TAKING THE TEST : Positives, Negatives of Verifying Exposure to AIDS: One Man’s Story

“Has it kept me awake at night? You bet it has,” Brian says as he nervously runs his fingers through his hair. “And there are times when I have nightmares. The worst thing is, you get a sore throat and you just gasp.”

He laughs wryly.

“I mean, we have a life to live and there are other things that keep me occupied. But you look for white spots. You think, ‘Am I losing all my hair?’ So let’s just find out and get it over with.”

After two years of doubts and two months of nightmares, Brian (not his real name) has decided to put an end to his worries--or maybe just trade them for some new ones. He has decided to take the AIDS test.

“Really,” he says, “I think the reason I’m doing it is to just know. I’m tired of just not knowing.”

Like many who have been sexually active with a number of partners, Brian worries that he might have been exposed to the human immuno-deficiency virus (HIV), which causes AIDS. With cases of the fatal disease climbing nationwide, his fear of the unknown has finally become overpowering.

But Brian also realizes that the test--which detects antibodies to HIV in a person’s blood--will raise a whole new set of complications.

For one thing, a negative test result offers no certainty that a person is free of the virus. According to the U.S. Centers of Disease Control in Atlanta, antibodies can take three to 14 weeks and sometimes longer to show up after exposure to HIV. And each new sexual contact after the test carries a new risk of exposure.

On the other hand, testing positive doesn’t necessarily mean that a person will develop AIDS. Although long-term projections vary widely, the CDC estimates that 20% to 30% of the 1 million to 1.5 million Americans thought to be infected with the virus will develop symptoms of AIDS within five years. But researchers are unable to predict what will happen over longer periods and are uncertain just what an infected person can do to avoid developing the disease.

Even if no symptoms surface, the consequences of testing positive can be traumatic. Many live in fear that their jobs and health benefits will be jeopardized if employers or insurers find out. A positive test result can break up a relationship, particularly if the other partner tests negative. Fear of the unknown often is replaced by terror of the known.

But for Brian, those are nagging but distant worries. For the moment, he is focused simply on the test results. Will he test positive or negative? Is he infected or isn’t he? Like thousands of Americans before him, he has decided to find out.

In his early 30s, tall, thin, handsome, with thin threads of gray running through his hair, he sits in his immaculate Westside apartment chain-smoking (“I don’t normally smoke this much,”) and drinking a Coke out of the can. It is a week before he will take the test, and his nerves are showing signs of fraying.

He has requested anonymity in telling his story, asking that his name and some particulars about his life be left out. While some of his friends know he is gay, his family does not; he wants to keep it that way. “Being gay happens to be a part of me,” he says, “but it is not only who I am. Basically it’s nobody else’s business unless I choose it to be. But I’m not ashamed or embarrassed of who I am.

“In a sense I’ve been hiding my head in the sand about (taking the test).” he says. “On a conscious level I say to myself, maybe I am positive and I will deal with it like that, but subconsciously I’m saying to myself it’s impossible. So let’s hope the subconscious wins out.”

Brian has allowed himself to think only in the short term about what would happen if he tested positive.

“On the one hand you want to know, but on the other hand you feel you’re much better off not knowing. It’s a real internal battle. But I think it would be better for me to know. Because if I do, God forbid, test positive, there are certain things I have to get in order. There are some debts I want to clear up; I’ve got certain things I want to accomplish, certain things I want to see. It’s like being diagnosed for time-delayed cancer or something.

“So in a sense it’s very, very selfish, and in another way I think it’s a very unselfish thing to do because I am concerned about how my getting sick would affect other people. Also, I’ve met someone recently, someone I think I want to spend a lot of time with. And I want to take the test for him.”

Any thought of dying has been pushed from his mind. “Everyone thinks they’re going to live forever,” he muses. “It’s a natural thing to block. I won’t permit myself to think that. It’s traumatic enough to go through the test. But I know subconsciously it’s back there.”

His long legs cross and uncross as he talks and smokes.

Brian works as a marketing consultant for a Century City-based firm; it’s a job that pays well and offers a lot of perks. A career upgrade brought him to Los Angeles almost 10 years ago from the large Midwestern city where he grew up, and where some of his family still lives.

Coming West was “the best thing I could ever have done for myself,” he says emphatically, “both personally and professionally. I thought this was the most amazing place . . . it was like going to a foreign country. Was it easier to be gay out here? Absolutely. People are a lot more tolerant of different life styles.”

Although he escaped the claustrophobia of his home town, Brian quickly confesses, “I was still not dealing with my sexuality when I came out here. I was dating women up until the first two, three years I was here, and enjoying it. All through high school and college I had major girlfriends. Major! I can’t say I didn’t realize it was there, because I certainly did. But I hoped it was a passing phase. It wasn’t.”

