Doug PollardTranscript - David Menadue
Music: Pet Shop Boys & Dusty Springfield: What have I done to deserve this?
DOUG: We’ve reached the hour where we spend some time with one, special person – somebody special to our community in one way or another – and it’s someone very special today, we’re going to be talking to David Menadue. David is probably one of the first people to catch HIV, he became positive in 1984 and from there on he’s been very active in setting-up support groups, in working with PLWHA, national association of organisations for people with HIV/AIDS, and he was awarded the Order of Australia in 1995 for his work. We welcome David to the show this morning - - -
DAVID: Good to be here, Doug.
DOUG: Now, I want to go right back to the beginning.
DAVID: Not my childhood I hope, Doug?
DOUG: - - - well, yes. We always do - - -
DAVID: Okay.
DOUG: We always start with where you come from ‘cause you’re originally a country boy.
DAVID: This is true.
DOUG: From where?
DAVID: Northern Victoria, actually a little place called Wunghnu, I don’t imagine too many people would know but it’s near Numurka and Shepparton. An area of town that’s been flooded at the moment.
DOUG: So, you’re well out in the country, there - - -
DAVID: M’mm.
DOUG: - - - where you part of a farming family?
DAVID: Yeah – well, my extended family were farmers. Wheat and sheep farmers but my father was a shearer - - -
DOUG: M’mm?
DAVID: - - - he was a very – you know - - -
DOUG: Knock-about sort of bloke?
DAVID: Knock-about, masculine guy and telling him I was gay, much later in life and that I had AIDS was a very big hurdle for me. But he coped remarkably well and that’s one of the things I always hold dear to me, that both my parents accepted me so much. Both that and the HIV, the gay and the HIV.
DOUG: Yeah. (and)Your mother was a housewife or did she have a profession?
DAVID: Well, pretty much. She worked as the local station mistress, it was a part-time job to – you know, feed six children.
DOUG: Well, yes [laughs] - - -
DAVID: M’mm.
DOUG: I was talking to someone last week who was one of 11 children - - -
DAVID: M’mm.
DOUG: - - - you can imagine – I can imagine what that was like. You’re one of those who didn’t have a good time at school?
DAVID: Oh, no. I was bullied like I think most gay boys are but - - -
DOUG: Was that because you were known to be gay?
DAVID: M’mm - - -
DOUG: Or because you were out at school or just because you were perceived to be different, in some way?
DAVID: Look, I didn’t engage in sport – m’mm, as in you know, football and cricket. I quite liked tennis and other things but, you know, they were considered a bit girly by Numurka boys. It was – sort of, more a perception that you weren’t going to be one that got in a scrape and there were plenty of fights and if you weren’t the first to throw a fist somewhere or other, there’s something a bit suss about you.
DOUG: Yeah, so, that wasn’t much fun?
DAVID: No and I remember once, one of the teachers who was obviously gay and I didn’t know what that meant, then – you know, there weren’t role models around for people in the ‘60s when I was at high school, for instance, to know what “gay” was - -
DOUG: M’mm.
DAVID: I know that’s a hard thing to understand but – you know, the only role model I had in my whole high school and the media was Number 96, “Don Finlayson”
DOUG: M’mm, m’mm.
DAVID: - - - now that’s weird and the other stuff was always people getting carted off to jail and seedy – you know, views about what homosexuals were and people don’t understand how different life is. So, I think I didn’t have a very – m’mm, strong role model or anyone to go to and this particular staff member I remember was held-up by throat virtually, by one of the rough boys in woodwork and said: ‘don’t you tell me what to do, ya "poofta"’. He ended up leaving the following day and I thought the principal didn’t stand by him, there was no real acknowledgement that that boy done(sic) a really awful thing and I just thought there’s some level of injustice happening here.
DOUG: But you got through it?
DAVID: Oh, yes. I was a good student, I just - - -
DOUG: Was that your saving grace?
DAVID: - - - yeah. Yeah - - -
DOUG: That you were academically good?
DAVID: I think you realise innately, you have to have something to survive on and that was being a good, academic student and hopefully becoming a – well, my ambition was to be a teacher. Which I ended up being – and – m’mm, not that I lasted long as that. But I - - -
DOUG: [laughs]
DAVID: - - - ended up in journalism which is really – you know, where I think I really belong.
