Photo by David Fulde/www.fulde.ca

Being a broad of a certain age who was a product of the sixties revolution, our motto was sex, drugs, and rock ’n’ roll. We fought for sexual freedom—and won!

Then AIDS hit. I was twenty-something and, well, had been ’round the block more than a few times. Am I ashamed? Heavens no.

But I often wonder what it was like coming of age in the shadow of AIDS—the often terrifying fear some felt about acquiring HIV, before they had even had sex.

I found answers to these questions in Canada! Scheduled to attend a seminar given by the AIDS Committee of Toronto (ACT), several days before I departed, I remembered my dear friend, Dr. Marc Narayansingh (Na-rine-sing) lived up there! I phoned him and Marc invited me to hole up with him at his townhouse in the Annex, a downtown Toronto neighborhood, near the University of Toronto.

ACT, an organization Marc strongly supports, is dedicated to the reduction of new HIV infections in the city they call “Hollywood North” (countless productions are shot here because it’s cheaper than LaLaLand) or “416” (their area code). Toronto has many more nicknames!

Dr. Marc, as I often call him, was raised in Winnipeg and has roots in Trinidad. This learned guy is a neurologist and sleep specialist. Can you give advice to this insomniac, Doctor?! Over time we’ve had conversations about his fear of HIV that he says stunted his sexual maturation. I want to pry more!

During his first two years of medical school, Dr. Marc worked at the National Microbiology

Illustration by Davidd Batalon

Lab (NML) in Winnipeg. His research project, under Dr. Frank Plummer, focused on looking at human genetic factors that determine HIV susceptibility among sex workers in Kenya. Dr. Plummer’s research focused on the Pumwani Sex Worker Cohort in Nairobi, Kenya. Members of this group have displayed variable responses to HIV exposure and infection. Some women rapidly acquired HIV and progressed to AIDS, whereas for others it took many years, and in some cases infection never occurred despite repeated exposure. It was postulated that both HIV viral factors and human genetic factors could explain this variability. “HLA (Human Leukocyte Antigen) proteins are responsible for presenting parts of a virus to the immune system, subsequently priming an effective response to that infection. There are many subtypes of HLAs that exist in all humans, but each individual carries only a few such subtypes. My work used the blood of these women (I did not work with them directly) to see if certain HLA subtypes were more commonly found in patients that rapidly progressed, slowly progressed, or remained resistant to HIV/AIDS.” explains Dr. Marc.Fascinating study.

Today is Sunday morning and it’s a “free” day for both of us. After he whips up a yummy brunch (eggs Benedict, mine without ham), we have a tête-à-tête in his inviting dining area.

Ruby Comer: [Marc corks-off a bottle of white, and pours.] Your digs are minimalist fashionable. I like it. Simple but tasteful. No clutter. [He smiles in appreciation.] Okay, my dear, what’s your life motto?
Marc Jevan Narayansingh, MD:
The pursuit of happiness seems to be one of the main driving factors of my generation. I’ve learned that happiness is not a destination, but the product of the journey itself. My life motto embraces the worthiness and importance of this journey.

Divine! Let’s talk your generation. I know you first kissed a woman at age twenty-three and your first male smooch was at twenty-nine. I wanna hear more!
I…forgot…I…told….you…that. [He chuckles to himself.] I had no sexual relations with women, as it didn’t interest me. My first gay experience was, yes, at twenty-nine, when I finally accepted myself as a gay man. That first experience is somewhat of a technical question and depends on your definition of sex. Overall, gay sex for me has been staccato and very tempered by fear of HIV.

Let’s talk about this. I’m sure many people can relate to your emotions.
I belong to the generation that hit adolescence during the nineties. At that time, the nature of the disease was generally understood. Sexual education and public opinion urged safe sex. However, with that message a heavy dose of fear was implanted: sex could kill you. And, as this disease was largely associated with gay men, I interpreted that message as: gay sex—that thing I was already so ashamed of desiring—was deadly and best to avoid.

Without a doubt…chilling.
This led me to the conclusion that gay sex was a punishment.

[I take a sharp inhale, feeling his pain.] You’ve worked through this.
Tell me.