By the time Brian accepted that he was a homosexual, AIDS was just creeping into public consciousness, and he was definitely conscious of it. “I read a lot,” he says. “I have to in my job. So I knew what was going on. But in a sense it’s very unfortunate that I started to deal with myself when I did, because I feel like I got ripped off. You had all these people experimenting (sexually) for years and then I roll onto the scene. It’s like someone put up the Berlin Wall.”

He pauses. “But I didn’t experiment. ‘Cause it’s not worth dying for.

“I’m not promiscuous,” he adds, lighting up another cigarette. “But I’ve had my share of fling-ettes. . . . I go to bars, but mostly for the social aspect. On three occasions since I’ve lived here I have gone home with someone from a bar. That’s a pretty low average considering I’ve been doing it for six or seven years. And I can remember their names.”

More serious relationships are recalled with a kind of sarcastic fondness. In all but a couple of cases, he says, he has practiced safe sex.

In recent years he’s lost only one “really, really good friend” to AIDS, he says, although he’s known others who have died. “There was a man who was a very successful attorney who had been married and had children, but didn’t deal with his gayness until he was in the midst of a divorce. He killed himself. He couldn’t take it anymore, knowing that he was never going to get better, the pressures from his family.”

He talks a little about his mother, who died recently after a long, painful illness. The memory of holding her while she screamed in pain is too fresh, and sometimes he cuts himself off.

“It’s been a rough year,” he says. “When she found out she wasn’t going to live, she changed. She’d always been someone who was very alive and this made her even more so. She just went for it all. That’s probably the best possible example of what to do when you find out you are or could become very ill.”

He thinks of the test again. He has decided to have it done by a private physician recommended by a friend, and to have the blood sent to a lab anonymously.

The night before the test, he is up watching TV, smoking, trying to keep his mind on the program. He says he has popped a Xanax (a prescription medication for anxiety) to calm himself.

“I’m really keeping it in perspective,” he says, the anxiety apparent in his voice. “I’ve sort of got this mantra that I keep saying, ‘Negative, negative negative.’ ”

He laughs.

“But I’m OK. I’m really fine. Tomorrow after the test I’m going to take a walk on the beach at sunset, then I’m having dinner with a friend. And work has been keeping me busy.”

Soon the conversation turns back to AIDS.

“One thing that I didn’t mention before,” he says. “Remember those guys I told you about who died of AIDS? Well, I slept with three of them. But we did practice safe sex.”

He failed to mention it before, he says, “because I was blocking it. It’s part of the denial. When I found out they had AIDS I thought about taking the test then, a couple of years ago. But at that point the tests were inconclusive. So I thought, why set myself up for this?”

In the doctor’s office the next day, Brian makes jokes as he fills out some forms. He’s wound up and makes half-hearted remarks about bolting from the room. Suddenly he realizes that the piped-in music playing is “That’s What Friends Are For,” the hit song recorded to raise money for AIDS research. He rolls his eyes and says, “I can’t believe this.”

In the examination room, a nurse takes his blood pressure and temperature. She pronounces both “fine.” Later Brian says, “I can’t believe she said I was fine. I swear, my heart was racing a mile a minute.”

The doctor comes in, introduces himself, takes out Brian’s chart and asks him why he wants to take the HIV test.

“I understand that testing positive, God forbid (both patient and doctor knock on the wood examining table), does not necessarily mean you’re going to get it,” Brian tells him. “Yet that seems to be the case at this point, whether it’s three years or five years down the road.”

“I don’t think that’s true,” the doctor says. “It’s interesting how the most alarming statistics get the most play because it sells the most papers or the most TV time. I’m not a statistician, but I have a lot of patients who are HIV positive for years and remain perfectly healthy. There are lots of things that can be done to prevent the convergence to AIDS.”

“And at the very least,” Brian says, “I don’t want to end up like a Typhoid Mary. . . . Why submit yourself to that stress when in reality you could be a negative?”

“Yes,” the doctor says, “except that if it’s positive, the stress could be a lot worse, perhaps.”

“That’s something I haven’t considered,” Brian says quietly.

“But it sounds like you think it’s real likely it’ll be negative,” the doctor says.

Brian says, “I think so.”

The doctor asks Brian some general health questions, and whether or not he uses amyl nitrate (a stimulant used by some to enhance sexual pleasure), if he is promiscuous, and if he’s had syphilis, gonorrhea, chronic diarrhea or hepatitis. He answers no to each. His health, he adds, has been very good lately except for a cold a few days ago.

Anonymous Results

Brian asks how his anonymity will be maintained when the blood sample is sent to the lab. The doctor explains that the sample is sent by initials only and the results are sent back on a sheet that won’t be included in the patient’s records unless he requests it.

