It’s not always HIV
There is no surer route to panic than googling a symptom. Or worse, having a friend google it for you.
On Thursday the rash appeared on my stomach. On Friday it broke into blisters. On Saturday I figured poison oak. And on Sunday a friend suggested ringworm.
Odd, I thought. So far as I knew I hadn’t been in contact with anyone infected. Then again I had been doing a lot of gardening, and maybe the fungus had been in the soil.
I looked up home treatment and within the course of five hours I had switched out my shower gel for antifungal tea tree oil soaps, and bought tubes of clotrimizole cream, terbinafine and hydrocortisone. I threw all my clothes and linens in the laundry, and then, just to be sure, showered, dried, and wiped my entire body down with distilled vinegar. Then I peeled and ate a whole bulb of garlic raw.
For three days I continued the treatment—minus the garlic, once was enough—and the symptoms only got worse. The initial patch wasn’t any bigger, but three others had appeared flowing in a line from abdomen to spine.
From my nearly hourly googling I learned it might be tinea, which though caused by the same fungus as athlete’s foot and ringworm sounded so much nicer than either. The alternative, athlete’s foot, or in this case ‘athlete’s gut’ was so unappealing. And there’s just no way to sex up ringworm.
But still the bumps didn’t itch. Instead they started to sting, then burn. I woke up nightly with abdominal pain that sent me to the medicine cabinet.
By the following Friday, the blisters broke and turned into scabrous lesions. I had an appointment scheduled to test for STIs, and let the clinician know beforehand that I had ringworm. She took one look and informed me otherwise.
“You don’t have ringworm. You have zoster,” she said.
“Is that with a Z or an X?” I asked.
“With a Z,” she said. “Z-O-S-T-E-R.”
The word was completely unfamiliar. An exotic flower? Commander of some ancient empire? Admiral of the Persian fleet? It was glad that she spelled it so I knew exactly what to google.
Shingles. I had shingles.
Shingles is the reactivation of varicella, the same virus that causes chickenpox. The virus lies dormant in the body and then years or even decades later reactivates in the nervous system, leading to burning, itching, or stinging dermal lesions that follow the neural pathways of dermatomes (areas of skin serviced by the same spinal nerves.) Shingles on the abdomen is easily diagnosed from other skin disorders as the patches follow a U shaped line from front to back.
Though associated with the elderly, roughly two-thirds of all Americans will experience shingles in their lifetime. Half of them will be under the age of 60. It is not contagious to anyone who has ever been exposed to varicella, either via vaccine or chickenpox itself.
Three groups are most at risk for shingles: the elderly, the immuno-compromised and people who contracted chickenpox before they were 18 month old. I got chickenpox at 11 months. Mystery solved. I could stop applying cream. I could use the hand towels in the kitchen again.
That afternoon I scheduled an appointment with my physician, got a prescription for antiviral meds, and let my friend know both our diagnoses had been wrong, that it was neither poison oak nor ringworm but good ole’ fashioned shingles. I still woke up with pain around 3 am, but slept better knowing what I had was treatable and would, most likely, go away on its own.
At 7 am the following day, a Saturday, my friend texted back. “Immune compromised,” she wrote. “Go get another HIV test.”
I texted that I had last tested negative only three weeks before, that I hadn’t had either penetrative or unprotected sex since, nor done any intravenous drugs, and besides I had been diagnosed with zoster by a nurse at an STI clinic. Surely she would have said something if she felt it was a concern.
“Get another HIV test,” my friend texted again. She’d been looking at the internet. Which then made me look at the internet. Which made me feel I’d missed something critical. Naturally I went to Google.
I found this:
“Diagnostic clues in a patient with suggestive findings [of HIV] include the presence of lesions and sensory symptoms that do not cross the midline, and pain or sensory signs that are characteristic of nerve injury.
And also this:
“The presentation of a patient with herpes zoster should always lead the clinician to suspect HIV infection, for since the beginning of the AIDS pandemic, herpes zoster has often been the first manifestation of HIV infection.”
My next google search was all keywords: “HIV testing Berkeley open now.”
I made a 3 pm appointment at the Berkeley Free Clinic.
Up until 7 am that Saturday morning, everything had been fine. But wasn’t there a chance that something had been missed? Was I still within the window period? My lymph nodes were a bit swollen. I did have a rash. What if it wasn’t just shingles? What if it was something more? What if while I’d been thinking of those fancy names—Tinea, Zoster, Varicella, three characters in a Shakespeare comedy—there was something darker behind them all, a menace in capital letters?
I was barely aware during the worst years of the AIDS epidemic, but it doesn’t take much for me to feel what men my age must have experienced during that time. A time when, after Stonewall, and after Harvey, the American public began to generally tolerate, if not celebrate, the existence of LGBTQ lives. When the price of tolerance was invisibility. And when gay men started to die, and die, and die, thought we were being handed the cost of a “chosen lifestyle.
For gay men, HIV is part of the inherited narrative. The virus could have, and does, affect all people, and yet it still feels a burden held in special reserve for us. Each time I’m sick a well-meaning friend or family member makes a comment. Maybe it’s not just a cough. Maybe it’s more than a fever. Maybe you should get tested. And each time I’m reminded swiftly, painfully that there is precious little separating me from the past. Heterosexuals are not told these things. Straight people can just have the sniffles.
There’s the expression, “Hope for the best, plan for the worst.” My strategy is “Plan. Don’t hope.” As I waited my results I laid out the next month.
Immediately after I would eat whatever I wanted for lunch and not feel any guilt. Then I would get a bottle of Veuve Cliquot and head for Indian Rock where I would just think and drink and maybe share the bottle with whoever else stopped by. At sunset I would call my family and tell them my status. I would allow myself to cry and not care who saw. Then the following day I would get seven T-shirts, one for each day of the week, each a different color of the rainbow. The front would be emblazoned three letters and one word. ‘HIV Positive.’ I would own my status. I would be an advocate. I would not be invisible.
That’s as far as I got when the clinician called me in and gave me my results.
Naturally, they were negative.
I cried just the same.
I went out to lunch. Indian Rock, Veuve Cliquot, and all the rest of it of course, no longer seemed so necessary and frankly more than I could deal with at that moment. I just sat for a while in the aftershock of so many emotions.
Oddly, I hadn’t planned for good news. And no idea what to google to help with it.
But the next time I’m asked by some well-meaning friend, “Have you considered it might be HIV?” I’m just going to answer honestly, and without Google. Sometimes a cold is just a cold. A rash is just a rash. Even gay guys get the sniffles.
Or, in my case, shingles.
Premium aged, naturally aromatic, produced in a facility that also uses soy, nuts, dairy, and gluten: these are the words that might be used to describe Cirrus Wood. Or they may just be something he read off a bag of basmati rice he had in the pantry because he didn’t know what to write here.
Cirrus Wood is a freelance writer and photographer, fine art model, bike messenger and, occasionally, adult film actor. His writing has appeared in the Bold Italic, California Magazine, UC Berkeley alumni journal and other publications.
The opinions expressed in this article are those of the author alone. They do not reflect the opinions or positions of BETA or of San Francisco AIDS Foundation. BETA serves as a resource on new developments in HIV prevention and treatment, strategies for living well with HIV, and gay men’s health issues. Our goal is to inform, empower, and inspire conversation.