Annette Perez never believed she had a reason to get tested for HIV/AIDS.
“Why would I?” she asked. For 21 years, she had been in a monogamous relationship with a man she trusted.
Of course they had couples’ quarrels, though they never fell out of love. But the romance began to crack when Perez’s partner began to ask: “Have you gone to the doctor?”
“Why would I need to see the doctor?” she thought. “Why does he keep asking?”
Soon after, she developed a rash of cauliflower-like clusters on her body, and told her primary care physician at NYC Health + Hospitals/Bellevue. When the prescribed medication didn’t help, she was then referred to Sonia Rivera, a Public Health Advisor in Bellevue’s Virology Clinic.
Rivera conducted a 20-minute HIV test that required wiping a cotton ball in Perez’s mouth for a saliva sample. The mouth swab was followed by questions to assess risk of contracting a sexually transmitted disease. She could hardly answer without crying.
Within minutes on World Aids Day 2016, Perez was told that she was living with HIV.
“All I wanted to do was jump out the window,” Perez said as she broke down in tears. “Why put burden on my family? Why put shame?”
Inside the exam room, Perez erupted into a mix of sadness and rage. She punched cabinets, wailed and fell to the floor. Rivera, the Public Health Advisor, immediately called a therapist to help compose her. Perez’s two daughters were told to rush to the hospital to meet their mother. When they arrived, Rivera helped explain the HIV results to the family. Together they cried, and fell on one another for support.
During the discussion about the HIV diagnosis and treatment options, Perez and Rivera discovered they shared a similar faith. They prayed, and it calmed Perez and her daughters. It gave them hope, Perez said, to take one step forward into tomorrow.
“I saw that it wasn’t the end of my life, but a new beginning,” she said. “If you love yourself, people will see. I’m fighting. I’m strong.”
Perez is one of more than 14,000 patients living with HIV who receive comprehensive care at NYC Health + Hospitals. The health system continues to fight the virus by providing testing and treatment, including PEP and PrEP to prevent transmission.
Clinicians focus on treatment and eliminating stigma, Perez said, and their efforts emphasize knowing your status. With that knowledge, you can take steps to stay healthy, she said.
“There’s no judgment here,” she said. “They don’t treat me like a disease, because I’m not.”
Six weeks after being diagnosed and starting antiretroviral therapy (ART), Perez’s viral load was undetectable, meaning that the amount of HIV in her body is so low that it cannot be transmitted nor can it appear in lab results.
For Perez, who has eight grandchildren, her priority is now staying healthy. She continues treatment and keeps regular appointments with Angelica Kottkamp, MD, an infectious disease specialist. Dr. Kottkamp said she worked closely with Perez to understand her medical history and her physical response to medication. Together, they discussed Perez’s lifestyle and health care goals before creating a treatment plan that was unique and best for her.
Dr. Kottkamp helped Perez feel comfortable and answered questions she had about care. Speaking about sexual experiences is not always easy, Dr. Kottkamp said, especially when dealing in trauma from a past lover.
“I listen to patients, not just as a doctor, but as a human being,” Kottkamp said. “I worked with Annette to build trust. Gaining that connection in whatever amount of time it takes is very important.”
Perez said she felt that connection with every doctor, nurse and social worker she encountered at Bellevue. When she walks into the clinic for her appointments, staff greet her like family with laughter and warm hugs. She feels compassion and the strength to move forward with her life.
“People who are positive and believe in you give you power to go on,” she said. “The Bellevue staff gave me the lift I needed, along with my daughters.”
“It feels good when someone tells you that you’re healthy,” she said, “and I know that I am.”
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