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"We've just seen a lot more couples express this issue," says McLeod, a social worker and advanced clinical practitioner who has worked in the field of HIV for more than a decade. "We've got to listen to the beat of the drum and respond."
When Ron Drumm moved home to Houston five years ago after living in San Francisco for 20 years, the last thing he thought he would do was date someone who was HIV-positive. In fact, he barely wanted to have any kind of relationship at all.
"I went through a period where I thought I was the angel of death, because I had seen so many people through to the end," says Ron, 52. While working as a bartender, Ron dated and befriended many people who eventually succumbed to the virus. Having been in relationships where honesty had not been a prerequisite, he was getting tested every four months and felt like he was "sitting on top of a barrel that was about to explode." Finally, he felt like he couldn't handle one more death -- especially his own. So he retreated to his hometown of Houston, HIV-negative and determined to be by himself, at least for a little while. For almost a year he lived with his brother, went to work and rarely ventured out socially. He just shut down, he says.
But one evening a co-worker suggested a drink after work. Ron, who didn't have a car, accepted the offer and the ride. At the bar, Ron saw Thomas. The two started talking. When Ron's friend got ready to go, he asked if Ron would need a lift home.
"But Thomas said he would make sure I got home okay," says Ron, laughing. "Now we're starting our fifth year."
That very first night, Thomas says, he told Ron about his HIV. He had tested positive in 1987 and lived in an AIDS assistance facility. The fact that Thomas was honest right off the bat, something Ron had not experienced in other relationships, was enough to make Ron wonder if he could fall in love again.
"Thomas had a lot of the same values I have about coming into a relationship," says Ron, a soft-spoken man who works in inventory and delivery for a local florist. "My values were centered about creating a home space, having the security of someone to go through all those things with."
Thomas, an extreme extrovert who speaks in a fast clip and peppers his conversation with jokes, says he knew right away Ron was someone he was interested in.
"I want you in my life because you add to my life," the 40-year-old says in a rush. "You have to be loving and caring and fabulous and vivacious. I just like beauty. Things like flowers and piglets and angels and Ron Drumm."
Ron and Thomas dated for about a year, spending lots of time together and getting to know each another. Ron liked to stay in and be a homebody, Thomas wanted to go out a lot. Ron liked horror movies, Thomas chose drama. Ron enjoyed bowling, Thomas preferred to be "the pom squad" and watch from the sidelines. But they both say they enjoyed being together so much and cared about each other so intensely, they knew the next step was to move in together.
"Honesty was what I demanded," says Ron, of his ability to enter back into a relationship. "I can trust him further than anyone I've ever known in my life. And I knew that. And I fell in love with this person, and HIV is a part of him. So I learned to embrace that too, just like he does."
Ron and Thomas became an ideal example of a mixed-status couple who made it work. Amid good discussions about how they were feeling and what they were thinking, they decorated their new home together.
"I like things, as Ron says, 'nelly,' " says Thomas with a laugh. But they compromised. Ron's bathroom was a subdued Santa Fe style. Thomas's was done up in piglets and angels. Ron did some dark green stenciling around the dining room table. Thomas, a florist, wanted to put greenery on anything that didn't move.
And as far as intimacy, there was never any question from the beginning that it would be safe. Because of the risk of transmission, "with many couples, the sex life goes to hell," counselor McLeod says. "And getting people to talk about sexual problems is always a problem, even without the HIV." But Thomas and Ron did discuss it, and unsafe sex is not an option for them.
"We've always, always practiced safe sex," says Thomas. "We can't even use the excuse of drinking. I don't drink, and I'm going to make sure he has a rubber on. Period." In addition, Ron still gets tested every six months.
And while the experts say it's common for mixed-status couples to fall into an unhealthy "nurse-caretaker" relationship -- taking away from the mutual caretaking and other ways of relating that go on in couples where HIV is not a factor -- Thomas says Ron never babies him. In fact, he says he became the caretaker, preparing dinner, decorating and mixing up fresh chicken soup for Ron when he was feeling under the weather.