Amy Dickinson is a general advice columnist.
DEAR AMY: Several years ago I was diagnosed with HIV. At the time, my husband, who thankfully is not infected, and I decided that we would wait a year before telling anyone. It has been four years now and I have yet to tell anyone. I have a conservative family and it took me a long time to even come out to them, and the thought of having to tell them is scary to me. Not only that, but there is an embarrassment factor -- the fact that I did not take care of my body or take the proper precautions to prevent myself from becoming infected. Is it my responsibility to tell the people in my life about this disease? Do they have a right to know? I worry about my family's reaction, and I also don't want them to treat me any differently.
-- Getting Better
DEAR GETTING BETTER: I realize there is stigma attached to HIV, but it might help you to attain some clarity here if you could see this as a health concern that is chronic but manageable and ultimately concerns only you and any sexual partners.
So, imagine you have lupus. Would you disclose this to your parents? You might if you were having symptoms. Otherwise, maybe not. Disclosing a health condition is a very intimate act; before you do it you must trust that the person can receive the news and react in an appropriate way.
I shared your question with Kelly Ducheny, a psychologist and director of behavioral health at Howard Brown Health Center in Chicago. As a counselor who deals with individuals and couples wrestling with this issue, she has a ready answer: "It is completely every individual person's choice whom they tell -- and how and when, or if they tell. You are under no obligation to disclose anything about your HIV status. Furthermore, there is not one option that is healthier than another.
"If you do decide to tell people, have a plan for how to disclose it. Understand that there is a processing period and their initial reaction may not be their permanent reaction."