30/10/2014 10:55 GMT | Updated 29/12/2014 05:59 GMT

Positive Damage: HIV and the City

In January 2010, at the age of 24, I received the shock news that I was HIV positive. I was devastated, left speechless and numb. I found out over a lunch break appointment at the STD clinic and, having experienced no zero-conversion symptoms, was completely unaware I was HIV positive. Upon my return to the office that afternoon I hid the news, avoiding conversation whilst trying to appear occupied with emails. I left early and, still in a state of confusion, made my way to the gym. I didn't want to stop being a muscular, fun and happy young man, but was overwhelmed by sadness, experiencing a sense of loss as powerful as grief.

That night I told my friend Joe about my HIV. He was the first person I told and I went to bed feeling composed, sleeping remarkably well. However, the next morning, with a mounting sense of apprehension, I made my way to the office. It was difficult dealing with the platitudes at work, colleagues chatting about the weather and a quiet evening at home, while I was battling the emotional turmoil of having been diagnosed with a petrifying illness. I felt like the emotionally isolated and desolate figure in Edvard Munch's expressionist masterpiece The Scream, my soul in agony, but caught in a vacuum of silence.

Overwhelmed by emotions, I hid in an adjacent office. I broke down, my sadness manifesting itself in floods of tears. I was frightened in case anyone walked in and found me crying, potentially resulting in the discovery of my illness. The next week, preceding my initial appointment at the HIV clinic, was one of fear and, to a limited degree, suspense, as I was anxious to learn more about my condition, its potential impact and what my options were regarding treatment. Uncertainty was heightened and confusion compounded by the pressure I was under to conceal this from my employer. I took the morning off, lying and saying that the medical appointment was in relation to the removal of a mole. Somehow skin cancer seemed more respectable!

My friend Anthony came with me to the HIV clinic and I recall my composure slipping when a trainee nurse struggled to find a vane, missing eight times. The next shock came when, in the middle of the consultation, I was informed that I was not only HIV positive, but also co-infected with Hep C. The same nurse, ten minutes earlier, had reassured me that HIV was completely manageable, but had warned that I needed to be careful not to contract Hep C, as this could trigger complications. The nightmare was never ending! Afterwards, tired and lethargic on account of the numerous vials of blood which had been taken, Anthony took me to a cafe, buying me some sugary food. I ate slowly, gradually returning to normality and, registering the gravity of the challenge I faced, I struggled back to the office. A flawlessly bright blue sky was suddenly overcast, its horizon no longer panoramic, but opaque. I hid my pain in silence.

Over the next year my career continued to progress well; however, despite having great supervisors, I felt I couldn't tell them, or confide generally in the workplace, regarding my HIV. Few people are comfortable disclosing their HIV status in the workplace and certainly not in investment banking, at international law firms, large accountancy practices, or other City institutions. I was concerned there would be misunderstandings regarding my health. I didn't want to place colleagues in an awkward position and had to make excuses to attend medical appointments. Secrets, by their very nature, are burdensome and, although I was not ashamed of being HIV positive, being furtive about my illnesses in the workplace reinforced the sense of stigma I experienced, making it harder for me to come to terms with my diagnosis.

I was so disheartened that I would cry in the bathroom cubicles, lying in a foetal position, cradling my head on the cold limestone floor, my Gucci loafers pressed against the door. In 2011 I was seconded to the New York office, a time of great excitement. There were a number of international secondment destinations, some, like Singapore, with mandatory blood tests for HIV. In Singapore a blood test is required for any foreign national staying longer than 30 days, those with HIV expelled. The USA changed its immigration policy in 2010, no longer requiring travellers to declare their HIV status, which was a huge step for equality, discrimination no longer enshrined in law.

Upon my return to London, as an associate, I specialised in bond issuances, doing long hours, but enjoying the quality of the work. At the end of 2012 my CD4 count plunged, triggering a period of anxiety and depression. After initial infection patients are not treated with antiviral medication until their CD4 count falls to around 350, some people remaining healthy for up to ten years before their CD4 count falls and antiviral medication is required. I managed three years, which is about average, going on darunavir, ritonavir and truvada in January 2013. The medication is highly effective and within a month of going on treatment the physical decline in my health was reversed. I was open with the partnership and HR from the end of 2012 regarding my HIV and, from the beginning of 2013, was completely open in the workplace. The partners and HR were supportive, but there were issues with some of my colleagues, centring more on a lack of understanding rather than prejudice. This was an empowering process of acceptance, a second coming out as important regarding my identity as coming out as gay had been a decade earlier.

My autobiography "Positive Damage", describing the journey by which I came to terms with my HIV within the context of financial services, is out at the beginning of next year.