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What Next??
Jul 14, 1999

Hi, I have a loving relationship with my HIV+ partner of 6 years. He has been full blown for 5 of those years. Recently, the doctor told him that he feels this will be the last chance to get this virus under control as his viral load is 800M and his T cell count is 60. Since hearing this he is making all attempts to finish whatever dreams and projects he wants to see done before he is no longer able. Up to this time he has basically had a positive attitude, outside of the normal periodic blues. I am not sure what to do this time to change his attitude and let him feel some hope. He feels no future and it's been a bumpy ride, but, I don't want to see him give up. Any suggestions appreciated. Thanks

Response from Dr. Remien

The situation you describe seems like a tough one. I wouldn't begin to judge the prognosis for his future health and survival. However many people with extremely high viral load and low T cell counts have been able to respond to therapies and have renewed health and quality of life. That is not to say that his situation is not serious and of concern. It is also understandable that he be motivated to attend to dreams and projects because of the uncertainty that lies ahead. The uncertainty of health and survival when living with HIV can be very challenging psychologically.

I do think that it is helpful for you to be supportive, which may include being supportive of his current pursuits and priorities. Supporting his medical treatments and the difficult adherence that is required can also be helpful. You are not really able to "change" his attitude. He and you are facing tough and uncertain times. If anything, perhaps your maintenance of hope may be helpful as a model to him and may feel supportive to him. At the same time, it is important to allow the acknowledgment and expression of natural fears and concerns about the seriousness of his health situation. In my experience talking about the range of feelings that you both have is helpful in the long run. This may not always be easy to do, but that is what true "intimacy" is really about. Don't hesitate to work with a counselor you both trust who can facilitate some of these discussions.


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