When I found out I carried the HIV virus, I was given the choice to start with antiretroviral drugs. It wasn't necessary at the time so I didn't want to. My antipathy for unnecessary drugs was the main reason, but there were more.
First of all, long term effects of this medication were quite unclear: for sure it wasn't too good for your liver and kidneys in the long term, and the longer I could postpone starting with medication, the longer I would postpone, on average, kidney and liver problems. And then there were the immediate effects: the convenient-and-flexible-one-pill-a-day meds might not work for me, or have nasty physical or psychological side-effects, in which case I'd have to switch to a three-or-more-pills-a-day-during-meals therapy. And quitting was not an option once you started. In the worst case every pill would have some nasty side-effects. Anyway, knowing how absent-minded I can be, I was sure that I'd forget to take my pill at set times, and that soon enough my virus would develop a resistance against the pill that suited me best. My guess was that because of my forgetting to take them, within a few years the convenient pills would no longer work for me and I'd be stuck with the nasty ones.
There was only one reason why I would want to start though: to protect my sexual partners in case a condom would break. Although no condom that I put on myself has ever broken and I'm extremely careful, I've never cum inside someone ever since I'm poz. If just feels like too big a risk: the risk that the condom might break and that I might infect someone, and also the risk that after the condom breaking and my dutifully explaining to the guy I'm poz and that he should see a doctor immediately, he will tell this to other people and spread the word about me. I'm so afraid of getting marked in the not-so-big gay community of my city!
Yet my dislike and fear of unnecessary medication and my tendency to keep options open have prevented me from starting an antiretroviral treatment. I chose to wait until my immune system would be deteriorated to the level that medication was actually necessary, which is actually the common approach in my country. However, now that I had a boyfriend (see Meeting each other again) I thought I should at least rethink that choice: the last thing I'd want was to infect him. And although I never noticed any hesitations when we had sex, I knew that it was on his mind.
I wanted my boyfriend to enjoy sex with me without having to worry and I wanted to protect him. Was that a good enough reason? I asked the few friends that knew about the situation and got very varied advice. The generally more opportunistic ones told me to start, the risk averse ones told me to wait somewhat longer. And my boyfriend, he said I should certainly not do it just for him and that he had no say in this, because we only knew each other for a few months. But in fact he was by far the most important reason to start with meds.
Reading more about it, I managed to find a second reason to start with meds: the virus increases the chance of getting certain kinds of cancer. As most of my family members have died from cancer I've always tried to reduce the risks as much as possible: no sunbathing, no smoking, healthy eating. Suppressing this cancer risk increasing HIV virus would be a good addition, certainly considering the impact the cancer types involved would have on me in particular.
After thinking this over for a few days, I made up my mind. At my next routine blood check, which was already in two weeks, I would ask my doctor if I could start with meds.
Then I got the results of my blood test back. Instead of having continued deteriorating linearly, my immune system was stronger than it had been ever since I was infected; similarly, the virus content in my blood was by far the lowest since the infection. Without any pharmacological help my body coped with the virus surprisingly well. I started doubting again: starting with meds seemed very silly now. What to do?