5 Steps for Life-Altering Decisions in HIV

Shane was surprised at his own indecision. As a transgender man nearing his 30th birthday, Shane had always been clear about what he needed to do for himself. At an early age he had intuitively known the changes necessary to align his body with his inner identity and how to maintain pride in the face of bullying and shaming. Forced to leave home at a young age, Shane had then lived full-time as a man, overcoming one obstacle after another.

Now, however, he was uncertain. He had tested positive for HIV nearly two months ago and was confronted with overwhelming choices. His thoughts were muddled by many strong, uncomfortable emotions. His doctor insisted that he start antiretrovirals despite Shane's concern about their interaction with his hormones. He felt trepidation about disclosing his diagnosis even to his closest friends. Most of all, he was confused by this unfamiliar uncertainty.

Circumstances were forcing Shane to simultaneously absorb difficult news and make life-altering decisions. Like many people diagnosed with HIV, he was struggling to find his turning point and maneuver around potentially negative outcomes. When you or your loved ones are faced with health decisions, whether about HIV, addiction or other concerns, there are several principles that can make the process easier and guide you through this difficult period of transition.

1. Assess Your Feelings

The first step is self-assessment. Ask yourself, "What am I experiencing, or am I feeling anything at all?" It is not unusual to feel numb. At other times, reactions to challenging situations can include emotions such as fear, denial, shame and anger. If unacknowledged, these feelings can block healthy decision-making and foster the desire to numb discomfort with addictive behavior. Only by identifying and appropriately expressing your feelings can you move forward.

2. Get Informed

Obtaining good information is critical for maintaining our health. We are fortunate to have an abundance of knowledge available via the Internet, but caution must be exercised -- and only trusted resources such as TheBody.com should be consulted. I have many clients who scare themselves unnecessarily with misinformation from the Web, sometimes resulting in harmful decisions. Be certain to consult dependable sources, such as your doctor, friends and family, who can help you identify the information that will best equip you to maneuver through your turning point.

3. Stay Connected

One major impact of HIV is isolation due to stigma, shame, fear and depression. The natural reaction to pull away may seem self-protective, but it ultimately removes you from the essential support that is important at every phase of living with HIV. Fight the tendency to back away from the people who care about you. Break any tendency to isolate; it will result in bad decisions and increased your negative feelings.

4. Keep Moving Forward

Each aspect of dealing with HIV is unpleasant, and many people choose to ignore their condition, sometimes to the point that things go terribly wrong. HIV can be well managed with today's medication, yet a vast number of people are not in care or have fallen out of care. Remember that by delaying or doing nothing you are making a decision that could be harmful. Fight resistance and denial and keep moving forward with gentle but persistent determination.

5. Believe in Yourself

In the end, your faith in yourself will guide you through this turning point. There will be many junctures that require clear thinking and careful judgment. Issues of disclosure, medications, staying healthy and even confronting medical complications require you to commit fully to yourself and your health. This may require forgiving yourself for past decisions and learning to have a gentle compassion for yourself. In order to successfully manage life with the virus -- whether it’s your life or the life of someone you care about -- you must bolster both your courage and your belief in yourself.

Even after three decades and tremendous medical progress, HIV continues to present significant emotional challenges. It is associated with a host of feelings -- such as stigma and shame -- that are both unpleasant and unhealthy. Managing such feelings successfully requires the active participation of the person living with HIV and his or her "team" at every juncture. Following these five principles will make finding and moving through your turning points easier and contribute to a long, healthy and happy life.