DOUG: Did you go to College, then – after - - -
DAVID: Yes. University.
DOUG: So, you got out of Numurka?
DAVID: With a great sigh of relief.
DOUG: [laughs] Very glad to be gone from there, where did you study?
DAVID: I studied at Melbourne University and it was the early days of gay libs(sic) so I used to – sort of, hang on the fringe and try and build-up courage to go into gay lib meetings. I never really acknowledged I was gay until – you know, something happened. I took an ‘ecstasy’ tablet one night – no, an LSD trip. That was – I don’t think we had ‘ecstasy’ then and it sent me off the planet a bit. I didn’t know how to cope with it and a – whole – lots of things in a turmoil about my sexuality came out so I ended up on a psychiatrist’s couch and I said: ‘oh, I think I’m bisexual, maybe’ and before long - - -
DOUG: M’mm, the usual.
DAVID: But you know, in those days psychiatrists could be: ‘oh, I think you can change’ but I found one that was sympathetic - - -
DOUG: M’mm.
DAVID: - - - and he said: “I think you might be gay.”
DOUG: Yeah.
DAVID: (and) ‘I think this – there are plenty of other people in the world, you may not see them, they may not be visible to you but there are plenty of other gays out there and I see them in my own patients. You go and explore and you’ll find them.”
DOUG: Yes, I had a similar experience.
DAVID: Is that right?
DOUG: Yes, ‘cause I didn’t want to be gay - - -
DAVID: M’mm.
DOUG: - - - and I finally had to admit it to myself and I saw a psychiatrist about it and her instant reaction was: well, what have you done about it? I said: well, nothing – and she said: I suggest you go away and do something about it and then come back and tell me how you feel about it.
DAVID: Yes.
DOUG: But – just go and do some experimenting and find out, you know? It’s not the end of the world
DAVID: Exactly.
DOUG: Which was one of the most sensible pieces of advice I think I’ve ever been given.
DAVID: Did you have a religious background?
DOUG: No, I didn’t – did you?
DAVID: No, I think it makes it harder. I actually think that – you know, I didn’t have a(sic) guilt about it when it started happening. I thought: no, this is too good to be - -
DOUG: [laughs] I say I don’t have a religious background – yeah, I was fairly closely involved with the church but – m’mm, that was only when I was a kid and as soon as I left home and went to university - - -
DAVID: Yeah.
DOUG: - - - it dropped like a stone.
DAVID: Same thing, yeah.
DOUG: You know, it was just part of the way we lived and what we did.
DAVID: M’mm.
DOUG: So, you had a brief career as a teacher. Why was it brief?
DAVID: Same thing, really. I probably hadn’t sorted out my sexuality, I was sent to a country high school – m’mm, everybody – not everybody. But some of the rougher kids in the class would always – even the girls, I used to have more trouble with the girls than the boys. Year 9 girls, my God – m’mm, used to call you a poofta and I used to take it to heart. ‘Cause I knew I was. But I didn’t realise that the other staff members, the straight ones – married ones, even, were being called ‘poofta’, too - - -
DOUG: M’mm.
DAVID: - - - if that had clicked I wouldn’t have probably have panicked as much as I did - - -
DOUG: [laughs]
DAVID: - - - and I found it very hard to tell even the other members of staff. You feel very isolated in a country town and that’s where I came from and I knew I was back in the same culture - - -
DOUG: Yeah. Big city is better.
DAVID: Big city is better, I used to race down the big city as often as possible.
DOUG: [laughs] Okay. Well, let’s take a little break, there and have another piece of music now, you’ve chosen Bette Midler, “Wind Beneath My Wings”. This is a very different choice to Pet Shop Boys and - - -
DAVID: Well, I - - -
DOUG: - - - party culture and dropping tabs of LSD - - -
DAVID: I’ll explain that. It’s to do with some painful memories I have about AIDS in the late ‘80s and early ‘90s because – and I know it’s a corny choice, I don’t think this song’s really lasted the decades [laughs] it – sort of, you know – I mean, Bette’s one of our great, camp heroes but at the same time this isn’t the greatest song, either. I’m putting it here because it was the song of choice for funerals or you know, life’s celebrations - - -
DOUG: M’mm, m’mm.
