How Will I Ever Be Able to Tell Someone I Am HIV-Positive?

Among the questions many people grapple with after an HIV diagnosis is how to disclose the news and to whom. Coming to terms with an HIV diagnosis can be very difficult. Over the years, I’ve had the opportunity to work with many people who were newly diagnosed. (For the purposes of this article, “newly diagnosed” is defined as within the previous 12 months.) Another question I’ve heard is, “Must I tell anyone I’m HIV-positive?” Such questions are valid and part of a normal, emotional response to a potentially life-altering diagnosis. This article will help explain the important role therapy can play in helping someone prepare to disclose their HIV-positive status.

It has been my experience as a therapist that many people newly diagnosed with HIV have a desire to share their diagnosis with friends, family, and loved ones. (This article will not explore the issues involving disclosure of HIV-positive status to casual sex partners or in the workplace. Those are important areas of discussion, worthy of focus in future articles.) However, many individuals feel reluctant and/or afraid to do so.

There are several common reasons someone might feel reluctant or afraid to share their HIV-positive status with a friend, family member, or loved one. They include:

• Concern the person they tell will not be able to handle the news
• Fear of rejection
• Shame
• Potential breaches of confidentiality if those they tell repeat it to others
• Fear of potential physical harm from those they tell

All of these concerns are very real and potentially overwhelming to someone still acclimating to the news they are HIV-positive. Meeting with a therapist may provide the individual with the opportunity to give voice to their feelings and emotions. The therapeutic relationship is one of confidentiality, is nonjudgmental, and fosters unconditional positive regard. In fact, the therapist can be one person with whom the newly diagnosed individual can share their status without fearing the issues listed above. This may be particularly important for people who have no one else to share the news with. This has been the case on more than one occasion in my practice. I remind the person that they have shared the news with me. This often helps make the seemingly impossible feel suddenly possible, creating a safe environment where one can begin to share their thoughts and feelings about further disclosure.

For some people, fear and concern about how others will react to their HIV diagnosis is often a reflection of their own feelings.

It is important to realize there is no time frame or rule regarding when one should disclose their HIV status. However, because newly diagnosed individuals often feel overwhelmed by the diagnosis, there can be a sense of urgency to share the news. If an individual identifies any of the concerns listed above, I often give the same advice: wait. In these situations, I usually work with individuals to manage their own emotions and to come to terms with the diagnosis before disclosing it to others.

For some people, fear and concern about how others will react to their HIV diagnosis is often a reflection of their own feelings. For example, when someone states they want to share the diagnosis with their mother, but fears she will die if told, it may be a real indication of how the HIV-positive person is feeling. Therapy can help the individual understand these are normal emotional responses, help them begin to integrate the diagnosis into their larger life, and create a sense of mastery over the situation. When a person attains a sense of mastery over a given situation, the confidence to integrate it into their life and share it with others may naturally follow.

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