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A few days ago a good friend told me that he had just tested positive. He was in shock and had many questions, some of which included whether I could recommend a good doctor or provide advice on disclosure. He also expressed fear about finding a boyfriend and confusion about whether he would have to start medication. He asked many questions, products of his mind racing to make sense of new and troubling information, his life changed. His emotions varied widely, but more than anything his reaction was physical -- tightness in his chest, tension in his shoulders, nausea. He reflected on how he felt physically, remembering a similar feeling upon hearing about the death of a loved one. I validated every feeling he had, every emotion that poured from him. And I conveyed to him that it was no accident that his physical symptoms reminded him of a death. Both pieces of information -- his HIV diagnosis and word of a loved one passing -- were very bad news, difficult to comprehend, and worthy of grief. So I shared with him that accepting and integrating this news was very much like accepting a death, only that now he was faced with the end of living as an HIV-negative person. That life had ended, but a new one was just beginning. Confronted with this reality, my friend lost a certain carefree attitude about life itself. He was now a young man faced with the news of having a lifelong chronic illness at best and perhaps a terminal one at worst. His life had changed and there was no going back. After speaking with him, I was exhausted and melancholy for the rest of the day. I started to wonder about that reaction, given my level of acceptance regarding my own HIV infection. What I soon realized was that hearing his story reminded me of my experience of being diagnosed. I recalled with sickening clarity the early days of when I was seroconverting and fighting a stomach virus. I remembered vividly how desolate the hospital room felt and how frightened and sad I was. I relived how something fundamental shifted within me and how I began asking myself hard questions about my life and the way I was living it. My life needed to change fundamentally, I decided. I needed to put down the bottle and the drugs. I needed to rest. I needed to get help. I needed to reevaluate. While that process was excruciating, it was also, in an odd way, liberating. Matters of vital importance necessarily assumed prominence, while the old cares and concerns became trivial. My recently diagnosed friend shared the same sentiments. The deeply troubling news was both sobering and clarifying. Suddenly his relationships with his friends became all the more important. He noted that he already was taking his life a little more seriously. I have heard many such stories -- that seroconversion brings vibrancy and urgency to a life that has been aimless or destructive. I don't want to imply that life is necessarily 'better' post-seroconversion or that the news of my diagnosis was welcome. On the contrary, it resulted in many tears and difficult conversations. It brought tremendous fear, as I worried excessively and dwelled on my mortality. However, I do look back on learning of my infection as something that changed my life forever, in some ways actually for the better. For example, I am still unsure whether I would be sober today had I not seroconverted and made those post-diagnosis changes to improve my life. And sobriety has been a tremendous gift. Fransen is a licensed clinical social worker who is in private therapy practice in Chicago. He welcomes feedback at stillpoint4003@yahoo.com.
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