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Why would someone do this?
Dec 10, 1998

My boyfriend is HIV+, I'm HIV-. This year has been overall a good time for us personally and professionally. His lab values have been excellent and he is currently on a PI therapy. Over the past 2 months he has become careless with his medication-taking doses late or missing them all together. I've tried the direct approach of asking why he is doing this, is anything bothering him or can I help in some way. Generally met with stonewall responses. It is his decision to do this and I have to leave it at that but, it makes me so angry at times that he doesn't want to take care of himself at this time. Almost as if I love him more than he loves himself right now. Interestingly we have a friend who is also HIV+ and has never taken his situation seriously. My boyfriend will comment on how poorly the friend takes care of himself. Do you have any insight or encouragement? Other than letting him know that I love him and am there for him, he has to choose when to take care of himself.

Response from Mr. Shernoff

You are absolutely correct that you can not badger or parent him into taking care of himself. All that you can do is tell him that seeing him not take care of himself makes you angry and sad since it seems to mean that he does not care enough about himself to want to do everything that he can to insure that the two of you will be able to share a long and mutually healthy life together.

The whys are enormously complex. Adhering to the rigorous medication schedule is arduous and a constant reminder that one has a life thretening illness that needs to be treated. Many people report taking a drug holiday. Another possibility is that he is suffering from either a low grade depresion or a more serious depression and his not taking care of himself may be one symptom of a more general lethargy or malaise.

Another possibility is that perhaps he had adjusted to the fact that he was going to die from AIDS, andthat the new triple combination therapy that caused his blood counts to dramatically imporve and given him the hope for an extended life span may have thrown him into a state of emotionally not being able to cope with the ping pong ball effect that is now being labelled "The Lazarus Syndrome" for the person that Jesus supposedly resurected from the dead. This transition from someone with a lethal illness to being a person with a treatable but now only potentially life threatening condition is not a simple one to navigate.

Any combination of these dynamics or other ones that are unique for him can all be contributing to why he has suddenly stopped taking care of himself. Try to notice if there are other areas of his life where he is not taking care of himself like paying his bills, housework, pet care, etc. If it is a more generalized condition than just the meds, he might benefit from professional counseling.

The only other thing I think you may try if you have not already done so, is simply to ask him what has changed that at one time he was rigorously taking care of himself and now he is not. He may have a very clear reason for his behavior and by asking him and listening to him in a nonjudgemental way can offer the two of you an opportunity to discuss this and hopefully feel closer to each other.

Good luck.

Michael Shernoff, MSW



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