Question: My best friend has just died of AIDS and I cannot come to terms with the fact that she is gone, but worse still, that she did not trust our friendship enough to tell me that she was HIV positive. I feel so badly about it all. Why did she not tell me? What can I do?

Answer: Your sadness at the death of your best friend is evident. One of the hardest things in life is to lose a dear friend, especially when there is unfinished business between you.

HIV Infection has created a situation of distrust, sometimes even in the closest relationships. One of the reasons for this has been the terrible stigma associated with this illness. It is this stigma that has caused people with HIV and AIDS not to share the knowledge of their status with others, even those nearest and dearest. Receiving an HIV positive result inevitably causes a crisis for the person being told such news. Regardless of how good the counselling is that one receives, we should never underestimate the severity of the shock a person feels upon being told that the HIV test result is positive.

The Counsellor herself or himself is not unaffected by the result s/he has to give. The Counsellors one meets at the Community Health Centres have received very intensive and specific counselling training which enables them to do the work that they do. Many of them have been counselling for a long time and are very experienced. They are able to provide the necessary compassionate support and accurate information in order to obtain informed consent from their clients prior to the test being done, and to contain the person's emotions once the result is known. It is of the utmost importance that people should never agree to an HIV test without first receiving the necessary Pre and Post Test Counselling from a trained counsellor.
It is by way of the above explanation that I hope to reassure you that while your friend may have chosen not to confide her HIV positive status to you, she would have received the best possible support during counselling and testing.
While I do not wish to minimise the intensity of your pain and bewilderment at the fact that your friend died of AIDS related complications without divulging her HIV status to you, I would like to explain what happens to a person when s/he receives an HIV positive result. A positive diagnosis generates deep emotions within the person receiving the result. The crisis generated from this experience could last for many weeks while the person concerned comes to terms with the news and works through the feelings and possible consequences of what being HIV positive means in terms of one's self, one's loved ones (family and friends) and others. When one is given a positive result one goes into shock because it can be the most devastating experience ever. Often the shock is so great that afterwards, all the person remembers is that s/he is HIV positive.
Another deep emotion that comes to the fore is fear. Fear of what might happen to one, fear of the future, fear of rejection by family, friends, fear of causing hurt to one's loved ones by imparting the news to them. Speaking from many years of experience as a Counsellor, I have yet to meet a client who at some stage does not think about the effect that breaking the news of his/her HIV positive status will have on loved ones and what the consequences might be.
Anger, disappointment and sometimes guilt often play major roles in the kind of decisions people make around informing loved ones. These feelings are often directed at self. Again it is important for the person to discuss these feelings in a safe and supportive environment. The people living with HIV are vulnerable, both physically and emotionally. They sometimes choose to share their vulnerability with a trained counsellor, rather than with close family or friends because to do so would be too overwhelming.
It is hard to be strong for loved ones when one is feeling fragile. So people may choose to share their concerns and issues with a counsellor, where they are assured of a safe place; the space to ventilate feelings without reservation; where negative and positive feelings will be contained with respect, a non-judgmental attitude and unconditional compassion. One of the greatest fears people have is that they will lose the necessary support base provided by family and friends. The threat of this support being jeopard-ised, often drives people to keep silent about their HIV status. I understand that you have questions that might never be answered. May I suggest you give yourself permission to feel sad, angry, hurt. It will not help to suppress your feelings. At some point you may deem it appropriate to do something tangible, like visit her grave, or do something that you both enjoyed doing together that holds good memories. You will find, with time that: "Grief never diminishes, it only erupts less often.". If necessary talk to a Counsellor.