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An Ounce of Prevention…

Driving through West Hollywood these days, I often see the banners on streetlights and telephone poles with the faces of the “HIV Stops with Me” campaign poster-boys. This public health awareness/HIV prevention program is certainly high-profile, and like everyone else, I hope it does some good to reduce the sadly high number of new HIV infections every year in this country. But I’m not convinced of this campaign’s effectiveness.

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Decisions, Decisions – and a Leap of Faith

Many recent articles in AIDS magazines that I’ve read recently have focused on HIV treatment decisions. They have addressed issues such as when to start therapy, when to change therapy, and even when to fire your doctor. These articles give a great deal of information and advice, but to me something seems missing. When people … Read more

HIV, Mental Health, and Substances – Public Health or Politics?

Ever since the days of Prohibition in the 1920’s, or the 1938 camp film, “Reefer Madness”, substances and American politics have clashed in a way that goes far beyond the actual health risks of alcohol or “recreational” drugs and into a moralistic quagmire that leaves people confused and conflicted about just what to believe. I have seen this frequently in my work as a therapist with people who are living with HIV and have issues, or even just questions, about substance use, abuse, and addiction.

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Just Diagnosed HIV+: OK, Now What?

Many thanks to readers who have sent emails; I’m glad you enjoy this column. I want to start answering here some of the email I receive in case it helps others with similar questions:

Dear Ken,

I read Positive Outlook every month and I appreciate your discussions. I wondered if you could help me. Unlike so many in the U.S., I have good health insurance and a good social support system. However, ever since I found out I was positive about a year ago, I’ve been on a downward spiral. I haven’t been back to my doctor in many months, and I haven’t done anything to deal with HIV except have a confirmatory second test. I’m not in a good place because I find being diagnosed overwhelming. I just have one question: Where does someone start?

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Face It: Lipodystrophy, Lipoatrophy, and Self-Esteem

In the earliest years of the HIV/AIDS epidemic, many people were distressed by the appearance of nickel-sized purple lesions on their bodies and faces that were a visible sign of living with Kaposi’s Sarcoma, an AIDS-related opportunistic infection. The lesions involuntarily “outed” them as having the highly stigmatized disease of AIDS. Society’s reaction to patients with these visible symptoms often caused additional psychological distress to people who were already fighting a host of medical challenges in the days with almost no treatment options.

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It’s All in the Family: How Friends and Family Can Help Someone Living with HIV

Most of these columns have focused on advice or suggestions for how someone living with HIV/AIDS can improve their own mental health for a variety of topics. Recently, I had a request for a column on how family and friends can help. Too often, friends and family want to help out or react to a person’s HIV disclosure the “right” way, but they’re not sure how.

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To Have and Have Not: Feeling Empowered to Manage HIV (Regardless of Social Class)

As a mental health professional and licensed clinical social worker, one of things I do with a new patient is to take a thorough “psychosocial assessment” – basically, his or her life story in one hour or less. I ask about family history, history of current symptoms (depression, anxiety), current medications, work history, health experiences, education, social support, hobbies, and cultural background. But I also ask about his or her current and past socio-economic status; what “class” did he or she grow up? I ask this because I think the issue of money in American society is one of the most emotionally-laden, and can shape – positively or negatively – a person’s experience of the world.

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Magnetic Relationships

Recently my friends, colleagues and I have debated the idea of “magnetic” or “sero-discordant” romantic relationships, where one partner is HIV-positive and the other is HIV-negative. It seems opinions for and against can be adamant. My predecessor writing this column, Dr. Tony Zimbardi, is also a psychotherapist living with HIV, and he and I are friends and colleagues in Los Angeles. He has written about this topic before, but we disagree on this issue.

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Here’s to Your Health! Meditations on Adherence to “The Cocktail”

It seems like everyone in HIV care recently uses the word “adherence” as often as a transcendental meditationist uses the word “om”: over and over again. But isn’t that what “adherence” is? Taking your colorful collection of pills “over and over” again? Millions of people worldwide now toast themselves once or more times daily with a “cocktail” of antiretroviral medications.

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I love Halloween. Maybe it’s because of the theatricality of it, with costumes and props, or maybe it’s because of my addiction to chocolate. Author Peg Aloi, an expert on Pagan holidays, explains that Halloween, or “Samhain” as it is sometimes called (which means “summer’s end”), is observed as a celebration of the last harvest of the year before winter.

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