DAVID: - - - as people tend to call them now and it brings back some sad memories. But it also always never failed to make me cry at funerals and people can listen to it and maybe work-out why. But it’s just one of those songs that seem to hit the spot for some people.
DOUG: Okay. Bette Midler, “Wind Beneath My Wings”.
[music]
DOUG: (and)This hour we’re Digging Deeper with David Menadue and we just discovered he had a very short career as a teacher out in country Victoria but that was before he came to terms with his sexuality and started dealing with things back in the big city I presume?
DAVID: Oh definitely, one of the greatest blessings in my life was that I managed to get seconded to an area of the Education Department, took me out of the classroom but I was still working with children which I enjoyed doing – writing magazines so – like, a kids’ Women’s Weekly - - -
DOUG: M’mm, m’mm.
DAVID: - - - but they were all sent ‘round to all the schools around the state and interstate and it was a wonderful, creative job and I was working with a number of gay people both artists and writers and so, I actually think it helped me as a person and helped affirm my confidence as a gay man.
DOUG: Then the train hit.
DAVID: Yes, look – I – Doug, I was not sure what to make of it, when I got my diagnosis from the Sexual Health Centre. It was called something else then, VD Clinic or - - -
DOUG: Yeah. Well, this is 1984 - - -
DAVID: - - - m’mm.
DOUG: There was not a lot known at that stage, was - - -
DAVID: No. No, it was – you know, my doctor was very smart, infectious diseases specialist but he said: well, we don’t know what this means. It could be like the hepatitis – like, Hepatitis B. I mean, I had the antibodies to that and I never developed the actual illness and he said it could be just like that so that you develop antibodies but you don’t go on to get the full-blown AIDS and I said: I can live with that – and I said: what odds do you give me – and he said: one in ten chance you’ll get AIDS. Well, I thought I can live with that level of risk and I just went along my daily life. But then the scientists were starting to say ‘no, this is not like hepatitis’ – well, Hepatitis B – m’mm – and that basically, hundred per cent of people may end up getting AIDS. Unless there was some treatment found, of course. There were no treatments for a number of years - - -
DOUG: ‘Cause in ’84 we didn’t have anything, did we?
DAVID: No, nothing. Absolutely nothing and people were going to – people like Louise Hay who was a faith healer and – you know, naturopaths and trying all sorts of things. Some of which worked for a short period of time but ultimately, the virus was too strong.
DOUG: It became apparent that – fairly quickly, did it not – that a lot of the time in fact, in most cases if you were diagnosed with HIV you would go on to develop AIDS and it was a death sentence.
DAVID: Yes – m’mm, I developed it in 1989. So, within five years and that was a fairly standard, period of time. From being infected; but, when I did develop the illnesses I got – you know, sick over a period of six years. The first illness, PCP, only had an average life expectancy of 11-months - - -
DOUG: Now, PCP – what is PCP?
DAVID: Sorry. I’m talking in acronyms - - -
DOUG: Yeah. For those who don’t - - -
DAVID: - - - we learn to do that in the HIV sector.
DOUG: I know but not everybody may do.
DAVID: Of course not, Doug.
DOUG: This is a disease of the lungs is it not?
DAVID: Yes, it’s a pneumonia - Pneumocystis pneumonia. Before AIDS it was only really known in elderly people with a very severely, depleted immune system and it’s a – what is it – well, whatever it is it’s something that a lot of people would hold within their lungs. It’s the same with most AIDS illnesses, we all have bugs - - -
DOUG: Yeah. But your immune system keeps it in check.
DAVID: - - - keeps it in check. Yes, that’s - - -
DOUG: Yes.
DAVID: Like cytomegalovirus which you pick-up from kissing someone or whatever, most people have it but in people with AIDS - - -
DOUG: But they also have an immune system and you don’t.
DAVID: - - - yes and when your immune system is depleted which obviously, is what HIV was doing then and still does unless you keep it in check – m’mm, it led to people getting extremely sick and dying.
DOUG: But you came through that?
DAVID: Miracle of miracles, really and I have no particular recipe for why that happened. I think I was of an optimistic frame of mind and I had lots of good things going for me in life and I always think that those things help and one of those things as I said, was having my parents’ support. I really – you know, it took a long time to tell them but once I got AIDS I couldn’t hide it, I’d lost so much weight and I was needing – I really wanted their support. If I was rejected by them as a lot of my friends unfortunately were rejected by their families because they didn’t want to – you know, they were worried about what the neighbours might think. Or they were worried about sharing cutlery with them around the family dining – I mean, there was awful stuff. You know?
