We’ve all heard about the tricky issues that arise when two people in a relationship have different HIV statuses. But dope-discordance -- my term for couples with different experiences with drugs (such as addict/nonaddict or user/nonuser) -- is equally complex. And dope-discordance on top of serodiscordance has often led to life-discordance for me.

Let’s start with Joe, who’s been down the same road of drug use and crime as I have. We didn’t always get along, but we always understood each other. I could make critical comments to him peppered with references from my old life, like “What a citizen!” about some complete idiot without a clue as to what is really going on around him. Joe knew what I meant. He was also magnificently supportive of my health -- because he was so afraid that I would die and leave him alone -- and he had the energy and money to watch over me in style. Every week he trotted me around to the acupuncturist, massage therapist and chiropractor. Twice when I was too sick to walk, he carried me up and down four flights of stairs four times a week to my appointments. And when I got well and wanted to climb mountains, he came along even though he was afraid of heights.

Unfortunately, though Joe and I shared dope pasts, we were dope-discordant. I was sober, energetically following a 12-step program that he despised. When I discovered him shooting dope in my bathroom one night, I put him right out. That might seem cold -- to the uninitiated. But I knew that he would get me high long before I would get him sober. Joe claimed that he started on dope again because he was sure that I was going to die, and he wanted to blow up the relationship before that happened. Six years later, I’m healthy, while he is seriously ill with liver disease and wondering at the irony of it all.

Which brings me to my current relationship: Ajax is a white-bread country boy from New England. A dedicated rock climber and environmentalist, his choices in life, like his commitment to corporate social responsibility and his relationship with me, make him somewhat of a rebel. On the day we met climbing, he never considered for a moment that I might be HIV and hepatitis C positive, or that I’d led the life of a criminal dopefiend. And I didn’t tell him, either. As far as I was concerned, he didn’t need to know: We were just climbing buddies. Only later, after we’d gotten close and sex was imminent, did I sit him down and say, “Before we go any further, I have to tell you something.... I’m HIV positive.” Amazingly, he said the right thing: “That must have been tremendously difficult to say. Thank you.” Spontaneous safe sex followed, if there is such a thing. And over the last four years, Ajax has done his best to become a part of my life. Though not an alcoholic, he gave up alcohol and pot a short time after we got together and has supported my going to AA as often as possible. He thinks it makes me a better, saner person -- and he’s right. Still, I’d give our dope-discordancy mixed reviews.

As I related to him some of my life-defining, if unsavory, dopefiend experiences -- at least the ones the statute of limitations has run out on -- he seemed to process these stories as if watching TV, without understanding or empathy. I began to feel lost and alone, and I missed that look of complete identification I had with Joe. While I believe that Ajax would rise to the occasion and care for me if I became ill, he has difficulty relating compassionately to my day-to-day HIV challenges, whether emotional or physical. Somewhere along the line he became convinced that I’m able to care not only for myself but for everyone else as well. It’s great to be seen as strong, but somewhere inside I feel that my diseases make me special and that any HIV negative person I’m with should treat me special. On bad days, this dynamic leaves me feeling unloved. On the other hand, Ajax didn’t deal with his fear of my getting ill by going out and shooting dope, like Joe; he got a job working in AIDS and learned everything he could about HIV treatment.

All in all, I trust that the relationship I’m in now is the right one for me if I want to stay sober. The fact that Ajax isn’t like me means we don’t share the same flavor of dysfunction. But I can turn to my AA buddies for the support and insights I need about my past. Ultimately, I want to spend whatever time I have left with someone who enhances my quality of life, while fighting to stay in accord with the only person who truly understands me...HIV positive, dopefiend me.