Yesterday, I told someone he has HIV. Because somehow, despite 30 years of research and medical advances and prevention methods, there are still 50,000 new infections each year in this country alone and over 1 million people living with the disease.
By the end of my afternoon clinic inside the jail, I saw 5 more people who are living with the virus.
One has come back from the brink of death at least three times since the 1980s when he was diagnosed. He somehow lives on. Alcohol and homelessness have made taking his medicines difficult, and his T-cells* have come crashing down again, putting him at risk for those same infections that almost killed him before.
One tells me he is working on the cure for HIV from his jail cell. Schizophrenia has devastated his mind more than HIV ever could. Jail may be the safest place for him, because at least when he is there, he gets his medicines.
Another survived lymphoma, as if living with HIV was not enough.
Two continue to fight the addictions that first led to their infection.
This afternoon, I was at the county's HIV clinic, where I see both my patients who have been released from jail and also other individuals living with HIV in our community: a mother from Ethiopia, her daughter and husband also infected. A young man from Mexico. A young woman from Vietnam. Transgender, gay, straight, people of different colors and different languages, all choosing life and health - even when the path is marked by relapses and depression and hospitalizations and homelessness and discrimination and loss.
So, at the start of Advent and on World AIDS Day, a decade after I returned from Africa, thirty years since the start of this epidemic, and two millennia since the first Christmas, I breathe out a prayer offered up before Hope was born:
"By the tender mercy of our God,
*marker of immune function