HIV & Depression

 How Long-Term HIV Survival and Depressive Episodes Go Hand-In-Hand

Living with HIV for decades turns time into something strange. The urgency of the early years eventually fades, but the virus doesn’t. It just settles in, like a roommate you never invited and can’t evict. The crisis slowly becomes routine, and routine becomes its own kind of prison. That little pill that keeps me alive is both my miracle and my mirror—every morning it reflects back the part of me I’d most like to erase. I swallow it with water and a wince, a daily ritual of gratitude and resentment in the same breath.

What people don’t always see is that long-term survival comes with a quiet, grinding grief. I outlived the panic-era headlines, the funerals, the whispered “Did you hear…?” phone calls—but survival has a body count, and sometimes I feel like I’m standing on top of it. Survivor’s guilt isn’t just a dramatic phrase; it’s the heaviness you feel when you realize you’re still here while faces you loved live only in old photos and half-faded memories. You start to wonder why you were spared—what cosmic math decided you get to grow older with this virus while others never had the chance. The world moved on to new scandals and new crises, but my body never got to move on from this one.

Then there’s the stigma that doesn’t die, it just evolves. It lives in the awkward pause when I disclose my status. In the way some people say “Oh… thank you for telling me,” like I just handed them a ticking bomb instead of a piece of my truth. It’s in the dating apps where you either brand yourself with three letters—HIV—or play this exhausting game of timing and disclosure and risk. Even in 2025, with PrEP and U=U and all the science in the world, there are still looks, still questions, still people who treat you as a walking warning label instead of a whole person.

Sex, for me, isn’t a minefield of disclosure anymore; I took that part out of the equation a long time ago. My status is right there on every profile, in plain sight, so anyone who can’t handle it can quietly move along before we ever exchange a word. It’s a kind of harm reduction for the heart: I don’t have to brace for the awkward pause, the panicked unmatch, the “sorry, I didn’t realize…” message. But there’s a quieter cost to that system too. I never see the rejections—I just feel the absence. Fewer messages, fewer replies, conversations that die on the vine. You can’t prove it’s because of those three letters, but you feel it anyway. It becomes easy to see yourself less as a person who happens to have HIV and more as a filter people are silently passing or failing before they ever bother to meet you.

Over time, that kind of invisible sorting seeps into the bedroom, even when I’m with someone who does show up, who does understand U=U, who doesn’t flinch at my status. My body still remembers years of being treated like a risk instead of a partner. Desire gets tangled up with self-consciousness, with side effects, with the sense that I’m a “safer choice” only because I’ve turned my sex life into a disclaimer-first operation. It’s not that I’m afraid to be honest; it’s that honesty has taught me exactly how conditional other people’s desire can be — and some days my libido responds by just shutting the whole system down.

Depression doesn’t just drain my mood; it interferes with the one thing that’s literally keeping me alive. When I fall deep into an episode, basic tasks turn into impossible mountains. Getting out of bed feels like a negotiation. Feeding myself, brushing my teeth, taking a shower—those start to feel optional. The pill bottle on the nightstand stops looking like hope and starts looking like a judgmental little witness. On the worst days, I just roll over and let the hours pass, doses slipping by untouched. It’s not always a dramatic “I want to die.” Sometimes it’s just a quiet “I don’t care what happens to me right now,” and that indifference is its own kind of danger.

That’s what scares me when I finally surface: how easily survival can start to unravel in those stretches. If I miss meds for long enough, HIV stops behaving like a managed chronic condition and starts becoming a real threat again. The virus I work so hard to keep caged gets a chance to wake back up. Then the shame hits: You know better. How could you let this slide? That shame folds right back into the depression, which makes it even harder to pick the pill up the next day. It becomes a loop—virus, pill, depression, avoidance, more risk—and it’s terrifying to realize how quickly that loop could become deadly if it goes unchecked.

From the outside, it just looks like I’m “having a rough week” or “in a funk.” Nobody sees the small, lethal math happening in my bedroom: missed pills, skipped meals, a body quietly absorbing every choice I’m too numb to make. Long-term survival is sold as lab numbers and adherence charts, but for me it’s also this constant fight not to let the darkness talk me out of basic self-care. The same daily pill that gave me a future back can become the first thing I stop reaching for when the future feels too heavy to hold.

And yet, here I am. Still taking the pill. Still doing the laundry. Still paying bills, going to work, flirting on good days, hiding on the bad ones. That’s the darker side of survival no one prepared me for: not the drama of dying, but the discipline of living. Waking up again and again to the same virus, the same bottle, the same history, and choosing—sometimes reluctantly, sometimes angrily—to keep going. It isn’t inspirational. It isn’t neat. It’s just real.

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Lessons To Be Learned

When I was born in June 1973, my parents were only 19 and 18 years old. Mom, the older of them by two weeks, began feeling labor pains on her 19th birthday, three days before I was delivered, and Dad would turn 19 just a week and a half later. If anyone reading this wants to make a movie of it, take this note: I was NOT the birthday present they wanted, but I was the best damned birthday present they were going to get! Be sure the actors know to look mildly disappointed but also miserably resigned to their fates. Got it? Okay.

