World AIDS Day...again

On World AIDS Day last year, I wrote about how I had told another person they had HIV and reflected on how people's lives continue to be turned upside down by a microscopic retrovirus.

Yesterday, the story repeated itself. Again on the eve of World AIDS Day, I found myself sitting across from a young man inside the jail, telling him he has HIV.   

Today, just like last World AIDS Day, my schedule is filled with people from the forgotten edges of society who are all affected by the same invisible infection. 

Over and over, it feels the same: 
Our social worker, asking if I can double book him in again, even though he missed his last two visits. Of course. Because what if this time is the time he comes. 
Our nurse who does medical intakes for the jail, calling to verify the medications of the person who was just released from jail two weeks ago, back again. 
Our electronic health record, notifying me that she is back in the emergency room, high on meth.

It's the same collection of patients, filtering through the jail to the community, then back into the jai. Their promises to stay sober are often unable to stand against the forces of addiction and disconnectedness. It's the same stories of homelessness and untreated mental illness and the struggle to survive. It's the same journey to find healing and worth when the world seems stacked in the favor of anyone else. 

I traveled back to Africa this year for the first time in over a decade. Rates of HIV are going down and treatment is improving, but I still sat across mothers whose babies were born with HIV. I begged a man who drinks liquor instead of taking his HIV meds to go to the hospital because the x-ray of his chest showed tuberculosis. I listened as a teenage girl told me how it wasn't fair that she got HIV but her younger siblings were spared because preventive medications became available only after she was born. 

~~~

I recently attended a conference where another HIV jail doctor shared the same sentiment I've wrestled with over the past few years of working in correctional settings: that things may not change. That despite how much a patient promises this is their last time in jail, that we will probably see them back in jail. That our words and medical knowledge and kindness may not be enough to overcome all the other forces of brokenness in their lives. That all we have are single moments to speak love to someone. That the best and most holy thing we can do is be there in those moments offering Love.  

We do it again and again - every time someone is booked back into jail or stops taking their meds or relapses on meth or loses their housing or their temper; every time someone misses an appointment and wants rescheduled when it is least convenient; every time it feels like someone is never going to change.  Because there is Love that meets me again and again - so what can I do but offer that same grace? 

~~~  

Just like every World AIDS Day, I offer up a prayer: 
That despite how things may seem the same, despite how broken the world appears - that we may always find reasons for hope and courage to love.