We've been told we should test regularly for HIV, although many of us don't get around it to it - for many reasons. But did you know that if you are HIV positive, knowing earlier rather than later could literally add years to your life?
Steve (34), from Cape Town, discovered that he was HIV positive six years after he was actually infected. "I didn't get tested because I didn't really see the point in knowing unless I was sick. Why stress myself out needlessly?" he asks.
He only got screened once he started experiencing symptoms that his doctor suspected were more than a nagging chest infection that wouldn't go away
Thankfully, after some difficulty, his treatment eventually put him back on track and he's healthy now, but he wonders if things might have been different if he'd known earlier. That's the reality for many guys who go for years with the virus in their body before they notice any HIV-related symptoms; and all this while they could be infecting others.
Testing can be a daunting prospect because there's the fear that the results may be positive and a 'death sentence'. "Yes, people do avoid testing," confirms Dr Oscar Radebe, medical advisor at the Simon Nkoli Health4Men clinic in Soweto and the OUT clinic in Pretoria. "They lack knowledge and they fear the consequences. They don't know that they can still live a long and healthy life." He also blames the media for instilling a sense of fear and negativity in people when it comes to HIV and testing.
Thirty-two-year old Richard, also from Cape Town, has only been tested twice in his life, explaining that he's in a monogamous relationship and doesn't sleep around, while 26-year-old Sachin from Joburg, also in monogamous relationship, is screened every six months. "You never know how faithful your partner is," he notes. Andile (28), from Soweto, says he was last tested two years ago, explaining that he's not too concerned because he's not led a risky lifestyle.
Dr Radebe says that how often you should test is unique to each individual and depends on how risky your behaviour is, or might have been. "For high risk situations I recommend the minimum should be every three months, otherwise annually or every six months."
That could take months, and for some people that could be too late. "People die while they wait for treatment. There really is good evidence that starting early is better," he insists.
He asserts that the benefits of regular testing are overwhelming. The sooner someone knows they are HIV positive, the sooner they can take action to make sure they stay as healthy as possible. Studies suggest that earlier HIV treatment, before symptoms set in, will improve your life.
"The benefit is that it helps prevent the later consequences of HIV, and that includes avoiding you possibly not responding to treatment very well," says Dr Radebe.
He also points out, perhaps most importantly, that: "Research shows that if you start on ARVs at a higher CD4 count [the number of disease-fighting cells in your body that HIV targets] you are less likely to not experience the illnesses that define AIDS." Illnesses that could have long-term consequences on your body and your future.
He uses an example of someone who only discovers that he is positive when he's diagnosed with TB, often acquired due to a depressed immune system, thanks to HIV. In a case such as this, very common across South Africa, Dr Radebe says that the tuberculosis needs to be treated first, before the HIV is targeted.
Richard, Sachin and Andile all acknowledge that the sooner you know your status, the quicker you can plan ahead. "You can start living more healthily and change your diet," suggests Andile. "I have a friend and he's HIV positive. He got medication in the early stage and he's living and healthy now," he says.
"If found early you can start taking ARVs to prevent you from going too far down in your cell count" adds Sachin. Studies confirm that starting treatment sooner rather than later helps your immune system to recover faster and more effectively. That could mean the difference between living a life probably as long as you would have lived if you were negative, or a possibly shorter one.
If you are infected with HIV, it's not only your own health that benefits from early testing and treatment, but also your partners'. "It's important that you know, because you're not only putting yourself at risk but also the person you're interacting with," comments Sachin. Richard, agrees, adding: "You don't want to be spreading it around un-knowingly".
It goes further than just being a responsible lover, however; being on ARV treatment can actually reduce the chances of you transferring the virus to another person. That's only recently been proved in a groundbreaking study.
The HPTN 052 study, conducted in nine countries including South Africa, scientifically confirmed for the first time that HIV positive men and women on antiretroviral treatment reduce the risk of infecting their partners by a whopping 96%. It also confirmed that earlier ARV treatment improved the positive person's health.
"Earlier therapy is a superior option that benefits both an infected individual and his or her uninfected partner," confirmed Sten Vermund, the study's principal researcher.
The news is leading scientists to recommend that people start on ARV treatment even earlier than had been previously recommended. But, if you are HIV positive and don't know it, you can only start treatment and protect yourself and your partners by taking that first vital and simple step; getting tested.
Now, more than ever, it's time for all of us to stop burying our heads in the sand. Testing regularly is not just the socially responsible and PC thing to do, but it could literally save your life. It seems positively stupid not to do it...
For free and gay-friendly HIV screening, contact one of the OUT or Health4Men offices or clinics. They provide non-judgemental advice, counselling, testing, free ARVs and other services to men who have sex with men and can be contacted in Pretoria: 012 430 3272, Soweto: 011 989 9756, Green Point Cape Town: 021 421 6127 or Woodstock Cape Town: 021 447 2844.
*Names of some of those interviewed have been changed.