Brian asks if he can use other initials and the doctor explains that might get a little confusing. It will take three days for the test results to come back from the lab, and if the test is positive the doctor says he’d like Brian to come in for another appointment.

After a brief exam, the nurse comes in and draws blood from Brian’s arm. He’s no fan of needles but doesn’t flinch when she sticks him. “Negative, negative, negative,” he chants softly, over and over.

On his way out of the office he asks the nurse to call if the results come back negative before three days are up. “Could you call me if-- when --it comes back negative?” he asks.

Brian is still keyed up as he leaves the doctor’s office and drives to a cafe in Westwood. This weekday afternoon it’s almost empty, and he takes a table near the window and orders a Coke and a raspberry chocolate mousse, which he eats too quickly.

“I certainly feel a little better than before I went in,” he says, drawing a deep breath. “I’ve gotten it over with. Now I’ve got to sit back and bite my nails. But the doctor certainly didn’t have anything negative to say about me, so that’s a positive in terms of a negative.” He laughs.

“I’ve never even had mumps or chicken pox or measles. I never get anything. So wouldn’t that just be common to get the Big One after that.” He raps on the hard wood floor. “You know,” he says, “my knuckles are raw from doing this.”

‘Totally Focused’

He thinks back to what’s been occupying his mind for the past few days. “I’ve been totally focused on the test, really, and the outcome. I think it’s best to deal with only what’s immediately in front of you and what’s controllable, because otherwise why waste your energy trying to work out options and plans and everything for something that may not . . . will not even occur?

“Have I been bargaining with God? That’s a good question. I think I subconsciously have--negotiating, maybe, more than bargaining. I’ve been using my mom as an intermediary. I’m saying, like, ‘Mom, honest, this time I really will stop smoking.’ She used to send me brochures about quitting. I was in the brochure-of-the-day club. She’d send wall-size posters, too.”

He stubs out a cigarette and continues. “Another thing I’ve been thinking about is how testing negative is going to affect my dating pattern. If I’m a negative, am I going to in any way jeopardize this? No. So I’m just trying to figure out how I’m going to deal with that.

“It does seem real, real unfair,” he says with a sigh. “But a lot of things in life are unfair. It’s a cliche, but it’s true. If I was to test positive--which I won’t--I’ve been thinking that I’ve finally reached a point where I’m really feeling very comfortable with myself. I’ve learned to accept a lot of my quirks, although I know I have a lot to work on still. And I’ve finally reached a point in my career where I’m at a job that I love and maybe I’ve found somebody I want to spend a lot of time with. It would just be so unfair if all of a sudden I had to deal with a brand new problem--which is kind of the way life is. I just wish it were a different problem.”

The next day, in the early afternoon, Brian, in his office, says he’s feeling OK, but waiting for the results is starting to get to him. He skipped spending sunset on the beach because it was cloudy and he was feeling less anxious after the test than he thought. “I’m fine,” he says. “I’m really fine.”

An hour later he calls. “It’s Brian,” he says quickly. “I’m positively . . . negative! I couldn’t stand it anymore and I called the doctor’s office. They said, ‘Hasn’t anyone called you yet?’ I was absolutely elated. I was running around here but nobody knows why. God, I’m going to move to a monastery now,” he says laughing. He says he has to go, promises he’ll call later.

Some days later, when he’s had a chance to calm down, he’s begun to put the test results into perspective. “Will I take it again? I don’t know,” he says. “The doctor didn’t recommend it. God, I don’t know if I could go through this trauma again. I think I’ll deal with this six months down the road.

“I called my friend,” he says, “and told him the results. He was ecstatic. He’s taking it as soon as he can.”

‘Like Winning the Lottery’

Brian pauses. “I’ve had a lot of thoughts the past couple of days. My first reaction was that this was like winning the lottery. Then my second reaction was, it was almost like this secondary fear of now that I’ve gone through it, that I still may not be off the hook. But I am definitely going to continue to practice safe sex.”

He says he bought tickets to the fund-raiser presentation of the AIDS quilt knowing he wasn’t up to going. “I support similar AIDS organizations,” he explains, “and I’ve gotten to the point where it’s so frustrating and sad and overwhelmingly emotional. I’ve had these overwhelming feelings of sadness,” he says, “for all the people who died. I just couldn’t deal with going. It may be a selfish response, but in a sense I was protecting myself.

“God, if I had to deal with all this just getting the test, can you imagine what a person goes through when he finds out he has the disease?”

He’s told a few friends his test results, but held it from others. “A friend called me a couple of days ago, and I knew that he tested positive. So I wasn’t going to be all cheerful and say, ‘Guess what?’

“I’d like to get on a soapbox and say that everyone should have the test, but I don’t want to do that,” he says. “It’s a very personal decision. What would I say if I had tested positive?

“It’s the luck of the draw. It’s just the luck of the draw.”