotional sadism learned from his family.

At least he learned that HIV could be hiding behind that smile.

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Today is National HIV Testing Day. Information and a list of free testing sites are at hivtest.org.