A world shaped by stigma: Soldiers learn to live with setbacks, heartbreak of HIV-Positive diagnosis

By Lesley AtkinsonJanuary 11, 2019

A world shaped by stigma: Soldiers learn to live with setbacks, heartbreak of HIV-Positive diagnosis
(Photo Credit: U.S. Army) VIEW ORIGINAL

A partner with a hidden past. A cheating husband. An unconscious encounter during an evening of heavy drinking.

At first glance, the unfortunate events that befell three active duty Soldiers at Fort Lee seem to have little in common. The outcome, however, is a different story -- one in which the lies and errors in judgment thrusted them into the misunderstood and frequently biased world of a human immunodeficiency virus diagnosis.

In 2017, the Centers for Disease Control and Prevention reported 38,739 individuals in the U.S. were told they had HIV, adding to a population estimated to be in excess of 1.1 million. Each year, about 350 military members learn they are infected, according to military medical command statistics.

HIV weakens a person's immune system by destroying cells that combat disease and infection, according to the CDC website. There is no effective cure for it, but it can be controlled with proper medical care.

The Soldiers who agreed to tell their story asked to remain anonymous as a matter of privacy. "Sam" -- the pseudonym for one of those individuals -- said he enlisted for the same reason a lot of people do; to travel and see the world. The Army did not disappoint. He deployed to far-flung places, and said he was genuinely enjoying his time in service.

Sam's love life also blossomed. He met a man who was previously married to another service member. They dated and eventually tied the knot.

Previously a stickler for health check-ups, Sam let his guard down as a newlywed. About a year into the relationship, he had a bout of illness that required hospitalization, but nobody suspected it was related to a sexually transmitted disease. It was a group of concerned friends who learned his husband was HIV-Positive and notified public health, which ultimately resulted in an additional medical test that confirmed he had been infected.

"When I found out, my whole life fell apart," Sam recalled. "If my husband told me and was taking his medication, I wouldn't have become HIV-Positive. I could have taken pre-exposure prophylaxis. I'm still angry about it today. Why didn't he tell me?

"I hate to say it like this, but the diagnosis can make you feel like a piece of garbage on the street. Who is going to want you?" he questioned. "It hurt my self-esteem for a long time, and I had to learn to cope with it. It's one of those things you have to live with because it isn't going away. I take medication daily to suppress it, and I'm healthy otherwise. The chances of me giving it to somebody are slim to none. My status is undetectable."

Modern treatments for HIV include a prescription regimen called antiretroviral therapy, or ART for short. When taking it as prescribed, the viral load (amount of HIV in the blood) can become undetectable. CDC states if it stays at that level, the infected individual can live a long and healthy life and have effectively no risk of transmitting HIV to a disease-free partner through sex.

Sam has kept the details of his infection close-hold. Those in his confidential loop include a sister and a few close friends.

"I strongly feel this is a disease you need to educate yourself on before going out and carrying on lengthy discussions about it," Sam observed. "My decision has been to live it first. I know I'm going to be bombarded with questions just by mentioning it, and I don't want to be one of those people who are clueless about a serious topic like this. That's the way I look at the whole situation and the reason I really haven't talked about it much before now."

The realization that family and friends of his partner knew he was HIV-Positive but never brought it up is Sam's most-haunting thought. Equally disturbing is why the individual he fell in love with didn't share such information, but he has settled on the idea that he was probably scared what the news would do to their relationship.

"Clearly, if my husband and I would have gotten tested earlier in the relationship, I might not be where I am today," Sam concluded.

Routine laboratory tests during her second pregnancy revealed "Mary's" HIV-Positive diagnosis. She was supported by members of her chain-of-command when clinic physicians broke the news.

"My mind was screaming 'that is not possible, we need to do a retest!'" Mary recalled. "I was emphatic about the fact I don't sleep around, so how could I possibly get HIV?"

It was her husband who had been sleeping around with other men and women. "So, he contracted HIV and never told me," she interjected. "He didn't care about his health, so why would he care about mine?"