Brenda and Rusty had “fallen in love” their senior year at Dry Prong High School, where they were each something of a local basketball star on their respective varsity teams. (Where those sport-inclined genes went is beyond me.) Somewhere between all that jumping and dribbling, somebody scored a real three-pointer, et voila - I was made! The sperm must have wriggled and gnawed and battered its way into that egg late in the fall of 1972 as Brenda was settling into her dormitory suite and beginning a very short-lived college career studying art at NSU. Once she could no longer hide the baby bump, they were rushed quickly but quietly into a family church wedding and then forced to start our dysfunctional little family in a tiny little house on a great big hill in the middle of Kisatchie National Forest.

"Rusty" Murdock

My dad took a job as a rookie police officer, which it turns out suited him pretty well. His temper and resentment of being trapped in a marriage with a kid served him well with the department, and between routinely beating my mother unconscious and narrowly beating charges of sexual misconduct with underage girls while on duty, he began his meteoric rise through the ranks of the Pineville Police Department. Spoiler Alert: Last I heard, he still works there. Like I said, the job suited him.

Melvin Alvin Hataway

One of my earliest memories is of being given a bath by my grandfather during a weekend visit when I was three. I clearly remember feeling apprehensive about being truthful when he discovered red, blistering welts all over my legs, buttocks, and back from a beating my dad had given me with a switch. He had warned me in no uncertain terms not to let my grandparents find out about it, and here I was, a wet, naked stool pigeon spilling my guts to my pappaw.

Pappaw dried me off, dressed me, and drove the fifteen miles or so to the Grant Parish Sheriff's Office for a meeting with my great uncle, his brother, Sheriff Pop Hataway. I was asked to retell the story and then they pulled down my pants and photographed the welts for evidence, and we all drove back to my parents' house. Uncle Pop, as I recall, had the good sense to keep Pappaw away as he brought me inside to confront my dad.

I remember the house being so dark and foreboding, even though it was still a fully bright mid-afternoon outside. Dad worked nights, so that meant he had to sleep during the day. Our house was to be kept cool, dark, and silent when he was sleeping, otherwise we paid the price for waking him.

2nd Street Home, Dry Prong, LA

My eyes stayed locked on the pattern in the atrocious red plaid carpet that extended from the front door into the sunken living room. It was red, I know it for a fact, though in such perpetual dimness, I don't know how anyone could have guessed its true color.

L.R. "Pop" Hataway

I listened, eyes down, hands clasped behind my back, to Uncle Pop tell my dad that he understood that kids sometimes got sassy and needed a good spanking so they'd learn to be better. But Dad would be better off, he went on, if he'd stick to using a hand or a belt rather than drawing blood with a switch. He warned Dad that if he had to come back out to discuss more bloody welts on my butt, it would be as the Sheriff and not as family.

The bright, yellow-orange sunlight from outside struck my down turned eyes and I looked up in time to watch the back of Uncle Pop sauntering out the door and through the yard to his car. In a slow, angular way, it was pinched back and pushed out by the closing door, my dad's anger radiating from the shadows as his hand left the door knob and went to his belt.

Did I mention that my dad and his two hippie brothers fancied themselves leather artisans who made big, gaudy, embellished leather belts and watch bands in their free time? Oh, yeah. They totally did. I wonder if Uncle “Here’s-My-Advice-About-How-To-Beat-Your-Kids” knew that when he made his recommendation that day. My dad's favorite belt was a thick, ugly, brown one adorned with little brass sea shells that punctuated his circumference every 6 inches with a glint of tarnished gold and sounded like a tire rolling over rumble strips on the shoulder of the road when he took it off.

Those shells didn't break the skin like a switch. But neither did they give him the immediate satisfaction of a kid well beaten. It took hours, sometimes a whole day for the enormous purple and green lumps to fully ripen on my skin after a belt beating. And often, that meant that a belt beating could last much longer than a whipping with a switch, because there was no blood to indicate when he'd done it properly. So, not long after that visit to Uncle Pop's office and having my first set of naked photos taken in front of several men I didn't know, we packed up and moved out of Uncle Pop's jurisdiction and into to Dad's. Switches were back on the menu.

Before I’d started kindergarten, I had been thoroughly trained in the art of switch selection. It was a sort of tortuous ritual my Dad had had me learn. I could always feel his glare on my back, watching and savoring my terror as I traversed the length of the back yard to select a worthy instrument of pain for him.

Not too wispy; not too thick. It needed to be roughly 4 feet long, slightly thicker than a pencil's width at its base, and it should be green and mature, but elastic enough to allow its end to wrap around my hips and thighs many, many times without splintering or breaking to pieces.

At age four, I knew to have it stripped of all its leaves by the time I handed it over to him. I also knew without being told that I was to turn around, pull down my pants, grab my ankles and be silent while he inspected the switch I'd selected for my own whipping. I knew that my silence was to be held onto for as long as I could, in order to show that I understood the specific reason for each punishment and had accepted my responsibility for what was happening to me. To cry out too soon only showed weakness and a failure to reflect appropriately on my errant actions. Not crying at all was seen as obstinance, and obstinate was not the same as contrite. Failure nor obstinance would do. I would be taught. He was teaching me. I would learn.

I was a remarkable learner, even before enrolling in school. By the time my kindergarten teacher, Miss Tynes, welcomed me into my very first classroom filled with other students, I was already a perfectionist and a devoted student. Being a fast learner afraid to make mistakes before the age of five served me well in school, but I can't say I can recommend the Rusty Murdock Head Start Program. It's not for everyone.