Dear Michael:

I just found out the biggest bummer news of my life: I’m HIV-positive. I am only 25 and have had safe sex the vast majority of my life, but there were one or two times last year that I let someone fuck me without a condom. And now, here I am. I am so totally bummed. The doctor gave me all this information and referrals, but I just want to sit at home and cry. I don’t want to tell any of my friends because I know they’ll just feel sorry for me. All of us have always felt sorry for people who were HIV positive, and now I am one of these people. I hate this. You’re a therapist, what should I do?

Totally bummed

Dear Totally:

When a person finds out they’re HIV positive, it’s a huge shock – a jolt to the psyche and the body. Give yourself time to get used to this new piece of information. You’ve asked me for my advice as a therapist, so let me address a few of the initial reactions that my clients have had when they’ve received similar news:

Pitying yourself: It’s an irony of life that many, if not all, of us end up the people that we once felt sorry for. For example, when we’re young, we may pity old(er) people. We might even think: “How unlucky they are that they’re not as beautiful, young, sexy, fun-loving and party-hopping as we are!” Eventually, if we are lucky enough to live so long, we become the old(er) people we once felt sorry for, and we learn how to be old(er) with our own kind of beauty, sexiness and fun. This is similar to your situation: You are now the HIV-positive person that you and your friends used to feel sorry for. It’s time for a major shift in thinking. Pity isn’t a helpful emotion; empathy is. Most of us have been through enough private hells that we can either become angry, bitter and shut down or more compassionate, open-hearted and patient. Initially, given your difficult news, it’s probable that you feel angry, bitter and shut down. That’s OK. Let yourself feel it for a while – but not forever. Eventually, you’ll get sick of being sad and angry and will likely find the beginnings of acceptance. I don’t promise you that the anger and bitterness will completely go away; you may still be asking yourself for awhile: “Why me? Why not other people who had a lot more unsafe sex than I did?” Or you may go for the opposite.

Guilt and blame: Many of my clients, upon finding out they are HIV positive, felt guilty about it and blamed themselves for behavior that led to their seroconversion. Try to minimize the guilt and blame you heap on yourself. Instead, give yourself the kindness and love you would offer your best friend if he or she came to you with the same news. Often we’re a lot kinder to others than we are to ourselves. It’s unlikely you’d blame or guilt-trip a close friend who was HIV positive. It’s more likely you’d support him, give her a shoulder to cry on, try to cheer him up, help her cope with the bad news, etc. Do the same for yourself. You may isolate yourself initially, but eventually you need to come out of the HIV closet and get support.

Telling other people: You may have already told some of the people you’re closest to, or maybe you haven’t. Initially, I advise confiding only in the one or two people who you trust the most. Leave it at that for a while. You have enough on your plate right now, so don’t worry about how to tell your neighbors, work colleagues, acquaintances or relatives. That’ll come later.

I strongly recommend you connect with San Diego’s awesome and diverse HIV-positive community and personally get to know other HIV-positive people. There are HIV-positive support groups at The Center and other locations throughout the county, and there are HIV-positive social groups, like POZibilities. You may not be ready for these now, but keep them in mind for the future. It really helps to talk and hang with other people who are in the same boat. No one else knows how it feels to be HIV positive except someone who’s gone through it. Other HIV-positive folks will have wisdom and experience to offer you in helping you to decide whether or not to tell your boss, your family, friends and other people in your life about your status. While it’s helpful to consider their advice, it’s your life, so don’t let anyone pressure you into doing anything that doesn’t feel right for you. Let me know how you’re doing by dropping me another e-mail anytime.