DOUG: Well, I remember at the time that if someone was diagnosed with HIV the way they were treated even in hospitals, they’d be put in isolation rooms. There’d be people wearing isolation suits, there’d be some medical staff refusing to treat them - - -
DAVID: Oh, yes.
DOUG: - - - it was an appalling time.
DAVID: Yes, some right-wing politicians were suggesting we should all be put on French Island - - -
DOUG: Yes.
DAVID: - - - and that was a regular, hysterical response. There was one “Truth” headline I’ll never forget and we had the Melbourne Truth, then. It was a bit of a shock – gossip rag, “Die You Deviant” and it was about a guy in Queensland who’d given blood – unwittingly, didn’t know he was positive - - -
DOUG: M’mm.
DAVID: - - - and a gay man and it ended up some babies were transfused with it - - -
DOUG: M’mm.
DAVID: They ended up getting HIV. So, regardless of the fact that this individual didn’t know he was positive he wasn’t wittingly going and giving blood.
DOUG: M’mm. M’mm.
DAVID: They said – there was a lynch mob out for him.
DOUG: Yeah, it was not a very good time; now, you said you became positive in ’84. In 1986 you helped set-up I think what was probably the first support group for people who were positive in Melbourne?
DAVID: Melbourne Positive Friends. You know, I think to try and understand what it’s like to be infected with a really taboo disease and a stigmatised one, one of the best ways to handle it is to meet other people with the virus. But because of peoples’ fears about being exposed, losing their jobs, families rejecting them even ridicule within the gay community – I know some people might find that hard to believe but it certainly happened - - -
DOUG: Indeed, it did.
DAVID: At gay bars I was – you know, occasionally asked whether I was HIV in front of whole lots of groups of people and I always said: yes – but, you know, that’s – it was a lot of peoples’ nightmare, it would’ve ruined their lives and I think people took their lives because they couldn’t live with that, live with all the stigma so – yes, it was a very – m’mm, a very difficult thing to do unless you had others around you. So, we would meet in each others’ homes every week and we would just debrief and let all the stress out – you know? (and)We used to call ourselves infected – well, we used to use the language of other people the same way that we use “poofta” and things. But we wouldn’t like someone else to use it - - -
DOUG: Yeah.
DAVID: - - - we had our terms for – I won’t go into them ‘cause I don’t want the world to pick-up on the - - -
DOUG: [laughs] There’s enough of it out there already.
DAVID: - - - yeah.
DOUG: Without adding to it, yeah. It’s obviously important to have peer support. That’s why we have gay organisations in the first place.
DAVID: M’mm, m’mm.
DOUG: Because that’s where that all came from – in those days, we’re talking about you did this in 1986. You started Melbourne Positive Friends - - -
DAVID: M’mm.
DOUG: - - - when did there start to be any kind of treatment available to people who were HIV ?
DAVID: ’88 was the first treatment, wasn’t much of a treatment. It was called: AZT - - -
DOUG: I remember that.
DAVID: - - - a failed cancer drug. I was one of the first 22 people in Victoria, put on it. I just think I had a caste-iron constitution ‘cause for a lot of people we’re not sure, but it may well have killed them because - - -
DOUG: It was a very nasty drug - - -
DAVID: - - - it – yes, they didn’t understand the drug troughs and they didn’t understand the dose. A lot of people had – you know, we were all given something like 1500 milligrams and these days you’d only ever give 500 a day - - -
DOUG: M’mm.
DAVID: They didn’t understand – and we had to wake-up at four o’clock in the morning to take pills and they didn’t understand that drug troughs were – you know, in the night and all that sort of stuff. So - - -
DOUG: ‘Cause all the early treatments you really, really had to be very, very strict about timing of taking your pills and all the rest of it - - -
DAVID: Well, you did - - -
DOUG: - - - m’mm.
DAVID: As it turned out it was all nonsense but at the time it was a very onerous thing to have to wake up. Particularly if you had to hold down a job, get up in the middle of the night – you know, these things made you enervated. I lost weight, I lost – we discovered later that AZT caused a level of wasting as well – as the virus did, as well – of course; so, people like myself(sic) lost a lot of muscle condition. We were quite crook.
