The Lipodystrophy Look
"I Feel Self-Conscious That Everyone Who Looks at Me Can Tell That I Have HIV"
After years of being HIV-positive, I seem to have recently developed the "look" of having this disease. My face has lost its fullness and my cheeks have sunken into my face. Now, I feel self-conscious that everyone who looks at me can tell that I have HIV. As a single person going out, I sense that people find this HIV-positive look a sexual turn off. When I speak to my therapist about this she states that it's in my mind and that no one really knows I have HIV and that my lifetime partner is out there somewhere waiting for me. However, I feel differently and this affects my going out, having sex and any possible future relationships from these contacts. I have learned to deal with a lot physically over the years but how can I change my mental outlook when it comes to this?
A Response to This Case StudyWe all have to develop different coping methods for dealing with the positives and negatives of our own physical makeup. This ongoing process continues as we age and change throughout our life span. Generally speaking, when people don't like aspects of their facial appearance, they will either minimize or over-emphasize their actual effect on their physical appearance and within their personal interactions.
The sting of rejection you sense coupled with your HIV status is a real issue and concern that must be addressed since it inhibits you from social interactions. Ultimately you need to regain your perception that you are a desirable person with HIV. If you don't feel this way, it can strongly affect your physical well being; and retaining good health should be your number one goal. Let's examine the effect this has on your mental stability and how you can gain a sense of control over this new facial change.
Although your therapist does not agree with your viewpoint, I am not here to disagree or contradict her theories. I do not see you as a patient and I have no direct visual impression of your facial situation. Your relationship with your therapist is a working relationship and if you feel she is off base in her assessments then you need to discuss this with her. I would challenge her statements that your face indicates no HIV status and with equal importance I would address how your perception affects your daily personal interactions. If you are questioning her expertise as a mental health professional, then discuss possible termination with her and research other psychotherapists that hopefully are more appropriate in meeting your emotional needs.
From your statement, I can see your point and understand your feeling of rejection. Based on psychological research people do assess and judge others physically very quickly, sometimes in seconds. Their reaction could be based in part on what they perceived as possible physical illness from looking at your face. I would not go as far as to state that all people make this HIV connection you speak of, although some populations may be more sensitized to the facial structure you have discussed.
The world is not a just or balanced place, and I do not follow the myth that in this world there is a predestined "Mr. or Ms. Right" or someone with whom a relationship will last a lifetime. If the people in your dating pool perceive you as having HIV -- a life-threatening disease -- then you could face a number of problems. In a just world we would wish for everyone to be more open and less judgmental, but personal assessments are being done in a matter of seconds. Thus, based on a small number of these interactions you would then naturally develop a more guarded stance in your seductions and this would clearly affect your social skills.
Lipodystrophy 101With that in mind let's clarify this "HIV look" you have written about. The technical term for this condition is lipodystrophy, and it really can change people's appearances. People who are knowledgeable about HIV can often see signs of it present in the face and body. Lipodystrophy is a catch-all term for a number of conditions that can occur in people living with HIV. It is a medical term that means an abnormal change of fat. Medical experts cannot agree on what causes lipodystrophy, or even how to define it. The current thinking is that lipodystrophy has four components that are distinctly different but related:
Because no one knows for certain what causes lipodystrophy, medical professionals also don't know how to prevent it or treat it. However, here are some logical steps as possible pathways to deal with what appears to be a healthy perception of rejection based on your lipodystrophy.
Getting Beyond the SurfaceIn conclusion we do live in a very superficial society; how you look does weigh heavily on how you are treated. Studies have indicated that people will be more receptive to and more tolerant of a person they consider to be attractive, projecting positive attributes onto that person. But you can go with the flow; and develop methods in addition to what I have suggested for dealing with this recent change in your facial appearance. In addition please continue to do your medical research and hopefully in time you will feel a sense of control over this new development. Good luck.
J. Buzz von Ornsteiner, Ph.D. is a psychologist and behavioral consultant in New York City and writes the "Psychologically Speaking" column.
This article was provided by Body Positive. It is a part of the publication Body Positive.