Mary believed her world was ending. In her mind, it was a death sentence both literally and figuratively from an Army career standpoint. Her unborn child also would inherit the disease. She has held on to the hope that it was all a misread diagnosis for the past two years, but that meager strand of optimism is dwindling.

"I have to deal with what it means to have HIV in the military," she acknowledged. "It changes everything. You can't deploy or go overseas, and I'm no longer eligible for warrant officer training. I'm left with far fewer options for advancing my career."

Typically, a service member diagnosed with a potentially debilitating disease like HIV is placed into a restricted status that includes no deployments, overseas assignments or immediate relocations stateside. In reference to Army Directive 2018-22, which provides deployability guidance, an additional memo signed by acting Assistant Secretary of the Army for Manpower and Reserve Affairs Marshall M. Williams directs the categorization of HIV-Positive Soldiers as "deployable with limitations." This means they are retained in the Army unless they have another underlying legal, administrative or medical reason that makes them non-deployable.

Another Soldier, "David," can never forget the night he contracted the illness. After an argument with his long-distance boyfriend, he went out to a bar to blow off steam with friends.

"We were drinking, and I don't know what happened from there because I blacked out," David said. "The only thing I do remember is my friends leaving and me staying to talk to someone. The next day, I woke up inside my car with my pants down."

The embarrassing situation made him angry at his friends for leaving him at the bar. He wasn't sure if he had been raped, and the thought of that being a possibility brought additional shame because he had set himself up for it by drinking too much and passing out. He chose to keep the incident quiet, mostly because he was afraid he would lose his boyfriend. David went on with his life uncertain about what happened that night.

Until he started to feel sick and went to the hospital for an exam.

"I was telling them my symptoms because I had been Googling them, and everything was leading to HIV," David said. "I just didn't want to believe it."

A few weeks later, he received a call to report to his doctor, and was informed he would be accompanied by his supervisor and unit commander. The medical team broke the news that his tests came back positive.

"My commander didn't know what to say," David said. "I think it was the first time he had an encounter with an HIV diagnosis. I think he was surprised it was me, as well. I could see his disappointment, but at the same time, there was no indication he had lost any respect for me as a Soldier. I worked so hard for the company, and he knew I was a good, dedicated worker.

"He never asked me what happened either," the Solder continued, "but he was with me the whole way, accompanying me at my appointments. He was good to me and supportive, because only he and I knew, but I never opened up and told him I was gay."

David and his boyfriend have since broken up, and he thinks it is due to the HIV diagnosis. He isn't in a rush to get into a new relationship. The first order of business is to take care of himself.

"When I eat dinner, the pills I need to take sit next to me on the table," he said. "It took a year of counseling to get me where I am today. I still look online every day to see if, miraculously, a cure for HIV has been found. I am hoping one day they come up with a cure. In the meantime, I'll try to learn as much as I can to maintain my health."

The point of telling their stories, the trio agreed, is to promote understanding of the HIV epidemic and encourage healthy practices like getting regular checkups that include screening for sexually transmitted diseases, especially when entering an intimate relationship.

"Don't be afraid to ask questions," David succinctly said. "Closed mouths do not get fed and closed minds do not typically show empathy or acceptance of uncomfortable things in the world like HIV."

Testing is the only way for the people living with undiagnosed HIV to know their status and begin seeking treatment. The CDC estimates that more than 90 percent of all new infections could be prevented by proper testing and linking infected persons to care. HIV testing saves lives. It is one of the most powerful tools in the fight against the spread of this disease.

CDC recommends that everyone 13-to-64 years old get tested for HIV at least once as part of routine health care. Military personnel are required to get tested for HIV every two years as part of their physical health assessment. As a general rule, people at high risk for HIV infection should get tested each year. Sexually active gay and bisexual men may benefit from getting tested more often, such as every 3-to-6 months.

HIV testing and pre-exposure prophylaxis are available at Kenner Army Health Clinic. As always, the first step for beneficiaries is to schedule a consultation with their primary health care team through the clinic's appointment line, 804-734-9449. Don't let worry over an HIV test stop you from taking one. Whatever the result, it can help you make smart decisions about your body and your health.