How do I talk to a family member about HIV?

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      Two years ago, I found a letter in my sister’s car informing her that the blood she gave during a charity blood drive had tested positive for HIV. I didn’t say anything to her at the time because it was a really bad time, I wasn’t supposed to find out, and I didn’t know what to say. In the time since, there were a couple times that it sounded like she came close to telling me but never did. I worry she never will. She has also recently had some health complications that raise concern about how well she’s taking care of herself, and I am concerned that she’s missing out on treatment that she should be receiving out of fear that someone in our family might find out. (As an added complication, our family is a bunch of judgmental religious immigrant types.)

      My sister and I have had a complicated relationship growing up and have really only begun to get along in the last few years. In short, our relationship is fragile, but I care for her deeply. I can’t really understand the gravity of having to live with HIV, especially being from such a family as ours, but I wish we could have her diagnosis acknowledged between us so she can know that I’m not going to stop loving her, that I respect her no less, and that I want to help take care of her. I want her to feel supported, because this must be terrifying to face alone. But that means having a conversation that I’m not sure I have the right to start. What should I do?

      > Sensitive Issue Surrounds Treating Errant Retroviruses

      Your sister may not be facing HIV alone. She could have confided in friends, she could be seeing a great HIV doc, she could be attending a support group. And if your sister were in good health, SISTER, I would encourage you to run with those assumptions, i.e., that she’s getting the help and emotional support she needs. Because it’s generally a good idea to err on the side of respecting a sibling’s right to privacy—even if that respect is retroactive in your case—while also respecting your sister’s specific right to control who she tells about her HIV status.

      But it doesn’t sound like your sister is in good health.

      While it’s possible that she’s facing unrelated health problems that you’ve wrongly attributed to her HIV infection—people with HIV can come down with other shit—that could be a risky assumption. You wanna show respect for your sister, of course, but you don’t wanna respect your sister to death. If there’s a chance your sister hasn’t sought treatment because she feared it would get back to your family (she’s still on your parents’ health insurance, her physician is a family friend) or because there’s some other issue that prevented her from accessing services for people with HIV (language barriers, cultural barriers), I’m going to urge you to err on the side of speaking up. Tell your sister what you know and tell her how you found out. If you don’t tell her how you learned about her HIV diagnosis—“How did you know?” “That doesn’t matter!”—your sister will worry that rumours are spreading and that other people already know. So you have to come clean about snooping.

      Then tell her you love her, tell her you’re worried for her, and tell her you want to make sure she’s getting both the medical care and the emotional support she needs to stay healthy. She may be upset that you know something she wanted to keep secret—she may be furious—but you can point to the last two years as proof that you can be trusted to keep her HIV status confidential. You can’t be trusted alone in her car with her mail, obviously, but you’ve proven to her that you aren’t going to blab about this to the rest of the family.


      I’m a youth who identifies as asexual. That isn’t my question. I was born female, and I’ve been binding for a while and identify as gender-neutral. But I’m afraid to tell others that I’m gender-neutral for fear of being told I’m wrong because I wear dresses. Does wearing skirts and dresses mean I’m not gender-neutral? I just think I look better in dresses than flannel.

      > Gender Neutral Asexual Youth

      Wear whatever you like, identify however you like, and refuse to engage with idiots who think they have a right to critique, dictate, or overrule your gender identity.


      I’ve been reading your column for years, and that helped me tremendously as my husband’s kinky side began to emerge. We have recently started flirting with the idea of “same-room sex” with other couples. We want a couple to watch us have sex, and we want to watch them have sex, but there would be no physical contact between the couples. But we have had a difficult time finding couples that do not want a soft or full swap. Long story short, I have decided to surprise my husband with a prostitute who will watch and video us but not have contact with either of us. I think he will be thrilled. But I’m wondering if you have any advice on this situation. What are the dos and don’ts? I am totally naive about sex work and sex workers, and I’m also afraid I could get jealous since there would be no other man in the room for me! I should mention that we have had same-room sex with a couple and it went fairly well, but we couldn’t really perform because they kept trying to initiate a swap with us. Help me avoid possible pitfalls!

      > Monogamous Voyeurs And Exhibitionists

      “Surprises are generally unwelcome when it comes to sex, and especially to sex work,” says Siouxsie Q, a Bay Area sex worker as well as the creator and host of the WhoreCast (thewhorecast.com/), a weekly podcast about sex work and sex workers. “You think your husband will be thrilled by a surprise prostitute—but what if he is not?”

      You’re already worried that you might not be into it: you wanna be watched by a male/female couple, but you’re only thinking about hiring a woman, and that could leave you feeling jealous and left out.

      “But if you are going to hire a pro, you might as well get exactly what you want, right?” says Siouxsie. “There are plenty of escorts who do ‘doubles’ with other escorts. Take the time to do the research and find a provider who offers doubles with a male escort or a partner—some providers even specialize in this! Communicate about it with your husband, and instead of putting together an elaborate surprise, embark on a sexual adventure together. The process of looking through ads and picking out people you both find attractive may even be fun.”

      Siouxsie recommends booking at least two hours for a session like this—you don’t want to rush through your fantasy, right?—and to respect your sex worker’s quoted rate, i.e., no haggling over their hourly rate.

      “When your providers arrive, communicate your boundaries and expectations clearly so everyone is on the same page,” says Siouxsie, “and you and your husband should agree in advance about either of you being able to call a ‘time-out’ mid-session in order to reestablish boundaries or to talk something out. And finally, on a more personal note, this sounds like a really fun session that most providers I know would be really stoked to book! So get out there and make your fantasies come true!”

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