Living with HIV

Dear Dr Ren,

I just read your recent Xtra article and am impressed that you tell people not to panic when they get HIV.

But HIV still requires medication. Consuming one pill per day is still a scourge. If we live 30 years, that’s 10,950 pills. So how can you say, “Don’t panic”?

In your last sentence you mentioned celebrating life as though your glass were half full. It seems to me all this medication makes this impossible.

If somebody has been infected with this lethal virus, is there any point to his continuing on with life plans such as going to college?

Not So Full

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Dear Not So Full,

Perspective is everything, isn’t it?

In the 1980s, when young men received a diagnosis of AIDS, they knew it meant their days were numbered. Back then HIV truly was a “lethal virus.”

It took us many years to determine just what HIV was and what caused it. Then we had to stumble through more years of political and social stonewalling while the religious right pontificated about whether we should even treat the disease, and politicians withheld funding for research.

Finally, decades later, we can offer effective, life-prolonging treatment for what has become a chronic disease. Those of us old enough to remember going to more funerals than birthday parties rejoice at the progress that has been made. Those of you born midway through the story bemoan the imperfection of the resolution of the problem.

And imperfect it is. Thirty years on and we still can’t offer an immunization or a simple, effective cure for HIV/AIDS. I can’t tell you if the problem lies in the complexity of the virus, the political and social framework surrounding it or a combination of the two. When polio struck in the early 1950s, the medical profession figured it out within a few years, and mandatory mass immunizations all but eradicated the disease. Ditto with smallpox and measles.

HIV has proven a more thorny problem, and I encourage you to listen to the stories of those with longer memories than yours to gain an appreciation for the many years — and the many pills — you have to look forward to.

As to that number, you join the ranks of those with low thyroid production, diabetes, hypertension and any number of relatively minor ailments that require management. Add to this list the millions of women who cheer that they can simply swallow a pill a day to control their fertility, an option available to them only since 1960!

Having said all this, I’ve been addressing the question that rests on the surface. I suspect you are less concerned about the number of pills you must consume over the next 30 years (remember, you can look forward to another 30 years!) than you are about the realization of having contracted a “lethal virus.”

When newly diagnosed, it is understandable and natural that you go through a whole array of emotions coming to terms with defining yourself as an HIV-positive individual. The “glass half full” attitude is way down on the list, after you have grieved the loss of your former state of robust good health and socially acceptable sexual status.

Elizabeth Kubler-Ross’s template for the process of grief is a five-step progression from denial through anger to bargaining, into depression and finally moving into the stage of acceptance. Your concern with medication sounds like you may be between anger and bargaining, though the process is seldom linear or simple.

You’ve been dealt a blow, a sucker punch, and luckily there are many individuals and organizations available to help you along the path to acceptance and eventually a full and happy life, though compromised with a chronic illness. You needn’t do this alone, nor should you. Find resources to help you.

This brings us to your final question about how this life-changing news should/can/will affect your future plans. Should you go on to college? I can’t answer that question for you, but I can help you determine the right answer for yourself.

It may help to ask yourself the following questions:

What are your priorities at this point?

Do you need to address your situationally induced depression before you take on the demands of university life?

What is the state of your support system?

How do you feel about going to school?

How is your health at this time? Do you need to learn to live with this new situation before starting another?

Given that you read Xtra, you are hip and probably urban. Since you are considering college, I assume you are still young. Those factors alone give you advantages many in your situation don’t have. You have much to learn in the adventure that awaits you, and you have some choice in how you face what is before you.

The glass half full and the one half empty contain the same amount. It’s all in how you view it.