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A Second Bush Presidency in the Third Decade of HIV: Now What?

What does the re-election of President George W. Bush mean for the mental health of people living with HIV/AIDS? That’s a complicated question. While certainly not all people living with HIV in the United States were supporters of Bush’s challenger, Senator John Kerry, many (some would say most) were, because Democrats have traditionally been the party more of a friend to PWA’s than Republicans. This is probably because many people living with HIV/AIDS (PLWH/A’s) are gay men, people who live in urban centers, women, young people, people of color, and people with strained resources and inadequate access to full health care – all Democratic strongholds. So the reelection of Bush, probably, represents an enormous sense of disappointment for these constituents and their interests. In addition to disappointment, there may be shock: How could Kerry lose after “winning” three televised debates, Bush’s approval rating being below 50% before the election, the US experience of a net loss of jobs 2000-2004, and a major, controversial war in Iraq? There also may be helplessness and even rage. And, certainly, a fear that new Bush policies in a second term will practically guarantee that PLWH/A’s needs will not be adequately met over the next four years.

For many living with HIV, the disappointment and shock of the election’s results can easily give way to depression. One genesis of depression is when a person desperately wants to escape or change a situation, and yet is helpless to change it. These frustrated efforts then give way to despair. This must be how many Kerry campaign volunteers from the HIV, LGBT, and other minority communities have felt in their fight, seeing their hopes go up in smoke like prescription drug access reform, increased access to a full range of health care services, threatened reauthorization and funding of local Ryan White CARE Act services (which the new Republican-majority House and Senate will vote on in 2005), HMO reform, immigration policies, and certainly the threat or real loss of civil union and domestic partner rights in states that approved ballot measures to not only prevent gay marriage but to strip legal status of civil unions and domestic partnerships as well. Unfortunately, there are many potential new policies of Bush, and lost potential policies of Kerry, to mourn that affect many lives in very real, personal ways. What isn’t loss, which contributes to depression, can be the threat of loss, which contributes to anxiety.

In both depression and anxiety, we must mobilize our internal cognitive resources to cope. This means we must change the way we think, in order to change the way we feel. One of the best antidotes for anxiety is to take an action – any action – that proves to our inner selves that we are not helpless. People can focus on the positive things that are still left in their lives – seeing friends, spending time with family, and trying do rewarding and productive work. They can become active in local politics such as serving on consumer advisory boards, boards of directors, and volunteer campaigns for Congressional elections in two years. If they are gay or bisexual, they can come out to family, friends, and colleagues – which has proven to be effective in influencing socially conservative people away from voting for Draconian antigay measures if they know someone personally close to them who is LGBT whose life would be negatively affected. They can do letter-writing campaigns, public speaking engagements, public demonstrations, legal actions, or write magazine columns!

We can also do what we’ve been doing for many years, especially during Republican administrations of the 80’s, early in the epidemic, that hurt so many PLWH/A’s for so long: We can take actions despite the dominant paradigm in power, and prove that the power of the people speaking out must be reckoned with. That sense of self-empowerment, which began with those brave, early PWA volunteers of ACT-UP, is critical for survival (silence = death). And we can wait for someone to emerge in 2008 who champions our issues once again, and throw our full support behind them. Even if the current leadership enacts many policies that hurt us, there is a way for all of us, in our personal, meaningful, and specific ways, to demonstrate a resistance that preserves our personal empowerment and prevents despair. And unlike medication viral resistance, this kind of resistance can be a good thing. The ability to act effectively in the face of duress builds our personal capacity for coping, and helps us to develop an increased sense of compassion we can model for others – including our President.

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