All the bells rang inside Ross’s head. Things he learned a full decade ago and never considered since then, certainly not in terms of himself, were well beyond his grasp now.
It scared everybody when it appeared in the early eighties and nineties he learned in health class. An epidemic with absolutely terrifying results dominated those decades. Then the panic calmed down because they learned how to slow down the spread. Effective treatments and intensive research mitigated the threat of death and people began to live longer with the disease. When Ross became sexually active, he never even thought about HIV, because he had no reason to. He didn’t read the latest updates and information for surviving it, or know that the looming presence it once carried became less terrifying for society at large. Ross worried more about STDs like crabs or gonorrhoea, which both sounded gross and had totally noticeable symptoms, such as itching and a pungent discharge.
But HIV? AIDS? No. The threat of it never crossed his mind. His ignorant brain had no better excuse than that.
He snapped back into focus when the doctor said, “Ross?”
“Yes? I mean, what did you say?”
“I was explaining how the testing we do can determine your HIV progression. That’s how far the infection has already advanced inside you. We have to measure the CD4 in your blood.”
“CD… what?”
The doctor smiled kindly and Ross sensed he must have had many previous discussions about this with other patients. Sighing with chagrin, Ross admitted, “I’m sorry, Doctor, but I’m having a hard time processing everything you’re saying.”
Dr. Orslov leaned forward. “That’s okay. We’ll go over it as many times and as long as you need to or want to. Or we can wait and stop right here and see you after we’ve examined your blood for the next steps in the process.”
“No, Doctor. Please, tell me some more about it.”
“Okay, CD4 refers to the fighting cells of your immune system, so naturally, we want those to be very high. As HIV advances, your CD4 counts drops, which reflects and indicates the amount of damage you have incurred in your immune system.”
“So a low CD4 count in my blood right now is very bad.”
The doctor solemnly nodded. “Yes. It is bad. But it’s far from being, well, it’s not your worst worry. We now have medicines that prevent the HIV from destroying CD4 cells.”
“Okay, I get it. So we can keep those high.”
“Yes. In contrast, we want the viral loads to stay low. Meaning, we will use medications to prevent the HIV from multiplying. The goal is to get your viral load down until it’s undetectable.”
“Meaning, it’s all gone?” Ross asked, looking puzzled.
“No. It’s never fully gone. But by monitoring the CD4 count and your viral loads, we can determine how well the medicines are controlling your HIV.”
“Okay. So I’m not relying totally on hope?”
Dr. Orslov smiled and replied, “Hope is very important in battling this infection. Understand this: you have every chance for a long, full and healthy life. But you do have a seriously harmful infection. Something you must manage and control for the rest of your life. We can suggest good life choices, lots of exercise, a healthy diet and little stress, but you must take HIV medication every single day for as long as you live. There are other things to deal with as no two cases are the same, of course. Any resistance to the drugs interferes with their efficacy and we might have to seek alternative therapies to combat the HIV. But hope must never ebb.”
Ross stared down and felt like his heart climbed up and lodged in his throat. The terrified feeling he had in coming there and learning more about his condition was fully justified. It was still scary. His CD4 count and viral loads, combined with the possibility of drug resistance and what? Mutating strains? How strange and surreal it was to hear all of this regarding his own body.
Ross felt completely changed, yet exactly the same. His entire life was flipped into chaos and turmoil. Sure, everything was the same. He wasn’t sick. Not at all. He had no symptoms. He wouldn’t have suspected a thing. Asking Jody to have sex without a condom was the source of this critical knowledge. How long did he have it? Who knew? A dark cloud menaced his brain like an African elephant was sitting on his forehead.
After a few respectful moments, the doctor said, “Can I answer