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This Again? New Opportunities to Disclose My HIV Status (or Not)

October 29, 2013

David Fawcett, Ph.D., L.C.S.W.

David Fawcett, Ph.D., L.C.S.W.

I have lived with HIV for so many years that the whole issue of disclosure seems moot. Every important person in my life knows my status, as do my colleagues, clients, and for that matter, anyone who comes across my postings on TheBody.com and The BodyPRO.com. I am well aware of the complexities of disclosure and work with others to address their concerns, but it has been a long time since I experienced the issue.

That all changed recently when my partner and I took the trip of a lifetime -- an 8 day cruise with a group of gay men, almost none of whom I knew or knew me. Living in Fort Lauderdale I am familiar with the 5,000 passenger party-boat style of gay cruises which hold no interest for me. This was the polar opposite: a 300 passenger sail ship on the Mediterranean which was more sedate and provided an opportunity to focus on conversation, new friendships, and a shared sense of adventure.

On board I found myself wrestling with the issue of disclosing my HIV status. While I am certain (simply based on statistics) that many other men in the group were also living with HIV/AIDS, the whole issue was conspicuously absent. My feelings about this were conflicted. I was at once grateful that HIV, which seemed to have been a singular focus for my generation, was no longer front and center (at least in our floating community). For many years it seemed that AIDS had consumed all the oxygen in the room and here, on the open seas, it seemed very far away.

On the other hand, I felt a sense of separation and a bit out of place. I spotted a few other men my age whose faces bore the mark of antiretroviral medications, but for the most part, my fellow travelers seemed unaffected by the ominous shadow of HIV that had hovered over my entire adult life. For the first time I realized that the potential for an AIDS-free generation (although we are far from it) put me and my surviving peers into an "other" category that brought up old feelings of being marginalized.

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And that brings me back to the issue of disclosure. How central is AIDS to my identity? It certainly is an inescapable and significant part of my life, but I have endeavored to keep it in its place. I don't wish HIV to be the central core of who I am. Rather, I am a person living with HIV, a fact I must acknowledge twice a day when I take my medications. When I meet someone new there are many other aspects of myself to share. I am comfortable enough with my HIV status that I can share it when I feel it is appropriate. I see many people who minimize their anxiety about when and how to disclose by blurting out too much information too soon, and with too many people.

It is important to mention that my deliberations to disclose were made in a social context. I believe it is essential to share one's HIV status clearly and directly before sexual contact. Yes, each of us is responsible to take appropriate precautions and undetectable viral loads reduce the chances of transmission, but not disclosing our status to sexual partners puts us in moral and sometimes legal jeopardy.

Of all the people on board there were a few with whom we wanted a deeper friendship. With these new friends we had more dinners and extended conversations. It was clear to me that sharing my HIV status would be inevitable, yet I once again felt like a disclosure novice. How should I bring up the topic? When should it happen? Was it too soon? Or was it too late? I recall one dinner with new friends during which we shared stories from our lives. By the time dessert arrived HIV had not naturally come up. At that point I made the conscious decision not bring it up since the arc of the conversation had moved to lighter topics. Disclosing my HIV status as we were about to leave the table felt like the equivalent of clients revealing major issues as they walk out the door at the end of a therapy session.

Like all of us I carry my personal issues wherever I go. In this case, it was an old belief that I am somehow different from others and never fit in. This can easily lead to becoming a victim, which is not only unattractive (god forbid with this crowd) but is also very much a trap. Feeling powerless and sorry for oneself becomes self-perpetuating. Knowing this, I made a conscious effort to reach out and connect with others.

I understand that disclosure can sometimes result in very real abuse or even violence, and that the decision to disclose is the right of each individual. As I noted earlier, this new situation and all these new people created an opportunity for old thoughts and fears to come alive. At times during the cruise I felt the awkwardness of a kid who is out of place on the playground. When such old feelings are triggered they can result in a regression of sorts, putting us out of touch with the full range of our adult tools and skills.

Fortunately, at those moments, it took just a second to find my footing (or sea legs). I acknowledged to myself that I am a happy gay man living with HIV who has many talents, skills, and interests. People that I allow into my life accept me, and if they don't, I am powerless over their reaction. I know that their feelings arise much more from their own issues than from mine.

This came together for me one evening as we sailed off Spain under a rising full moon. The deck was full of gay men from many countries. They were various ages, shapes and yes, HIV statuses. They were dancing, chatting, and enjoying the singular experience of the moment. It occurred to me right then that, regardless of our backgrounds or health concerns, we are indeed connected as one.

Send David an email.

Read David's blog, Riding the Tiger: Life Lessons From an HIV-Positive Therapist.

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