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I Took My HIV Test, Why Don’t More Asian Americans?

John Guigayoma with co-workers at the Asian & Pacific Islander Wellness Center in San Francisco.

John Guigayoma (center) with co-workers at the Asian & Pacific Islander Wellness Center in San Francisco. Courtesy: John Guigayoma / Courtesy: John Guigayoma

I don’t quite remember the reason I went in for my first HIV test, but I do remember the feeling. It was a pang of worry: the realization that I was 21 years old and didn’t really know anything about any of the men I’d ever been with.

John Guigayoma (far right) and co-workers in 2012. Photo taken in Yerba Buena Gardens, downtown SF.
John Guigayoma (far right) and co-workers in 2012. Photo taken in Yerba Buena Gardens, downtown SF. Courtesy John Guigayoma / Courtesy John Guigayoma

I drove half an hour to a clinic a couple towns over from the suburban San Diego town I grew up in. I went alone because I had no one to go with—no one knew I was gay, much less that I was worried about contracting HIV. I had never really talked about that part of my life with anyone. Being gay was something I was living but an abstraction to me, not something I owned or controlled or even understood.

She asked about the men I’ve been with. “Just some guys.” What I knew about HIV? “Not a lot.”

The HIV test counselor who met me was a blonde woman in her 40's. She asked what prompted me to come in. “Just a feeling,” I replied. “Just thought I should.” She asked what sorts of feelings? “I don’t know.” What sorts of concerns? “I’m not sure.” She asked about the men I’ve been with. “Just some guys.” What I knew about HIV? “Not a lot.”

We kept talking. Actually I talked, and she listened. The men I met made me feel “good.” My feelings about having HIV were “nervous” and “scared.” It was the first time that sex felt like a part of myself instead of something that just happened to me. My test results were negative for HIV and the counselor told me to use condoms whenever I had sex. Since then, HIV testing has become a regular part of my life—as regular as my family, friends and relationships.

John Guigayoma (far right) gives an HIV test to a client at Asian & Pacific Islander Wellness Center in San Francisco.
John Guigayoma (far right) gives an HIV test to a client at Asian & Pacific Islander Wellness Center in San Francisco. Since taking his first HIV test, Guigayoma became an HIV prevention advocate and is the program manager in charge of men's and youth outreach programs and all HIV, viral hepatitis, and STD testing and screening programs at the organization. (2014) Courtesy John Guigayoma / Courtesy John Guigayoma

I wish my experience with HIV testing was common in my community, but the truth is that Asians and Pacific Islanders are the least likely race to get tested. I hear a lot of people say they don’t need to worry about HIV because “Asians are clean,” but no one is immune to HIV. I don’t care if you’re gay or straight. No one is immune. But there are things we can do to protect ourselves.

I felt more and more nervous when I would go in for an HIV test.

I moved to San Francisco six years after that first HIV test. I was hanging out on my friend’s back porch late at night, talking about how I was struggling with connecting to people in a new city. The bonds with family and friends I had built back home were distant ties now, and I had come to feel out of touch with myself again. Sex was an opportunity to get to know someone, but those connections were passing, rarely meaningful, becoming riskier. The times I didn’t use condoms felt reckless, like I didn’t care about myself or my partners. I felt more and more nervous when I would go in for an HIV test. Friends would snicker when I told them about who I slept with over the weekend; others told me I deserved to take better care of myself.

My friend told me about Pre-Exposure Prophylaxis (PrEP), a daily single-pill regimen of the HIV drug Truvada, which helped to protect him from HIV. The regimen, he said, gave him the sex life he wanted while minimizing his risk for contracting the virus. A few weeks later, I contacted my doctor and began taking the pills. I went from testing for HIV a couple times a year, to every month for six months as part of my doctor’s plan to monitor my status. I stayed negative throughout, and I’m still negative today.

I tell people that I needed PrEP at the time to catch up with myself. I was searching for something through other men, and I needed something to protect me while I figured out what exactly that was. I eventually came to find lasting connections here: friends I cared about, people I could trust. I eventually realized that the sex life I was living—of multiple partners and unpredictable condom use—wasn’t really because I was depressed and alone, it was actually the sex life I wanted to have.

We shame each other a lot in our communities. It’s one of the reasons Asians and Pacific Islanders don’t get tested for HIV. It's one of the reasons we don't talk about it as openly as we should. I look forward to a day when we can take the shame and fear out of HIV.