DOUG: But it was the only thing going?
DAVID: Yes and I mean, who knows? Maybe it helped saved my life, maybe it didn’t – maybe it kept me alive, who knows?
DOUG: When did it start improving as far as treatments are concerned?
DAVID: A big improvement came in ’96 but there were small leaps and developments in the early ‘90s that again, may have helped.
DOUG: ‘Cause there was a lot of optimism – we’ll have a vaccine in 5-years and all that sort of thing.
DAVID: Oh, yes and at one stage after ’96, I think it may have been the first AIDS Conference in 1998, where they said “if everybody takes these treatments we’ll be able to get rid of the virus and that’ll be the end of AIDS” well, this virus is much too wily for that sort of black-and-white answer and before you knew it we learnt about a thing called resistance to the drug and we had to develop all sorts of new drugs, constantly, to keep up with the virus because it keeps mutating - - -
DOUG: Yeah, it’s not a fixed thing. Unfortunately.
DAVID: No – I mean, we’re certainly in a state now as you know that people can live reasonably normal life spans, they’re infected now – I mean, it’s a live saving – and it’s a chronic illness is probably the better way to put it. But it’s also a disease with a lot of complications when you live with it and I’m starting to experience that now, in my fifties.
DOUG: This hour we’re Digging Deeper with David Menadue, past President of People Living with HIV/AIDS Victoria – vice-President of the VAC and Gay Men’s Health Centre – still involved - - -
DAVID: Yes.
DOUG: - - - in the HIV sector as we now-days call it. Although somewhat less now I think than it was in the past?
DAVID: Well, yes. That’s a little bit debatable, I’m not holding executive roles but I am involved in a number of Boards.
DOUG: Let’s go back to the history of your battle with AIDS and HIV; we heard about the first treatments, which was(sic) AZT and the fact that for many people it wasn’t particularly useful - - -
DAVID: M’mm.
DOUG: - - - and may even have been quite toxic for a lot of people. Where did treatment go from there?
DAVID: In – I think I’m just going to jump a few little drugs - - -
DOUG: Okay.
DAVID: - - - like D40 and DDI and all those. They were really, only vaguely significant because people continued to die at great rates and the highest death rates in Victoria were in 1994 - - -
DOUG: M’mm.
DAVID: So, by 1996 we were all – you know, every funeral I went to I thought ‘the next one’s going to me’ because I was up to my sixth AIDS-defining illness. Life was looking pretty grim and I was hanging on by my teeth, so to speak and HAART came along – HAART is: Highly Active Anti-Retroviral Treatments. It basically transformed the way people could be treated with HIV within months and I mean literally with months, some people call it the Lazarus Syndrome – people going back to work and going back to gym and feeling all this energy - - -
DOUG: Let’s put this in perspective, a lot of people were dying. A lot of people were at death’s door, literally - - -
DAVID: M’mm.
DOUG: - - - when this drug came along.
DAVID: That’s correct. There’s more than one, there were several different - - -
DOUG: Yeah, it’s a combination therapy isn’t it?
DAVID: Mainly – yes. It’s mainly a drug called: protease inhibitors. What we call a nuclear bomb - - -
DOUG: [laughs]
DAVID: - - - in HIV treatments because it really – and it’s now only used as a last resort - - -
DOUG: Yeah.
DAVID: - - - whereas that’s all we had then so people like myself were given it and it did save our lives. But further down the track there were some side-affects that could be talked about - - -
DOUG: Right, so - - -
DAVID: - - - m’mm.
DOUG: That was the point at which AIDS ceased to be an automatic death sentence?
DAVID: Well, we weren’t sure but – you know, certainly – m’mm, there was a thing called: viral load testing – introduced about this time and we’d always had a thing called: CD4s or T-cells – and your average person would have about a thousand T-cells and someone with AIDS would usually have less than 200 - - -
DOUG: M’mm.
DAVID: - - - so what we could tell was that apart from the T-cells which was one marker, there was a thing called: viral load – and we were realising that these drugs were completely taking people’s viral loads down to nothing. That meant that there wasn’t virus circulating in the body and - - -
DOUG: (and)The virus has stopped replicating - - -
DAVID: - - - well to some degree. Now we’ve discovered it’s not quite as good as that. It’s pretty good - - -
DOUG: As I understand it and correct me if I’m wrong because you’re the expert by a million miles, the virus is still there. It’s locked inside the cells - - -
DAVID: Cells, that’s right.
