When I first starting taking Truvada last October, I thought that I would finally be done with the incessant freaking out about HIV and self-diagnosing that many HIV-negative gay men go through on a regular basis. If you are (or have ever been) an HIV-negative gay man, you likely know what I’m talking about. You wake up in the morning with chills—or wake up at night feeling feverish. Almost by instinct, your hands fly to your neck to check your lymph nodes. The internal monologue begins. “Are they swollen? They feel lumpy?!? Is that normal?” Suddenly, you’re in the bathroom with a thermometer lodged in your mouth. “Do I have a fever? I feel fucking hot in this sweatshirt. Am I sweating? Jesus Christ, I’m fucking sweating!”
Of course I was sweating. The heat was on in my apartment and I fell asleep in a sweatshirt and under three blankets. But nevermind the facts. The mind is a powerful organ, able to repeatedly convince me that those beads of sweat are signs of something much worse than overheating—it’s gay cancer! Cue the horror music.
By the time I started taking Truvada, I had been fucking guys for 15 years. I can safely estimate that I’d have something just short of a panic attack every 3-6 months during those 15 years. That’s a lot of anxiety to cope with, needless to say. I had hoped that PrEP might finally put a stop to that ridiculous cycle of fear and acne-inducing anxiety. But I was wrong.
Last weekend, I woke up feeling… off. I had the chills. I felt feverish and a bit nauseated. Now, unless you live under a rock, you know that we’re in the middle of a gigantic fucking flu epidemic. I had spent an hour on the elliptical machine just days prior watching CNN reports with bleeding maps of the United States, highlighting the massive epidemic that was sweeping the country. So naturally I concluded that… I had seroconverted.
I spent the entire day trying to figure out my symptoms. Were my lymph nodes swollen? They didn’t feel swollen—but maybe I wasn’t looking in the right place. I felt sick, but only mildly so—like a very weak flu. Ah, of course. It must be the Truvada. I had seroconverted, but the sickness associated with it was lessened because I was on Truvada. Of course! Bing! Genius.
I’m not a medical doctor. I have no training to come to such an outrageous conclusion (seriously, I have no idea if or how Truvada would affect seroconversion sickness). But by midnight Sunday night, I was downright certain. I sat on my computer, feverishly researching the newly available rapid, at-home HIV test. I was THIS CLOSE to making a midnight run to CVS to shell out $40 for the test, when I finally managed to calm myself down. I reminded myself that there was a national flu epidemic and that I had just had a viral load test for HIV a month prior. And even if I had seroconverted, a rapid test would be unlikely to pick up such a recent infection.
Of course, that didn’t stop me from heading to the clinic the next day to get a free rapid test, which unsurprisingly came back negative. It is possible that I am in fact HIV-positive and that only a viral RNA test could pick up such a recent infection. But I asked myself what was more likely: that I had contracted the flu during a massive flu epidemic in the U.S., or that I had contracted HIV while on Truvada?
In the end, this is one of the things I hate most about being HIV-negative. And before you go on about how it’s because I’m engaging in such risky sex, let me point out that gay friends of mine who have the most boring sex lives in the world report similar experiences—perhaps less frequently, but nonetheless frustrating.
What do you do to help avoid or assuage the self-diagnosis spiral of panic? I’d love to hear your thoughts! Leave a comment, or shoot me a note at firstname.lastname@example.org.
Jake Sobo is a pen name used for anonymity. Jake has worked in the world of HIV prevention for nearly a decade, and is eager to share his experiences taking PrEP. Having closely followed the development of PrEP from early trials to FDA approval, he was excited to give it a shot when it was approved for use among MSM for preventing HIV. He has spent the better part of his adult life having as much sex as possible while trying to avoid contracting HIV, and started taking PrEP as a way to help him stay negative. He is well aware that the drug is not 100 percent effective and that he could test positive; while he hopes that does not happen, he knows that he can rely on his numerous HIV-positive friends to deal with that situation should he seroconvert.