My Friend Is Newly Diagnosed, But He Is Resisting Treatment

You Can Lead a Horse to Water
How do you help someone who just won’t accept it?
by John Francis Leonard

lead-a-horse-to-waterIn my July column, I told the story of a friend of mine at work, Robert, and how he had reached out to me when he was newly diagnosed with HIV. He was in a state of shock, as many would be, and needed some help and support. The first thing I had to convince him of was that he wasn’t going to drop dead in a day or two, and, that if he did the right things and made the right choices, he could expect to lead a long productive life. Unfortunately, as Robert’s new reality set in, he seemed to quickly slide into some sort of apathy about the whole situation.

My initial goal was to help Robert get on ADAP (AIDS Drug Assistance Program). I myself work just a few nights a week at the grocery store (where we both work) to keep myself busy and bring in a little extra money. For Robert, this is his full-time job and, while he does it well, he has trouble meeting the minimum requirements for further advancement in the company, namely punctuality. So, for now, while he’s not exactly starving, with limited education this position is as about as good as it will get for him.

He’s made progress in one key area since I wrote about his situation, though. He now has his own apartment and is no longer staying with a friend. He’s very proud of and pleased by that; he had been in a very stressful situation. Unfortunately his drug use continues; he is functional and keeps it and his life in check, but it’s still troubling. I know all too well, through my own battles, how difficult of a struggle that addiction can be. I have a grudging admiration for the fact that, while he does go on binges, his car payment, insurance, and rent are always covered first. But I worry—it’s a dangerous game to play. Over the past few months, however, he’s been slipping. He increasingly calls in sick to work, and, on occasion, just not showing up. I can’t help but think that it’s the drugs that might be the problem.

My major concern, however, is that more than seven or so months since his diagnosis, Robert is still not on medication. It’s a ticking clock but again, he has developed a sense of apathy about the situation that troubles and frustrates me. When the social worker at the clinic he started going to for HIV treatment dropped the ball, I got on the phone with ADAP and found out exactly what was needed and even faxed it for him. All they need now, from what he tells me, is a simple piece of paper from work, proving that he is basically insured. Again, it’s been about seven months, and he still hasn’t done this. To make matters worse, he hasn’t been back to the clinic at all, despite their repeated calls. That means no blood work, which means no monitoring of his T cells and viral load. He missed an important deadline in obtaining ADAP coverage just recently and now will have to begin the process anew. With a dangerous new administration ready to take over, it’s likely that we’ll be seeing at least some serious cutbacks in the Ryan White CARE Act, which funds ADAP. The Vice President has made no secret of his belief that the cost of prohibitively expensive HIV medications should be borne by the patients. At the very least, we could be facing very long waiting lists for drug benefits. The sooner Robert is signed up, the better.

Robert and I are not close friends by any means. We are vastly different people. About the only thing we have in common is the fact that we have sex with men. He’s very much a straight guy at heart; I know that I’m about the only gay friend he has. He’s never actually been in a relationship; he chooses not to be. We do talk though and I’ve regularly, to no avail, tried to convince him how important taking this medication is. Also of concern, he has no real idea of when he contracted the virus. Generally the virus, if untreated, takes up to ten years from transmission to an AIDS diagnosis. But, things can progress much more rapidly in some cases. It’s imperative that he get on medication as soon as possible. He laughs this all off every time I tell him; it’s a slightly nervous laughter, but it’s still dismissive. I also worry about another thing: Say he got financial assistance, got a prescription from his doctor—would he even be compliant with his medication? Would he show up for the long series of doctor’s appointments ahead of him? I recently threw in the towel, I just couldn’t get through to him! Then, some weeks later, we were talking and I asked him, again. The answer was the same. He listened to my litany of HIV/AIDS facts and to my recounting of the horrors of dying from this disease and how he was incredibly lucky to be able to stop it in his tracks. But it was all to no avail. Same dismissive attitude, same laughter.

I’m at a crossroads here, I’ve tried to help. I want to help. I’m a bleeding heart liberal for heaven’s sake! I feel compelled to make a difference. But I can’t make someone do what they don’t want to do. Maybe it’s time for me to step away; maybe I can’t help.Ultimately, though, I know I’m going to approach this again with him. I’m just stubborn that way.

John Francis Leonard is an advocate and writer, as well as a voracious reader of literature, which helps to feed his love of the English language. He has been living with HIV for thirteen years and he is currently at work on his first novel, Fools Rush In. Follow him on Twitter @JohnFrancisleo2.