What It's Like to Tell Someone They Have HIV

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Today is World AIDS Day, which means that, with any luck, thousands of people will get tested. Most of those tests will come back negative, but some will not. Some people will find out that they have HIV.

When I was an HIV tester and counselor and I would tell people about my job, the first thing they would say is, “That must be so hard to tell someone that they have HIV.” And it is. As a friend put it, “Sharing a positive test result with a client remains the most difficult thing I've ever done, but I had to always remind myself that, as difficult as it was for me to share that news, it would have been far more difficult to hear the news.” She was a good tester because of that empathy.

In my own experience, giving a positive result was nerve-wracking and intimidating.

You’ve just been cast as a character in a major moment of someone’s life. You don’t want to do or say the wrong thing. Once when I was anxiously preparing to disclose a positive result, an HIV-positive volunteer overheard me. “It doesn’t matter exactly what you say,” he said. “He won’t hear anything after the word ‘positive.’”

On a bigger level, telling someone that he or she is HIV positive is one of the best things you can do to fight the spread of the virus. There are a couple ways to think about HIV testing. One is that you’re providing a service to the community: people come in, you test them, you give them results and/or referrals, and then they leave. But another way to think about testing is that you are on the front lines of stopping the virus: you are looking for people who are at high risk for HIV, testing them, and then if they test positive, you make sure they transition immediately into a continuum of care.

In the first model, a positive result is a fraught event, but in the second model, it’s an accomplishment. It means you found the person you’ve been looking for, and just by telling them their status, you dramatically reduce the likelihood that they’ll transmit the virus to someone else. It makes all the posters, street outreach, school visits, ads, and community events worth it because you just punched HIV in the face.