DOUG: - - - not replicated throughout the rest of the body. But if you stop taking the drugs, it would?
DAVID: Yes, it would come back and in fact, quite savagely in some people. So therefore, this is the issue now if you start taking treatments you’ve probably got to stay on them, for life.
DOUG: Right – now, the other issue – there were two other issues which have come up since it’s become and I hate to use the words but ‘a treatable disease’, a chronic disease rather - - -
DAVID: It’s treatable.
DOUG: A chronic disease rather than an automatic death sentence. There’s been an awful lot of discussion about – okay, how do you persuade people to have safe sex if it’s not a death sentence? Because we are beginning to see increasing rates of infection particularly among younger men – there’s been a big study come out in the UK, for example - - -
DAVID: M’mm.
DOUG: As you’ve put in your notes you gave me, you mention “bare-backing”, this whole business of choosing not to use protection – where do we go from here with protecting the next generation who are coming along. ‘Cause even though it’s treatable it still ain’t(sic) a walk in the park.
DAVID: No and nobody knows what it’s like to walk in the shoes of a positive person ‘til it happens and the people who are taking big risks think ‘when it happens it’ll be okay’. But when it does happen they suddenly realise they’re going to have to take pills for the rest of their life, probably – I mean, I’m not saying “everyone” should take treatment, straight away – or anything; but there’s a lot of research, now, coming out about the long-term affects of having HIV whether they’re on treatments or not - - -
DOUG: M’mm.
DAVID: - - - and - - -
DOUG: Which is another issue we’ll come to in a moment.
DAVID: Yes. So, I mean I think that’s a really strong incentive for people not to get HIV and we can explain that. But the other reason is do you want to live with a secret for the rest of your life – are you prepared to tell people you come in contact with particularly sexual partners, your dentist, your doctor maybe even your employer if you have to leave for doctor’s appointments and things – are you prepared to tell them you’re HIV ? M’mm, okay, some people say it’s not their business but living with secrets is not something that I ever was able to do very well and that’s one of the reasons I came out as a gay man quite early in the piece. Further on I think, I came out as a HIV person in the ‘80s and – m’mm, it’s one of the reasons I joined the HIV community orgs(sic) ‘cause I wanted support. Because it was such a hostile environment.
DOUG: So, how do we persuade people though? Because it’s no longer – the ways we’ve been trying to do are no longer enough - - -
DAVID: Well - - -
DOUG: - - - can’t bring back the Grim Reaper.
DAVID: No.
DOUG: (and)The message is – you can’t say to people: don’t take the risk because this will kill you. Because they - - -
DAVID: Well – I mean, human beings - - -
DOUG: They go around and see people taking the risks and it doesn’t - - -
DAVID: Human beings innately take risks.
DOUG: - - - m’mm.
DAVID: Look, I think if we can change the climate for positive people so more people can disclose then other people won’t make – they’ll be making judgments, the difficulty around this is as soon as positive people disclose there’s often rejection and you’ve got to be a pretty tough individual to be able to knock back a whole lot of sexual rejections all the time. Just because of your blood because you could be having safe sex, anyway so for people to make assumptions about other people’s status based on a lack of negotiation is certainly wrong. But I think if they could only talk to positive people and understand what it’s like a lot people – and I think a lot of our campaigns, we’re about to bring out a stigma discrimination campaign, nationally – is going to show what it’s like to be HIV . So the people can understand while it’s certainly not a death sentence and people can live well there are issues you’re going to have to deal with. Are they things you want to deal with in your life? Secondly, the thing I think is really important for people to understand is that HIV doesn’t really go away with treatments. What we’ve understood there’s a level of inflammation happening from Day One when you’re infected with HIV, it’s not stuff we like to talk about in a way, because it’s scary stuff. But the truth is that I’ve developed six – what we call: co-morbidities. I’ve got diabetes, I’ve got rheumatism, I’ve got gout. I’ve got severe joint problems and things, wasting – now all those things add up and what it means is that people are suffering a thing called: premature aging – and our quality of life is going to suffer and if you’re prepared to live with that and maybe in your forties you’ll be at higher risk of heart attack than otherwise. Or prepared to be at risk of things like diabetes well, quite frankly I don’t think many people would want to take that option,
DOUG: So, what you’re saying is it’s causing premature aging now – is that being caused by the disease or the treatment or both?
