Coping When AIDS Hits Your Family: Part II

When a family member is diagnosed with HIV/AIDS, it presents a host of unique challenges. Dorothy Holmes, a psychologist who counsels people infected with HIV/AIDS and their families, offers advice.

FARAI CHIDEYA, host:

I'm Farai Chideya and this is NEWS & NOTES.

Before the break, we heard from a mother with AIDS. She has been getting great support from her family. But that is not always the case.

Dorothy Holmes is a psychologist in Miami. She has been working with people infected with HIV and their families for several years now.

Hello.

Dr. DOROTHY HOLMES (Psychologist; National President, Association of Black Psychologists): Hello. How are you doing today?

CHIDEYA: I am doing great. So, we just heard from Carla. She waited to tell her kids and family about her illness. So let's start off with disclosure. When is the right time to really reveal the illness to others if you have HIV or AIDS?

Dr. HOLMES: Well, disclosure is based on a needed-to-know, and that need to know starts with, of course, the individual's sexual partner. However, when it comes to disclosing some of your status to your children, there's no black and white answer or yes or no in terms of when to or when not to disclose. It depends on several factors, which include - some of these factors include the age of the child, child's emotional maturity, the child's intellectual and the child's intellectual functioning. And - but before disclosure takes place, my recommendation is that the infected person, of course, meets with a mental health professional who has experience in this particular field.

CHIDEYA: So when you, as a psychologist, deal with individuals who have a diagnosis of HIV or AIDS, what are some of the most common questions that come up in your sessions?

Dr. HOLMES: Disclosure is typically the first issue. Do I need to tell my children? Is, (unintelligible) the children or younger than 15 or 14, parents are probably concerned about their longevity in terms of whether they'll be, whether or not they will be available or be around to see their children grow up, finish high school, become functional adults themselves. So they really want to know when and how do I let my children know, or if I let - should I let my children know.

CHIDEYA: Do you ever see people who react in ways that are completely unhealthy? Drug abuse or recklessness or acting out with anger?

Dr. HOLMES: Yes, in terms of not disclosing their status to…

CHIDEYA: Well, after they have had…

Dr. HOLMES: …the partner.

CHIDEYA: After they've had a diagnosis.

Dr. HOLMES: After they've had a diagnosis, yes. Unfortunately, unfortunately, that is the case for some people. Because of their anger and rage, they do act out inappropriately and not disclose their status to a sexual partner.

CHIDEYA: Now…

Dr. HOLMES: And that causes the incidents to - of HIV/AIDS to increase.

CHIDEYA: Yeah. I was just going to ask you about that because we heard earlier in the show how rampant AIDS has become among African-Americans in the Washington, D.C. area particularly, but obviously, there are plenty of places where there's just a huge increase. And when you think about this idea of telling someone, there have been all these campaigns to ask people to open up. But do you think that's really working?

Dr. HOLMES: Well, again, the issue of social stigma, shame, guilt, lack of education and knowledge are some of the factors that prevent individuals from disclosing their status. One of the things that must be readdressed was the need for information and education and that's our first line of defense. Once we educate ourselves, then we're able to protect ourselves.

CHIDEYA: Carla Bailey has been living with AIDS for 13 years. There are people who've been living with AIDS for over two decades. But if, in fact, your loved one has AIDS and it's becoming a nearing of the end, what things should people think about as they face mortality?

Dr. HOLMES: Again, this is - some people are in that position where they have not disclosed to family and loved ones their status. And that would be fine(ph) to disclose to your loved ones. And so you can begin to mend and bring closure to relationships and to issues and work through whatever unresolved issues you may have lingering with a particular loved one or individual. So yes, that does that happen in people. Some people are able to work through these issues.

CHIDEYA: Well, thank you so much for your time.

Dr. HOLMES: Thank you.

CHIDEYA: Dorothy Holmes is president of the Association of Black Psychologists, and she's worked with HIV-infected clients and their families since 1995.

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