HIV: Supporting the Human

This World AIDS Day, we’re sharing US Babylon therapist Christopher Hall’s honest and moving experience of supporting people with a diagnosis of HIV.

A human issue

This may be a weird first statement, but HIV still exists and, unfortunately, ignorance still exists about what HIV is. HIV is not a curse for a particular lifestyle, it is not limited to a specific race or age, or gender. HIV is a human issue.

I have worked with HIV positive gay men and have seen first-hand the tragic results of how ignorance, stigma and shame can destroy a person’s self-esteem and cause deep psychological scars that never truly heal.

I have served clients who were afraid to take their life-sustaining medication because it served as a reminder of family abandonment, religious persecution and social exclusion.

A client’s story

The following is a client encounter that embodies some of the attitudes and ignorance that still exist around HIV.

I remember the day quite vividly. I was informed that I would be assigned a nineteen-year-old male client who learned he was HIV positive a week earlier after administration of a rapid test. He wanted his initial session to be a family session that included his grandfather with who he lived.

When I greeted the client in the waiting room - our eyes met, and I could instantly see an overpowering confusion as so many questions invaded his thoughts. I could feel his fear as he grasped for understanding and emotional stability, his shame as he quickly broke eye contact and tilted his head down in a defeated manner. I still remember the look in his eyes, the loss, grief, desperation that caused him to speak with hauntingly long pauses as if struggling to breathe.

The client’s grandfather towered behind him in a manner that I immediately read as intimidating and aggressive. Within the first two seconds of our office time, the grandfather made it clear that he did not tolerate the lifestyle that the client led and felt it was ultimately responsible for his grandson’s HIV diagnosis.

He continued in a very blunt manner to ask a question, “My grandson had a nosebleed in the house over the weekend- does this mean everyone in the house needs to have an HIV test?”

(One important fact I wanted to save for this place in the blog is this happened during 2019).

I know my jaw dropped; I don’t know for how long, but I know it did. After I gathered myself back together, I looked into his eyes, perhaps for the first time since we both sat down, I could instantly see an overpowering confusion as so many questions invaded his thoughts. I could feel his fear.

Fear is often rooted in a fundamental misunderstanding perpetuated by misinformation. It was important for me to use this moment as one to educate both the client and his grandfather about HIV and not to react to my own basis of the grandfather’s initial posturing, but to treat everyone with the respect and dignity that human beings deserve. This created the space necessary to begin healing and focus on the true enemy, HIV.

Supporting clients who are HIV positive

If you succeed in treating a client as human, half of your job as a therapist is done. To support a client, you must first see them as a human being not a color, a religion, a race, or gender, but as a human being. This does not mean a therapist should ignore or discredit the aforementioned but honor them as part of the clients’ human experience and allow the client to be the educator.

A therapist’s work is really about honoring the client’s experiences and understand where they are at emotionally, psychologically, physiologically, and spiritually at the beginning and during the therapeutic process. The most rewarding moment in therapy is when a client begins seeing themselves as a beautiful, complex, unique being that has the right to interrupt the world around them with as many inflections and colors as they desire, freeing themselves from the shame and guilt often imposed by those afraid of the repercussions of freedom.

There is no perfect blueprint for the human, and forced uniformity of the human spirit is at best torture. It is never my place or intention to dictate what a person should focus on in therapy but to support them as they begin to explore new perspectives based on hope, faith, and choice.

A therapist’s approach

My answer to those asking how I approach therapy with clients living with HIV is “exactly like I approach therapy with anyone else.”

I have been blessed with the opportunity to work with many diverse client populations, including a period of time where I worked exclusively with clients who were living with HIV. Serving this population effectively equated to being sensitive to the shame, stigma and trauma that, for a high percentage of clients, is an integral part of the experience.

As a therapist, one of the most important things that you can provide for a client is a non-judgmental, safe space in which to honestly begin an exploration of their concerns. This means patiently constructing a framework of mutual understanding where trust and empathy are essential. This work involves navigating through layers of defenses uncovering and naming trauma, shame and resentment, which is at the true core of their issues. The work then transitions to assisting a client in recalibrating their perspective to adopt a new position of power.

Successful treatment is multidimensional

People are multidimensional. Having a diagnosis of HIV doesn’t mean you lose your identity or transform into a disease. The disease adds to the complexity of your experience, it introduces new obstacles to maneuver. One of the most difficult things I witness in treatment is watching someone struggle with who they are after an HIV diagnosis.

Many factors dictate successful treatment. The first is immediately connecting them with a supportive community that includes scheduling their first doctor’s appointment and prescribing their initial medication. Educating the client on what is going on within their bodies (what HIV means from a physiological viewpoint) is vital. Equally important is connecting them to local support networks, including agencies with peer support and a behavioral health therapist to assist with the emotional and psychological components of coping with HIV. It’s imperative that a person knows that they do not have to do this on their own.

Despite how far we think we have come in the battle with HIV, and we have made significant progress, we are still limited by our willingness to understand and accept the experiences of others. And although this blog comes from the perspective of a therapist and focusses on HIV, the reality is that it can be applied to how human beings should aim to treat one another.