DAVID: It’s both. It is in fact, both – m’mm, I acknowledge that therefore, there’s a down-side to treatments. But the treatments have got a lot better - - -
DOUG: M’mm.
DAVID: - - - the reason – one of the reasons I have diabetes is probably because of my treatments but as I said the nuclear bombs had much more side-affects than the drugs we have now. They’re only used as a last resort, the nuclear bombs.
DOUG: Yep. Because it is possible to develop resistance to the drugs, too. Isn’t it? In some cases.
DAVID: Very much so and that’s happened to me, I’ve got so many different drugs I can’t take any more.
DOUG: (and)This could happen to people who are on HAART?
DAVID: Oh, yes. In fact I think most people could expect to change their drug profiles at least every five years if they’re lucky but certainly, sometimes even every two or three years.
DOUG: So in fact there may well come a point where – although these drugs are holding the disease, there can come a point where they don’t and there are none available that do anymore?
DAVID: Well, people aren’t dying Doug. So – I wouldn’t want to be too – so negative about it - - -
DOUG: Okay.
DAVID: - - - we’re not having many opportunistic infections like we did. The only people that we are seeing with opportunistic infections are those that don’t test. Those that don’t know they’re positive end up at the Emergency door with Kaposi’s sarcoma or PCP – Kaposi’s is a really nasty - - -
DOUG: Nasty skin cancer, yeah.
DAVID: These people are really being foolhardy. They know they’ve been putting themselves at risk but they’re [indistinct] - - -
DOUG: Yes. One last thing I wanted to ask you about – we’re going to have to wrap it up ‘cause we’re running out of time here – m’mm, there was a famous statement came out of Switzerland a little while ago about this whole business if you had an undetectable, viral load you weren’t infectious.
DAVID: M’mm, m’mm.
DOUG: Tell us about that?
DAVID: Look, it’s caused some controversy within the community because of course, the AIDS Council has promoted safe sex and condoms and I think they still understandably do and there is nothing to beat condoms. But say you’re in a relationship with a positive man and you’re a negative man if the positive man is taking treatment, if you occasionally have unprotected sex as happens – that’s the way human beings are. I’m not condemning – you know that; then your risk is going to be low, it’s still there and people who have a lot of casual sex – and this is where the Swiss statement didn’t apply, it really was for heterosexuals. It was to try and work out if you’re in a couple, the two of you where one of them was positive what would happen. What are the odds – and the odds were very low - - -
DOUG: Yes.
DAVID: - - - almost to the point of being negligible - - -
DOUG: But that doesn’t apply if you’re - - -
DAVID: No – well, it hasn’t been done with gay men and there are some studies being done, currently, with gay men in the hope of trying to work out what the relative risks are for gay men. But we do know that people who have a lot of casual sex it won’t apply in the same way because the chances of them getting STIs and what STIs do is lift your HIV viral load so you’re actually more infectious.
DOUG: Yeah.
DAVID: (and)If you don’t know you have an STI - - -
DOUG: Ouch. Yeah, there are no easy answers as you know from experience.
DAVID: But I think if people do become HIV then there are many supports for them and people should be shown compassion. We make mistakes and that’s life. If you have had an unsafe sex episode I’d also remind you about PEP which is - - -
DOUG: Post-exposure prophylaxis.
DAVID: - - - yeah.
DOUG: You can go and get your shots within - - -
DAVID: Well, I think you should go within 24-hours but it says: 72.
DOUG: Yeah.
DAVID: There is some evidence you should go quicker rather than later.
DOUG: Right. So, if you think you’ve been exposed go and get PEP.
DAVID: Absolutely.
DOUG: Okay. David, there’s a million other things we could have talked about today but we only had an hour.
DAVID: I enjoyed it Doug, thank you.
DOUG: Thank you very much for your time today, your last piece of music is by Yunupingu.
DAVID: Yes. I just think this man’s very spiritual. It gets me, really deep.
DOUG: Okay. David, thanks for your time today.
