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In the United States, the life expectancy of a person without HIV is 79 years. The life expectancy of a person with HIV, diagnosed at age 20, who has access to modern HIV medication and takes it faithfully for the rest of their life, is 71 years.

Now, eight years of life lost is a serious thing. And having HIV is not exactly pleasant: there’s stigma, the medication has serious side effects, and even during clinical latency HIV can affect your health. It is best to avoid getting HIV. But with modern treatment you can live long enough to die of something else.

But without treatment the life expectancy of a person diagnosed with HIV at age 20 is not 71. It’s 32. Appropriate HIV treatment buys you literally decades of life.

Being treated for HIV also increases your chance of having an undetectable viral load. If you have had an undetectable viral load for the past six months, evidence suggests, your chance of transmitting HIV to a partner is negligible to nonexistent. That’s right: we can actually eliminate an HIV-positive person’s chance of transmitting HIV.

The problem is that only thirty percent of people with HIV have an undetectable viral load. The biggest cause of this is that many diagnosed people are not in treatment: nearly half of people diagnosed with HIV are not engaged in care. That I can’t do much about. However, the second biggest cause is people with HIV not getting diagnosed, and that I can do something about.

If you are reading this and you are at risk of getting HIV, get tested for HIV every six months.

That means:

  • Trans people and/or men who have PIV or anal sex with trans people and/or men.
  • People who inject drugs.
  • Poly people.
  • Full-service sex workers.
  • People who have vaginal or anal sex and do not use condoms correctly and consistently outside of a committed, long-term relationship with a person (or small number of people in the case of quads and triads) who has been tested and either doesn’t have sex with anyone else or uses condoms correctly and consistently.
  • Anyone who has PIV or anal sex with people in the above groups.

About “correctly and consistently”: perfect use of condoms is not hard. You have to use the condom every single time you have sex for the entire time you have sex, you have to use a condom that isn’t expired or already used or likely to break due to excessive heat exposure, you have to use non-oil-based lube if you use lube, and you have to get a new condom if you put it on backwards first. The most important thing is using the condom EVERY TIME. Condoms do not work if left in the nightstand. However, some of you people are the ones making condoms’ typical use effectiveness rate so much lower than its perfect use effectiveness rate, and if that’s you you need to acknowledge that about yourself and get tested.

Look, I get it. Getting tested is an enormous pain. You have to make a doctors’ appointment or wait in line at a free clinic; I myself have skipped my HIV tests for over a year because I was too flaky to make an appointment. Getting your blood drawn hurts. And lots of people don’t want to admit– even to themselves– that they’re the sort of people who can get HIV, because that’s for other people. People who are dirty or slutty or make stupid mistakes. Lots of other people are afraid to hear the news. If you think something might ruin your life, it’s only natural to try to push it away as long as possible.

But shame, stigma, and denial are not acceptable or evidence-based ways of preventing HIV. They are not worth sacrificing potentially years of your life. They are not worth infecting people you know, perhaps people you love, with a chronic illness. HIV is manageable and survivable but only if you know you have it so please for the love of fucking god get tested.

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