TAMPA — Three years ago, 19-year-old D.W. Swain came down with a severe cough and high fever he couldn't shake.
It didn't occur to him, he said, that he could be HIV positive because his sex life had been limited to a man who swore his love and that he was HIV negative.
But when Swain heard from friends that his former boyfriend was "spreading the ninja" — infecting people — he got tested.
The test came back positive, and Swain discovered that he already had full-blown AIDS. His immune system ravaged, he rapidly developed pneumonia, then nearly fatal kidney and liver failure.
He was shocked to find that a man he loved had knowingly spread a fatal illness.
Just as shocking to Swain was hearing about a few local men actually trying to get the virus that can lead to AIDS.
In gay chat rooms, he had heard of the shadowy world of "gift givers'' — those who knowingly spread the incurable virus — and "bug chasers'' — those who seek it out. The sardonic nicknames describe people who refuse to believe the virus is deadly, or who know it is and don't care who is harmed. Swain had trouble believing such a phenomenon had touched his own community, much less his own life.
More than 100,000 Floridians have HIV. Relatively few — perhaps up to 100 in the Tampa Bay area — are thought to be bug chasers or gift givers. Theories on their motivations vary. Some infectors are thought to be showing their power, or maybe even wreaking vengeance. Virus seekers might think mistakenly that HIV will make them eligible for more public benefits, or that they're proving their love to an HIV-positive partner.
Whatever drives them, their impact, both on people like Swain and on the effort to combat the epidemic, has health officials deeply concerned.
Doctors, nurses, counselors and AIDS educators are bound by medical confidentiality laws not to report to law enforcement the names of those they suspect of intentionally spreading the virus. And even when a person who did not want the virus steps forward to accuse his "gift-giver,'' prosecutors have a tough time proving the charges in court.
So health workers watch and cringe, as more people are infected. Some, like Swain, naively trust their partners rather than practice safe sex.
"I can't believe how stupid I was. I learned the hard way that each of us has to be responsible for our own protection," said Swain, who keeps his condition under control with a daily regimen of powerful drugs.
Now 22 and a college student, the Tampa native works as an AIDS educator, urging others to protect themselves, no matter how convincing a partner's promises.
Plenty of people share Swain's initial skepticism about local bug chasers and gift givers.
Dr. John Sinnott, director of infectious disease at the University of South Florida and Tampa General Hospital, met with a reporter in his office recently to talk about the issue.
"Urban myth, I suspect," he said. But he picked up the phone to ask a colleague who works more closely with AIDS testing and programs.
Dr. Todd Wills, associate professor of infectious diseases at USF, came on the line.
"They're out there,'' Wills said. "We can't say what the numbers are because the evidence is not data driven, but anecdotal."
Sinnott: "How many in this area — 100?"
Wills: "That's high. But possible."
Sinnott: "Really? I had no idea."
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease Department at the National Institutes of Health, said he is "not surprised" to hear of the phenomena because he gets similar reports from all over the country.
He said he is baffled by people's cavalier behavior because HIV can still cause deadly AIDS even though drugs have been developed to keep it in check. Patients might have a viral strain that develops resistance. The powerful antiretroviral medications are toxic and can damage the kidneys and liver, or may conflict with drugs needed for other conditions. Patients often suffer from depression, drowsiness, nightmares and odd redistribution of weight. Opportunistic infections, such as pneumonia, and of course death, are real possibilities.
"I have never talked to anyone who became HIV-positive — regardless of how it happened — who didn't say they would rather not be infected after it happened," said Fauci.
In 2009, 1,232 people died of AIDS in Florida.
Most AIDS educators and health care workers don't like to talk about bug-chasing and gift-giving. They fear these few people only add to the stigma that the HIV community already experiences and could even cause more cuts to already dwindling public services.
But the behaviors have been documented in medical literature and popular media.
In 2003 on CNN, documentary film maker Louise Hogarth talked about her film The Gift, which featured bug chasers. She called them a "fringe group" with "misperceptions about what it means to get infected."
The film was followed by a controversial article in Rolling Stone magazine about bug chasers and gift givers in San Francisco. The story led to Internet debates and a 2004 Centers for Disease Control and Prevention workshop.
At that workshop, a presenter said he had heard getting infected described as "the gift of the positive brotherhood."
