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 rumors 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.