Yesterday I saw a patient I’ve gotten to know well. She’s HIV+ and came to our clinic after being released from jail. For a while she managed to stay sober and was attending all of her medical appointments. Recently, though, she became depressed and relapsed on drugs. She came into clinic to tell me that she’s planning to leave for her home country (a Caribbean island) in a few days. She doesn’t think she’ll be able to stay on her HIV meds because her family lives in a small town and there’s no local HIV provider. But she thinks that living with her family will keep her on the straight and narrow path. And if she gets arrested again, she’ll go back to jail–so living with her family will hopefully keep her sober AND free. What to do? Stay here and get free HIV meds and a ton of social services (assuming she doesn’t get too strung out to access treatment)? Or go home to her family, get sober again and go without HIV treatment?
I assume she will probably die faster if she doesn’t get sober and get off the street. So I wished her the best of of luck and told her I thought she was doing the right thing. I also encouraged her to try to get HIV care when she gets home. I doubt I’ll ever find out what happens to her…but I’d like to think that she’ll be sober and healthy with her family.