In 2006, a BBC documentary called I Love Being HIV+ chronicled the filmmaker's experience of going on a gay dating website, announcing he was HIV positive, and receiving dozens of requests from men wanting unprotected sex so they could get the virus.
The Times asked local AIDS workers to put the newspaper in contact with people trying to contract the virus, but none would speak for the record.
Johnnie Hurst is director of Brothers Making a Difference, an AIDS testing and education center in Tampa. He met D.W. Swain when the young man sought counseling after his diagnosis.
Around the same time, Hurst noticed that the man Swain had identified as his former lover began coming in about once a month, each time bringing in a different young man to be tested.
When a drop of their blood in a vial of chemicals formed the dark line showing them to be HIV positive, most doubled over sobbing, said Hurst. Meanwhile, the man Hurst now calls "the notorious gift giver" feigned surprise and hugged them, smiling behind their backs.
"He seems to get off on their vulnerability," said Hurst.
Hurst said he has seen this scenario unfold at least 10 times.
He said he also sees young men, who get positive test results, pump their fists triumphantly while yelling "yes" or "finally."
People who actually seek out the virus aren't taking its consequences seriously, said Andrew Maldonado, AIDS officer for the Hillsborough health department.
"They think all they have to do is take a pill and the benefits outweigh the downside," he said. Some think getting the virus proves their love to their HIV-positive partner, and gives them a sense of belonging to a community, even one defined by a deadly disease.
More common, he said, are those who seek the virus because they believe a bonanza of services, from free housing and food to a visiting nurse, awaits them.
"They'll say things like 'Okay, time to get the services rolling,' " Maldonado said.
But services, which were never abundant, have since dried up, or require lengthy waits to obtain, he said.
"What we are trying to do is educate bug chasers about the truth — that they are wrong on all counts," said Maldonado.
A United Nations policy brief in 2008 said purposeful HIV infections are rare, but that "the resulting harm justifies punishment."
Governments around the world have enacted laws against intentional HIV infection.
Hillsborough County State Attorney's Office records show that from 1996 to 2010, charges were brought 91 times against suspects for "criminal transmission of human immunodeficiency virus infection." Of those, more than 30 resulted in convictions.
Local prosecutors say it's difficult to stop a gift giver because they usually can't prove who had sex with whom and who infected whom.
The first big hurdle, said Pinellas-Pasco State Attorney Bernie McCabe, is finding out who the infectors are, then proving they knew they were HIV positive and failed to tell their sexual partners.
The next hurdle is proving the target was infected by the gift giver, not someone else, and then proving the victim didn't know the infector was HIV positive.
McCabe could recall only one case in Pinellas that was successfully prosecuted in the past decade.
"It's not an attractive situation for a prosecutor," he said.
Biology adds to the legal problems. "The virus mutates after infection, which makes it very unlikely that it could be tracked from one person to another," said National Institutes of Health spokeswoman Melanie Padmanabhan.
But Polk County Assistant State Attorney Chip Thulberry said convictions were not impossible. A few years ago, his office convicted a man for criminally spreading HIV.
"The prosecution has to start with a victim coming forward and complaining,'' he said. "That's the first step."
A video plea
After he was well enough to get out of bed, Swain made a YouTube video addressed to the man who he says infected him.
He begins by saying he forgives his former lover. His smooth young face overcome with sadness, Swain looks away, then stares back at the camera. He mentions another friend who, he says, fell prey to the infector.
Swain laments his own dashed dream of military service. He tells his infector: "You repulse me."
Then, his face softening, he concludes: "Be up front with people. Realize what you're doing to people before it's too late."
After the video appeared online, Swain said his infector called and threatened to sue him if he divulged his name.
Even though he was not a health worker when he was infected, Swain maintains his current employment means he can't divulge his infector's name.
"But if subpoenaed, I would," he said.
As an AIDS educator at Youth Educational Services in Tampa, Swain said he has met five more young men in the past year-and-a-half who say they were infected by his former lover. They also say the infector claimed to be HIV negative.
"We hear he's having unprotected sex with women now," said Hurst.
Last month, a young man came into the clinic where Swain works. He knew Swain's HIV status, and asked him to have unprotected sex.
"A bug chaser," said Swain. "I can't sleep at night just thinking about it."
Times researchers Caryn Baird and Carolyn Edds contributed to this report.