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Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.

The participation of Dr. Ewald Horwath in this Forum is made possible by Boehringer Ingelheim.

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Deep Dish Denial
Aug 14, 2008

My boyfriend of three months is in denial of his confirmed HIV status. He actually believes there's a possibility his HIV+ status can turn into an HIV- one through prayer, time and well wishes. Moreover, he's doubtful of the help that trained HIV counselors can provide and he's slow to follow up with locating a primary care doctor or to even get the results of his initial blood work to establish his current viral load.

He's been tested at least twice before I came along and aware of his HIV+ status for years but never followed up to get any kind of profesisonal counseling or treatment. I'm worried nothing I say or do can help him. I've refused to have anal sex with him until he can get some basic answers about his status and talk with someone other than me. He says he's embarassed. According to him, coming from a traditional African American background, where HIV and homosexulaity is not discussed freely, there's a heavy stigma he can't escape. He's not on the "DL" but none of his family, closest friends or church members know of his HIV+ status. He refuses to open up with anyone other than me. I don't know how to express the importance and the urgency of following up with his care givers is. Nor do I know how to convey the key to a healthy life beyond the HIV is steeped in his moving forward. His continued denial and non-reactive approach is sad to witness.

I told him I love him and I'm here for him no matter what, but no one should live in ignorance. I only want the best for him. What should I do? Loving him is like watching a puppy chase it's tail. He's going no where fast and I'm frustrated and exhausted.

Response from Dr. Horwath

By seeking counseling or medical care, he does not need to reveal his HIV status to anyone else other than the counselor or medical personnel. If he changes his mind about speaking to friends, family, etc., in the future, of course he always has that option. But he does not need to do so now in order to seek medical care.

You are correct that he is in denial. There is no way for you to force the issue. You can speak to him and try to educate him about HIV. If he learns more information, this may calm some of his fears. Knowledge about HIV and the treatment is often quite helpful in dispelling fears and fantasies that people have that are more frightening than the reality.

Don't give up. Let him know that you are there for him whatever he decides to do. Keep talking to him, but don't try to "push" him. If you get him to talk to you more about his fears, his embarrassment and other feelings, this may help him to get past his denial.



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