QUESTION
A friend/co-worker confided in me that he was HIV+ and that he had never told anyone before. While I'm honored that he would trust me to tell me, I can't help but worry about him and his lifestyle. He has not been to a doctor, he parties every night, and I'm almost sure that he is not discussing his HIV status with his sex partners. It seems like he is just trying to run away from it all. How can I get him to face this and begin a relationship with a doctor without ruining our friendship?

ANSWER
The best thing you can do is listen when your friend talks about his experiences of being HIV+. He obviously trusts you since you were the first person he told about his status. Asking some questions about his HIV infection can help you and perhaps him understand what he knows or doesn’t know about HIV and show you care. He should see a doctor and perhaps you can help convince him based on what he knows or doesn’t know why that is important. There are lifesaving medications available for HIV-infection, and a new one that is one pill, once-a-day.

As trust continues to grow between you both about his HIV infection, you can begin to talk about his lifestyle and how he's balancing his partying with his work, particularly if he starts that conversation. If you start that talk (often called unsolicited advice), he may feel judged. In the end, it's your friend himself who has to make the choices that will keep him healthy.

It's great that you are a caring and supportive friend. To further educate yourself about the difficulties surrounding disclosure check out this material by The San Francisco Disclosure Initiative or read previous Ask Dr. K answers to "New Partner, Serodiscordant" and "Barebacking with Partner He Didn't Know was Poz".

To your health,
Dr. K