On Top of It
Naturally, many facets of living with HIV can and do cause depression. Which is all the more reason why, experts say, HIVers should be hypervigilant about developing effective coping skills.

Ken Howard, a licensed clinical social worker with a therapy practice in West Hollywood, Calif., and an 18-year survivor of HIV himself, blames what he calls “an era of profound HIV stigma” for much of the anguish in the HIVers he counsels.

“These are people who have perfect health, who are feeling well, who are looking and feeling fine,” he says, “but they’re feeling depressed because they feel like they are forever damaged goods. In some cases what they experience is not just ‘I don’t want to sleep with you because you have HIV’; it’s ‘I don’t want to know you because you have HIV.’ ”

Randal Province, a 48-year-old who lives in a suburb of Memphis with his HIV-negative wife, knows about that kind of reaction from people. On disability because of an injury, he says gastrointestinal side effects from his anti-HIV meds make him afraid to venture too far from home.

But stigma that stems from his having HIV has played a cruel hand in furthering his isolation. Afraid of how the local community would react to his serostatus, he’s told only his close family and one friend that he has HIV, and even that has proved to be too wide a circle of disclosure. A few years ago his brother, a well-educated businessman, served him Thanksgiving dinner on separate dinnerware from the rest of the family -- which he then disposed of after the meal.

Province says he tries to cope with his depression by keeping busy. He loves to garden and tends to his elderly neighbors’ yard free of charge. He says he also always has some home-renovation project brewing. And he tries to take care of his overall health by hitting the gym. If he doesn’t exercise regularly, he says, he feels the effects in just a few days and begins to spiral into feelings of apathy about his well-being.

But he’s quick to put the brakes on that kind of thinking when he realizes it’s going on.

“It’s like, No, I’ve got to take care of myself. If nobody else cares, I do,” he says. “Because nobody else looks at me in the mirror every morning -- as scary as that can be for me some days.”

Tags: Health