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Many columns ago I noted how much easier it is when living in a large metropolitan area to cope with having HIV, not unlike the greater ease with which one can be openly gay. When one is surrounded by others in a similar situation -- or at least by a general populace tending toward the progressive side of the political spectrum -- feelings of safety and security more readily occur. And for those finding themselves in supportive communities, this comfort can be taken for granted. Recently when visiting my family in a smaller community, this stark reality confronted me. In my rush to arrive at my destination, I happened to forget my medications. I panicked. While missing a couple doses is not the end of the world, it nevertheless frightens me, since I don't want to squander my drug regimen needlessly. While confident in the state of my health, I find it remarkable how I am gripped by fears of mortality and illness in such moments. In my anxiety I sped to the nearest pharmacy to see whether I could obtain enough medication to sustain me during the trip. As I pulled into the parking lot, however, an old and familiar feeling returned -- fear of judgment. I had experienced much judgment in my hometown while growing up, and I felt that discussing openly with a pharmacist in this community would yield similar judgment. I understood once again how many of you living in smaller communities may feel when navigating your lives. I tried reminding myself that any pharmacist is a working professional with a code of ethics. This helped assuage my anxiety somewhat as I approached the counter. Rather than be circumspect I directly described my condition and predicament. To my pleasant surprise the pharmacist responded as though I had asked whether he sold cold medication. He checked my insurance benefits -- as well as the inventory, since he doubted that they carried all my medications. Here again I was reminded of what it might be like to live in smaller communities. So much easier to approach pharmacists in the first place, and doubly so when confident they will have the medication, and one will not have to navigate a potentially awkward interaction. He couldn't have been more helpful. And I was enormously grateful. Like so many people I know, I have been lulled into a state of complacency given the community in which I live. It's a version of the 'gay ghetto.' The assurance and validation accompanying such an experience is immeasurably good. However, it can also create the illusion that society is more enlightened than it actually is. It can also evoke shame that had been thought buried. As I reflect on the experience in this moment, I have great compassion for those who live with HIV in silence or shame, given the communities in which they live. I also recognize in the deepest part of my being, that while I have done a lot of work regarding my own shame, there is still plenty of work to do. 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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