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Best ways to be supportive
Nov 10, 2005

Hi. Thank you so much for this website - it has been a big help. I'm dealing with a tough situation and I hope you can give me some advice.

My nephew is a citizen of a country where access to HAART is very limited. While I was visiting this summer, he found out that his ex girlfriend was HIV positive. After I spoke with him about HIV, he decided to get tested and asked me to come with him for support. He said that if it was bad news, he didn't want to get it alone. Unfortunately, he tested positive. In his country, there's a lot of stigma associated with HIV infection, so I and his wife are the only family members who know about his test results. I'm very close with him and his wife, but living so far away, it's hard to know how to offer them support.

He and his wife are expecting their first child, and she has tested negative. They're both struggling with this diagnosis, and he seems to be in denial. It's been a couple of months, and he hasn't gone back for a follow-up visit with the doctor, and has seemed reluctant to talk about his diagnosis over the phone.

I'm concerned, first of all, about being supportive to him, especially since he doesn't have other people in his life who are aware of this diagnosis. I hate being the one to "nag" him about going to the doctor, but I am scared that he sees this as a death sentence and isn't seeking out treatment that could help. Most of all, I'm very concerned for his wife and their child, as they're not taking steps to make sure that she does not become infected.

I feel torn between supporting him in whatever stage of coping he's at, and feeling like no one else is taking care of him or his family, and that I have a responsibility to do that. Do you have any advice on balancing those two concerns?

Thanks for all your help.

Response from Dr. Horwath

He would benefit most from education and understanding. You can send him information or direct him to websites (like TheBody.com) so that he can better educate himself about HIV infection. The most immediate concern is preventing the HIV infection from being transmitted to his wife. Since she is currently negative, there is no danger to the infant unless she becomes infected while she is still nursing the baby. They need to be informed about safe sex and the need to use condoms all the time.

Educating your friend about the natural course of HIV infection would probably help him to feel more hopeful and better able to face and cope with his HIV infection. If he understands that there is a long period of latency during which he will not be ill, but will need monitoring by a doctor, then perhaps he can go ahead with what he needs to do.

There is no way to force the issue. Information and education will help him to move ahead and to be best equipped to protect his family and care for himself.



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