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What should I do?
Jun 12, 2006

My uncle is HIV positive. Now, I am the only person living with him and going to school as an international student. Nobody in our extended family (still living back in my home country) knows about this matter yet. I dont think he is ready to disclose this to the family. I only accidentally figured this out when I saw a card of an AIDS Early Intervention Program that he is currently follow-up for treatment. I understand that mental support (such as food preparation, sharing the feeling of fear, anxiety, and distress) from family members is as important as physical treatment of medication in managing this chronic disease effectively. I feel helpless because I dont know what to do to help him. Conversely, he is helping me while I am attending college and that makes me feel that I am putting a burden on him (I think he wants to help me to complete my college as he had promised my mother). Everyday, I leave for school until afternoon and my uncle stays at home on his own and nobody is to make sure he takes the pills on time. I am concerned about the lack of family support will have a negative effect on his management of the disease.

I really dont know what I should do to help him the best. I asked myself Should I let the family know this?

On the one hand, I want to share this matter with the family so that we can find some way to help him because I dont see how I can handle this matter myself and continuing my college at the same time. I am also concerned that not knowing about his HIV positive can lead to a consequence of someone in the family being an unintended victim from the incident of blood contact. It is already so hurtful for my uncle to be the case, I dont want anybody else to be in his situation ever again.

On the other hand, I feel that I should respect him as a patient with the right to his confidentiality and it is his decision to disclose or not disclose the matter to the family. After all, I want the best for my uncle and try to do everything I can do to help him manage the disease effectively and live the rest of his life normally as long as time allows.

I would like to ask you a question which may help me make my decision. I would like to know the current stage of disease of my uncle, given the current combined treatment of Truvada, Norvir, and Reyataz he is on and how long it will be before the disease reaches the terminal stage of AIDS symptoms. I will let my family know within a minute if there is not much time left before it is too late. However, if you say that he is going to do fine with the help of medication, then I think I will put it off for another two years (which I will be completing my college education by then) to let him have some more time before ready to talk about it. In the meantime, I will convince him to travel back to my home country more frequently to spend more time with the family so that he can have the feeling of being surrounded and supported. Thank you for sharing my concern and I am looking forward to your advice. Thank you very much, Doctor.

Response from Dr. Horwath

You should speak to your uncle directly. You are aware of his situation and you can let him know that he allowed you to find out by leaving his papers where you could see them. You can offer your help and support. Disclosing his status to others is not an option without his permission. You can discuss this with him, but he needs to decide if he feels ready to disclose his status to the family. You can encourage him to do so if you feel the family will be supportive, but ultimately it needs to be his decision.

If he is in treatment and taking his medications regularly, then his prognosis is probably very good.



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