On the evening of October 4, 2004, I found myself nauseated and weak, traveling to and from the bathroom after a five-day hospital stay where I'd lost weight that I didn't need to lose. I was struggling to manage basic life tasks so I was staying with a friend who took care of me as I struggled to eat food that disgusted me and drink liquids to keep me hydrated. While I was enormously grateful to be alive, I was miserably sick and stunned by my HIV diagnosis one day prior. 'It's not the end of the world,' I told myself. 'It's not the end of the world. It's not the end of the world.' I truly believed the words, but I also needed them for reassurance--with anxiety and depression lurking under the surface and a sense of dread pervading how I looked at everything. How much time do I have left? Will I be constantly sick? How will I tell others? And I vividly recall standing near my friend's kitchen sink, holding a glass of water in one hand and Lexiva, Truvada, and Norvir in the other. It was official. I had HIV. In those days I was sick and vulnerable, terrified of what my future held. I knew on the one hand that HIV is more manageable than it once was. I had plenty of HIV-positive friends who had full lives and were happy and fulfilled. But I still remembered the early AIDS films--An Early Frost and the like--that left an indelible print that AIDS was fatal and that I would die a horrible death. I was scared. I am in a far different place today: healthy, medication-compliant, expanding my circle of support, and dealing with my issues of depression and self-destruction. The days of lost weight and marginal health are far behind me. My daily regimen is still working. I take my meds daily, almost like I take my vitamins or allergy medication. I take medication in front of others. I know dozens and dozens of HIV-positive people--and no longer feel alone. I am living with HIV, no longer overwhelmed or terrified, and I accept it. I'm calm, even. It is tempting in such moments of serenity to presume that I have done the emotional and spiritual work to attain such serenity. And while I certainly have done my fair share and do not wish to discount my efforts, I must be honest with myself. How did it feel when my T cells were skipping along in the 700s but at my next checkup were suddenly 525? How did it feel when my sinus infection kept recurring despite rounds of antibiotics? How did it feel when I read the obituaries in the local gay paper? How did it feel when my friend who has lived with the virus for 20-plus years became extremely ill? The fact is that I am still very healthy (my doctor says I'm more healthy than her HIV-negative patients), and even with this fact, I can become shaky when confronted with the least bit of disappointing news. While I tend to be hopeful regarding my status, I realize that it's easy to be so when things are going well. However, when challenges arise, so do the old fears. Right now I use these feelings--fear and hope--to center myself, recognizing that neither holds the complete truth. Rather, as with most things in life, the truth is in the middle. Optimism balances fear and fear balances optimism. Fransen is a licensed clinical social worker who is in private practice in Chicago.