AIDS is now a fact of life and poses new challenges for everyone: not only persons who are ill, but their friends and loved ones as well. Often it is people who are young that have become ill, and their hopes for a long life have been severely affected. Their situation is not isolated. It is shared by people close to them.

When someone you know is ill, with a serious illness like AIDS, you may feel helpless or useless. If the person is a friend you may say, "Just call if you need anything." But because of insecurity or a sense of helplessness, you may fear the call, if it comes. Here are some thoughts and suggestions that may help you to help someone who is very ill.

• Don't avoid your friend. Be there. It gives hope. Be the friend, the loved one you've always been, especially now when it is most important.
• Touch your friend. A simple squeeze of the hand or a hug can let him or her know you still care. (Don't be afraid. AIDS cannot be contracted by touching or casual contact.)
• Call before you visit. Your friend may not feel up to a visitor that day. Don't be afraid to phone again and visit on another occasion. Your friend needs you and may be lonely and afraid. -- Weep and laugh with your friend. Don't be afraid to share such intimate experiences -- they may enrich you both.
• Tell your friend what you'd like to do to help. If he or she agrees, do this. Keep any promises you make.
• Call to say you are bringing your friend's favorite food. But ask to make sure it is something he or she is able to eat. Be precise about the time you are coming. Bring the food in disposable containers, so your friend won't have to worry about washing dishes. Spend time sharing a meal.
• Call to find out if anything is needed from the store. Ask for a shopping list and make a "special delivery."
• Be creative. Bring books, magazines, taped music, a wall poster or home-baked cookies. All of these become important now and can bring warmth and joy.
• Bring along another friend who hasn't visited before.
• Volunteer to take your friend for a walk or an outing, but ask about and respect any limitations.
• If your friend is a parent, ask about and offer to help care for any children. Offer to bring them to visit if they are not living with your friend.
• If there are young children living with your friend, offer to take them to or pick them up from school or day care. Ask if you could make them lunch or supper or take them to the dentist, doctor, etc.
• Help celebrate holidays -- and life -- by offering to decorate your friend's home or hospital room. Bring flowers or other special gifts. Include your friend in your holiday plans. A holiday doesn't have to be marked on the calendar; any day can be made a holiday.
• Offer to help answer any letters or phone calls your friend may have difficulty dealing with.
• Offer to do household chores, perhaps by taking out the laundry, washing dishes, watering plants, feeding and walking pets. This may be appreciated more than you realize. But don't take away chores that your friend can still do. He or she has already lost enough. Ask before doing anything.
• Send a card that simply says, "I care!"
• Don't be reluctant to ask about the illness. Your friend may need to talk. Find out by asking, "Do you feel like talking about it?"
• What's in the news? Discuss current events. Help your friend from feeling that the world is passing him or her by. Keep your friend up to date on mutual friends and other common interests. Your friend may be tired of talking about symptoms, doctors and treatments. Take your cues from the person with AIDS.
• Like anyone else, a person with AIDS can have both good and bad days. On good days treat your friend the same as your other friends. On the bad days, treat him or her with extra care and compassion.
• Talk with your friend about the future: tomorrow, next week, next year. It is helpful to look toward the future without denying the reality of today. Hope is especially important at this time.
• Don't feel that you both always have to talk. It's okay to sit together reading, listening to music, watching television or holding hands. Much can be expressed without words.
• Bring a positive attitude. It's catching.
• Can you take your friend somewhere? Transportation may be needed to a treatment, the doctor, store, bank, or perhaps to a movie or community event. How about just a ride to the beach or the park?
• Appointments with Social Security or Medicaid can often be frustrating and exhausting. Offer to accompany your friend and to help fill out the forms. Stay with him or her until the business is finished.
• If your friend is a recovering alcoholic or drug user and is unable to get to his or her 12-step program meeting such as Alcoholics Anonymous, offer to call other people in the program to suggest they consider coming to his or her hospital room or home to hold a meeting.
• If your friend is in outpatient treatment for drug addiction, he or she may need help getting to and from the treatment facility.
• If your friend expresses concern about his or her looks, be gentle, but acknowledge these feelings. Just your listening may be all that is needed. Try pointing out some positive physical traits. It may make him or her feel better.
• Be sure to include your friend in decision making whenever posssible. Illness can bring about a loss of control over many aspects of life. Don't deny your friend an opportunity to make decisions, no matter how simple or silly they may seem to you.
• Be prepared for your friend to get angry with you for no obvious reason, although you have been there and done everything you could. Permit this, but don't take it in a personal way. Remember, when a person is very ill, anger and frustration are often taken out on the people most loved because it's safe and will be understood.
• If you and your friend are religious, ask if you could pray or attend services together. Don't hesitate to share your faith with your friend. Spirituality can be very important at this time.
• Don't lecture or become angry with your friend if he or she seems to be handling the illness in a way that you think is inappropriate. Your friend may not be where you expect or need him or her to be.
• Do not confuse acceptance of the illness with defeat. Acceptance may free your friend and provide a sense of power.
• Don't permit your friend to blame him or herself for the illness. Remind your friend that lifestyles don't cause disease, germs do. Help him or her through this one. It may be very hard.
• If you and your friend are going to engage in sex, be sure you know about the precautions which make sex safer for both of you. Be imaginative -- touch, stroke, massage. Sex need not be genital to be fun or intimate.
• A loving family member can be a source of strength. Remember that by being a friend or lover you too are part of the family.
• Check in with the people who are taking care of your friend. They too may be suffering. They need a break from the illness from time to time. Offer to stay with the person with AIDS in order to give the loved ones some free time. Invite them out or offer to accompany them places. Remember, they may need someone to talk with as well.
• Don't allow the person with AIDS or care-partner to become isolated. Let them know about support groups and other concrete, practical services offered without charge by local AIDS organizations or hospitals, as well as opportunities for political activity or AIDS advocacy.
• Finally, take care of yourself! Recognize your own feelings and respect them. Share your grief, your anger, your helplessness -- whatever emotions you may have, either with friends and loved ones or in a support group. Getting the support you need during this crisis will help you to be really there for your friend.

Dixie Beckham, Diego Lopez, Luis Palacios-Jimenez, Vincent Patti and Michael Shernoff, ed. Philip G. Ryan, "When a Friend Has AIDS..." (New York: Chelsea Psychotherapy Associates, 1989).

Dixie Beckham is director of Chelsea Psychotherapy Associates.

Vincent Patti is in private practice in Manhattan.

Diego Lopez and Luis Palacios-Jimenez are both deceased due to AIDS.