By Benjamin Ryan
Originally published on Advocate.com December 10 2010 1:20 PM ET
When Mark Ciano, who’s been HIV-positive since 1998, settled in San Francisco after 20 years in the army, the 46-year-old found himself at a loss for a group of friends. Used to the melting-pot social scene in London, where his buddies came from a diverse cross section of backgrounds, he found the Bay Area more segregated—cliquish and overly youth-oriented for his tastes. He wasn’t about to start going to nightclubs to meet people. So he joined a club: his local chapter of Positive Pedalers, a collective for HIV-positive cycling enthusiasts with similar groups in cities around the country.
“I found a community and a group of people who I want to be around,” he said. “And getting on the bike, I got back into really good shape.”
“The experience of being HIV-positive can be enormously isolating,” says David McDowell, MD, a psychiatrist in private practice in Manhattan. “You can feel like you are no longer a part of the larger world. And so anything you can do to get out of yourself and also find other people is really important and really helps that sense of depression that sense of isolation.”
Estimates of the rates of depression among people living with the virus run as high a 40% to 60%. Using more rigid definitions, Glenn J. Treisman, MD, Ph.D., the director of the AIDS Psychiatry Service at Johns Hopkins Hospital in Baltimore, figures that at any given time about one in five HIV-positive people suffer from depression severe enough to require psychiatric treatment. Regardless of how depression is defined, it’s clear that people with HIV suffer from depression at rates four to five times that of the general population.
Going well beyond the model of the chairs-in-a-circle support group, many organizations around the country provide activities and social clubs for people living with the virus that give them a chance to get out and meet people in a environment that’s safe and definitively understanding.
San Francisco-based Healing Waters runs white-water rafting and other wilderness-based expeditions for people living with the virus and has certified proof that shooting down the river with other HIV-positive thrill seekers can lift the spirits. In 2005 the group’s founder, Cale Siler, conducted a study with Rochester University and found that after a weekend trip, participants experienced a 38% decrease in depression, a 27% increase in vitality, and a 28% increase in mental health.
"In living with a chronic illness, too often you become the illness,” says Healing Waters board cochair Bradley Zaller. “You start focusing on your limitations and all of the things that you can't do. And I think that we come in and say: 'Look at the things that you can do.' I've heard several times from people that 'I've learned to trust my body again.'"