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Can you help me be a supportive friend?
Nov 16, 2012

Yesterday my friend told me he was HIV positive. I was unsure what to say, but asked him how he felt, and then he said he felt fine and wasn't too worried, so I said good, and the conversation continued to other things. However, inside of me, I felt shocked and really sad, and my experience of the conversation after that point was that it was sort of fake.

I guessed that the most supportive thing was NOT to express how I was feeling. I think this because I have previously been to an STD education meeting for sex workers, where the (gay escort) educator opened by saying "I would never assume that anyone here does not WANT to get HIV". I was sort of non plussed, and aware that I may be behind in understanding current attitudes toward HIV, However, I intuit from this statement that thinking that HIV is a bad thing is somehow tied to oppression of gay men.

However, I still sort of think it's a bad thing to get, and that to pretend that it's not seems like ignoring the potential mortality of the individual who gets it.

So...I guess I am asking for advice or affirmation on what the appropriate response is if your friend tells you they are HIV positive, and how best to walk the knife edge between acknowledging the potential seriousness of the issue versus not being oppressive.

I'm just not sure where to look for resources, and want to get it right.

Also, perhaps the crux of the matter is that I feel really sad that he is HIV positive. I don't want him to die early, or have heavy and complicated health problems. I think he is great! Where do I get to say that part? Do I need to mourn by myself because being sad is oppressive?

It's tricky because I grew up with a lot of cancer in my family, and I went through a long process to break OUT of the idea that silence was the best thing for the person, and to dispel the myth that ignoring the severity of the problem would somehow make it all easier. I had to train myself to really express how I feel when someone lets me know about their diagnosis, and to support the other person in expressing their real feelings when faced with a life threatening disease. I learned to communicate a lot about fear of death and mortality, acknowledging the possibility that it could be a death sentence. The social justice piece that's apparently tied in to HIV complicates my idea that integral heartfelt communication about life threatening disease is always good for the person, even if it's scary and hard. I wish I could act in integrity and still share my feelings with our mutual friends, but I get that this is not an option, as it's his personal health.

Any thoughts are gratefully appreciated.

Response from Dr. Fawcett

Thank you for writing and for being such a thoughtful and considerate friend. I have thought and written about HIV-related stigma a great deal, particularly as it pertains to gay men, and acknowledge your desire not to contribute to the very real oppression of marginalization of anyone living with HIV.

I think it's important, however, to separate the healing power of validation and empathy from judgment and shaming. Many in our society are too quick to judge and shame those living with the virus, some even want to criminalize behavior. This is, of course, particularly hurtful (and worse) to those struggling to manage their health and social support systems. However, I believe that receiving a loving expression of true feelings expressed in an honest and supportive manner is probably what someone revealing their HIV status most needs to hear. A great fear (and unfortunately a reality, as well) is that sharing one's status will only lead to further hurt and rejection, especially at a time when one needs support the most. For me it comes down to motive. If someone (for their own needs) can only convey feelings that shame or judge, then I believe those are best left unspoken. However, honest feelings that come from the heart can be tremendously healing. I don't equate acknowledging real feelings of sadness, fear, or even anger as oppressive, but rather, as you note, as a healing force even if it's scary or hard.

I also want to commend the work you have done to be able to acknowledge your own feelings in the face of serious illness around you. Most people find it much too easy to deny or avoid these feelings. Being able to own them and express them, in the name of mutual healing, is a great service.

Thank you and good luck to you and your friend.

-David



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