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. Following the feedback of many HIV-positive clients, as well as my own experience, I’d like to offer some guidance to people who have just been told by a friend or relative of his or her HIV status. Try the following steps:
1. Give yourself time to process, accept, and “digest” the news. This disclosure is big news and it is appropriate that the feelings might be strong. HIV is a daunting challenge and has many implications and emotions associated with it. Start by taking a deep breath.
2. Next, when you feel comfortable, either in that moment or some time later, share your own feelings with your friend. What’s going through your mind? Is it curiosity on how the virus was transmitted to this person? Do you feel comfortable asking your friend about sexual or intravenous drug issues where they might have been exposed? Or would that be inappropriate and intrusive for your relationship? Why do you want to know – what difference would it make for you if you knew the method your friend was infected? Are you having feelings for your friend such as pity? Moral reproach at sexual or drug behavior you disapprove of? Fear of their death? Are you confused about just what “being HIV-positive” means, or the difference between being HIV-positive and having AIDS? Try to identify your feelings, and honestly tell your friend what those feelings are. Ask him or her to share whatever he/she is comfortable telling you, and remind him/her it’s OK to not answer some of your questions. Remember, during this time, your friend needs your support, and frankly, you need to be there to support him/her, not the other way around. Ideally, you would be there to share your feelings and support with each other. Try to remember why this person is important to you aside from the HIV issue.
3. Think rationally and try to contain your own fears. Far too often lately, I have heard of family members (particularly mothers, for some reason) thinking that they’re being generous by allowing their adult HIV-positive child to stay in their home – but then they bleach everything in sight, make their child use separate paper plates, glasses, and cutlery, clean obsessively anything the “patient” has touched, and even restrict their son or daughter from contact with children or even the family dog. This is not only an irrational ignorance of how HIV is transmitted, it’s also cruel. These parents are acting out their own irrational fears and stigma associated with sex, gay sex, drugs, fear of illness, or fear of death. Yes, HIV/AIDS is daunting, but it’s not – for the umpteenth time – transmissible under casual circumstances living in the same household. Unless you’re a parent shooting up drugs with an adult child and sharing a dirty needle, or having unprotected sex with them (which are far more serious issues), you need to get a grip on reality. Challenge yourself to use rational thinking and get reliable information on HIV prevention from credible (not “I-heard-a-rumor”) sources such as the US Centers for Disease Control and Prevention. If you can’t get your fears under control, seek mental health counseling from a local social services agency and help your adult child find alternative housing until you’re better.
4. Identify ways of helping your friend or family member. These will generally fall into three categories of help: practical/tangible things like giving them a ride somewhere or helping with the laundry; emotional support like long talks, hugs, games, or reassurance; and informational support, where you use your own professional or life experience and skills to help another. Everyone discovers their talents that shine when they try to help someone else.
5. Get used to living with a certain amount of uncertainty. You might not be able to answer questions like, “Will my friend die of AIDS?”, or “What’s going to happen to them now?” You have to approach HIV like anything else in life; you just do the best you can – which is what you would do if they weren’t HIV-positive anyway.
6. Last, try to live in a state of “normalcy, with exceptions”. Try to let the HIV issue be an issue only when it “has” to be, such as when taking meds, going to doctor appointments or lab visits, and paying extra-special attention to diet and exercise. Whenever possible, try to preserve the relationship you had with this person before their disclosure. You might find it’s not as different as you feared, and you might find that your relationship becomes deeper and more meaningful.
If these suggestions don’t cover all you’re going through, try to find a local AIDS service organization or mental health clinic funded by the Ryan White CARE Act that might help with HIV-knowledgeable counselors or therapists; there is probably one in your area, and they are there to help.