It has taken the better part of two decades to dispel this myth by confronting my internal homophobia and embracing the fact that the need for love, sex, and companionship transcends the details of sexuality.

A part of your journey was to extinguish the fear of HIV.
Sex carries risk. I know this from observation and through my work as a physician. This fear led to starting PrEP about two years ago as a way to reduce anxiety and allow for sexual expression. It’s been integral in resolving this disconnect. It also effectively reduces the risk of transmission by over ninety percent with regular use. My feelings towards sex and my own sexuality have been transformed.

Whoa, Marc. Thankfully an answer came, and what a journey for sure. When did you first test for HIV?
[Suddenly and silently, Marc leaps up, lifts up his glass, and motions for me to follow him upstairs. We head out onto his top floor terrace. The weather is tepid and luminous. He settles into the contemporary woven patio loveseat, looking out through the heavy-leafed poplar tree to the old, shiny, red-bricked Victorian houses that line the street.]

Let’s see. [Dr. Marc recalls my question, collecting his thoughts.] It was during my neurology residency in the 2000s that I took the HIV test. I was not sexually active, but I had worked in the HIV labs in my early twenties and had contact with positive patients on the wards. Even though I had virtually no chance of acquiring the virus from these contacts, I still had an irrational fear of what would have amounted to an “immaculate infection.” I still believed that being tested was an important first step. Testing was part of healthy sexual behavior and I wanted to demystify that process. [He breaks.] Now that I am on PrEP, I get tested every three months, as recommended.

Sounds like a good plan, Stan! So when you date, Marc, how do you bring up STIs?
[He strokes his designer stubble beard with one hand, while the other grasps his wine goblet resting on his lap. Marc then announces] I believe first and foremost, we are all responsible for reducing our risk of STI exposure through: education on the nature of these diseases and the risks associated with various sexual activities, routine testing, understanding of the risks and benefits of all prophylactic options, and knowing where and when to get help if a concern arises.

Smart. There’s the right way, and then there’s every other way.
Ideally, part of this process should include a frank discussion about sexual practices and consent between partners. Open communication is never a bad thing. However, I understand that there may be situations when such communication is not feasible, which again highlights the importance of being responsible for one’s own health.

Photo by David Fulde/www.fulde.ca

Key me in on your South Asian descent, like its cultural understanding of the epidemic.
My family is from the Caribbean island of Trinidad, where same-sex sexual intercourse was decriminalized in 2018. [My face reins in shock, and my baby blues pop.] This is a huge step forward to a culture steeped in homophobia and toxic masculinity. LGBT citizens still continue to have fewer rights than their non-LGBT counterparts. I can only imagine that this inequity is further amplified among those dealing with HIV.

Of course, we have citizens in America with this horrifying attitude as well….
The cure for ignorance, in my mind, is always education. The lack of exposure and a failure to see the humanity in any misunderstood group leads to hatred and fear.

You are right as rain. Say, what’s the best thing about being a doctor?
Sleep is such a fundamental part of being human, and so many suffer with sleep issues. Through providing guidance and treatment of their sleep disorders, I can make a tangible difference in the quality of my patient’s life. Once their sleep improves, you can see changes in personality and mood, productivity, and the strengthening of relationships. It can be truly resurrecting in some cases.

Help me, Doc; help me, Doc! [He grins, exposing his ultra-white teeth. I’m envious. Marc also knows my sleep issues and has thrown out some remedies, using behavioral therapy.] Just how do you feel about turning forty this year? [I mutter lowly, with a sly grin.]
Age is a matter of perception. And sure, a fulfilling life at forty will not look the same as it did at twenty, but that’s the challenge: How does one redefine what it means to be present and vital as a human living in their forties, or for that matter at any age? [He lets out an animated childlike giggle.] This challenge excites me, Ruby!

One last thought. As gay men, we all are connected by the struggle, and we need to remember that. We work best [he pauses, his walnut-hued eyes divert directly into mine, then Marc peacefully exhales his last word]…united.


With gratitude to Kirk Dangler for his exquisite eye for detail!


Ruby Comer is an independent journalist from the Midwest who is happy to call Hollywood her home away from home. Reach her by e-mail at [email protected].