Big Deal

Offering advice to a friend who tests positive

by Jim Pickett

I heard from a friend the other day, someone I had not spoken to or seen in quite some time, years actually. We just hadn’t been in touch, not due to a lack of friendly feelings for one another; rather a result of the different orbits in which we travel.

A little younger than my 41, he’s gay, really funny and super smart—a great guy.

He was looking for some advice as he had just tested positive for HIV.

This was relayed to me in a voice message. I had not answered my phone when he rang, as the number from which he was calling was coming up unknown—he had blocked it. I listened to his voice, and despite this news, he sounded fine, he sounded like himself, but what he said really struck me. I felt sad that this had happened to him, and was a bit shocked, as I guess one always is, when a friend who has navigated the mine field for so many years comes up positive. As it turned out, his last negative test was at the end of 2006.

We played a bit of phone tag over the course of more than a week, and finally connected over a recent weekend. My friend had lots of questions. He wanted to know what I thought about his t-cell count and viral load—both his first. Ah, you always remember your first, don’t you? They weren’t great, but not catastrophic either. He wanted to know about the meds—what I thought about “hitting hard, hitting early” and the side effects. He wanted to know if I thought he needed to get started.

He wanted to know if the meds were going to make his face sink in, and give him “the look.” The prospect of wearing HIV all over his face was not appealing.

And he wanted to know if he would be able to lead a normal, happy life. And he wanted to know how long he might expect to live this normal, happy life, if indeed normal and happy were possible.

He was worried, concerned, and not to put too fine a point on it, scared.

I listened and offered him my empathy, “expertise”, and sense of humor as I tried to reassure him that he was going to be okay, he was going to get through this, and right now he simply needed to think about taking care of himself mentally and emotionally while allowing himself to go through the phases of grief that invariably come with an HIV diagnosis.

“Above all, be patient and kind with yourself right now,” I told him.

I also gently suggested that while he didn’t need to tell the world he was HIV-positive, and that disclosure was a very personal thing that we all must deal with in our own way and in our own time, at some point he would need to “tell” his insurance company. He had been paying for this initial blood work and doctor visits out of his own pocket, wary of putting it on his insurance and having them find out his status. I told him I understood how he was feeling, but the cost of his care and treatment needs would certainly put a huge burden on his bank account, and would be unsustainable. That’s what insurance is for, hello! While many Americans have crappy insurance, I knew his was not.

Now, none of this is remarkable, right? Many of us have been down this road, are on it right now, thanks. My advice was nothing special or earth shatteringly original. My jokes had been told before. Of course, for my friend, all of it was completely new, and thoroughly overwhelming and frightening. Remember? But again, we’ve all been there, bought the t-shirt, and can now recount funny stories around the campfire about how we thought we were going to DIE TRAGICALLY in those initial days—boy, were we drama queens!

He would and will survive. There will be some dark and confusing days ahead of him, pangs of regret and worries that do not pass, bouts of nausea and perhaps some explosive diarrhea, but he will be alright

What is illuminating to me in all of this is the fact that my friend is a medical doctor, with a great salary, a roof over his head, friends and family who love him, assets, and stability. He has his health, and will likely be able to keep it with the access his position in life affords him in terms of high-quality care and treatment. And hello again, he’s a DOCTOR. He can understand all this stuff better than most of us, right?

A large percentage of people who test positive for HIV have none of these things, are not supremely situated to take a hit like this.

With the CDC, policy makers, the medical establishment and many AIDS service organizations in a headlong rush to eliminate counseling and consent in a misguided effort to expand HIV testing, and test, test, test, test, test, TEST, it is the INDIVIDUAL who is forgotten in the hysteria.

My friend.

Testing positive for the virus that causes AIDS is still a big deal, even for someone who seemingly has everything he needs already in place.