‘Aging with HIV: A Gay Man’s Guide’ by James Masten; James Schmidtberger

At last, the book we’ve been waiting for. By “we” I mean the hardy gay survivors of the AIDS crisis—men like me. I reckon I’ve lived with HIV/AIDS for well on 30 years now. I spent my youthful 20’s in San Francisco during the rollicking sexual liberation era of the 1970s. You do the math.

How could any of us known what was shortly to befall? Taking a huge swath of an entire generation not so gently into a nightmare of painful suffering and premature death.

Some of us made it through the eye of that needle, however, until the advent of palliative drugs in the mid-1990s. While still no cure, protease inhibitors and other newly-coined medicines have greatly slowed the fatal course of the HIV virus. This has put fresh wind into our sails and will even make old age possible. While deeply grateful to be among the living—and among a rather exclusive clan of courageous storytellers—there are now new challenges to be faced. In Aging with HIV: A Gay Man’s Guide (Oxford University Press) author-researchers James Masten and James Schmidtberger address these complex issues with compassion and alacrity—and not a moment too soon.

With early death no longer a certainty, the big question of how well we’re going to live is foremost before a generation of gay men now into their 50s and 60s. We made it this far, so now what? Historically it has been a grief-stricken, unknowable, vertiginous ride through three decades of one of the worst global health crises of the Twentieth Century.

The influenza pandemic of 1918/1919 took an estimated 50 to 100 million lives around the world, but then the number of new cases suddenly dropped, attributed to, among other reasons, better preventative care. The HIV virus was officially identified in 1981 and still continues its grim march though the world’s populations—mostly in those places without proper education and treatment—with no end in sight.

The gay men interviewed in Aging with HIV do not claim any solution to the vast problem of HIV-AIDS, but they do possess a treasure-trove of coping mechanisms and survival skills which the authors wisely dip into and share throughout the book.

Rather than writing a medical tome, they have created a reader-friendly guidebook aimed at helping AIDS survivors stay alive and fit. They naturally start with the “shock and awe” aspects of the plague—how it took so many in such rapid succession. “Hopefully I can talk [about this] without becoming too emotional,” says one of the 15 middle-aged gay men interviewed in the book. “Because all my friends are dead and I just didn’t think I would see 40. And I’m 50.” But then, thankfully, the authors quickly move on to the places where hope and possibility remain as steady as a heartbeat.

Following chapters about the physical changes hastened by HIV, one’s sexuality, issues of love and marriage, relationships both familial and friendly, work and career, and healthcare bureaucracy are concisely and neatly addressed. Useful facts and research reviews are set apart in highlighted boxes. So too are helpful questions presented as personal reflections—they invite us to step-up to the mirror of self examination. This device makes the book at once a source of timely information and a life coach. We’ve come this far, step by step, with no small measure of luck and love assisting us along the way. So now, what are the future tasks ahead?

There are no easy answers presented here, just a whole lot of companionable advice and collective wisdom from those who truly know. Aging in general “is not for sissies” (as it’s been famously stated time and again), but aging with HIV presents its own unique set of challenges—and yes, rewards—if only we can let that happen.

If for nothing else, I appreciate and applaud this book for the hearty thread of optimism woven throughout it. But Aging with HIV is about so much more than just lessons of pluck and endurance. Like our survivors’ lives, the ultimate story and its final conclusions are greater than the sum of its parts.
A Gay Man’s Guide
By James Masten with James Schmidtberger
Oxford University Press
Paperback, 9780199740581, 225pp.
January 2011