›› My Community has AIDS, and They are Drinking Themselves
to Death

        by Robby Giunta

When I began working in the field of HIV nursing in 1988, treatment was largely palliative. AZT was the primary antiretroviral, with a few protease inhibitors being investigated. I was working in an infusion center that occupied a turn of the century house in the Central West End neighborhood of St. Louis. We supported people in what ways we could, and never felt like it was enough. The staff was small, one secretary and me.

Our secretary and I spent many hours together. One day during my morning coffee, she walked into my office while I was deep into my daily reading. She winked and said, “I guess we have more in common than what we do for a living.” We were stronger as a team because of our ability to share our recovery, and probably had more tolerance for each other’s character defects.

It was Christmas 1994, and we were having a party for clients at the infusion center. I was in the kitchen chatting over the snack bar when a client said to me, “I haven’t had a drink in 26 years. I just found out I have Kaposi’s Sarcoma.” I had no words to offer as he picked up the bottle of bourbon and poured a glass. I have ample opportunity to reflect on that night every time I see J’s picture hanging on the wall at a twelve step club I frequent.

I still work with people who are living with HIV. HIV treatment and my role have both changed considerably. I am now a substance abuse counselor and specialize in working with people who are HIV positive. I frequently encounter people who have a CD4 greater that 500, an undetectable viral load but who wash their medication down with vodka or who elect to buy crack cocaine instead of get their Combivir. Addiction is a selfish disease and doesn’t like to share in the limelight. Their HIV is being managed, but they are drinking themselves to death.

Recently, I was given the gift of seeing the miracle. The miracle when someone stops existing and reclaims living. JM is a mid thirties male who came to our clinic with a severe benzodiazepine addiction. His chief complaint was, “Someone stole my lorazepam.” A turning point in our work together happened when I used therapeutic disclosure and told him I had said the exact same thing to a doctor once. I jokingly added, “And it didn’t work for me either.” JM gained a powerful skill that day, honesty. I have always had the strong belief that if someone can achieve honesty, they can achieve anything. JM works full time now and has been clean for six months.

I’ve always felt that as a clinician, I was a privileged guest allowed to observe and walk, just a bit, along a person’s personal path. That privilege compels me to continually grow as a professional, and as a person. I feel privileged and fortunate to be a substance abuse counselor at this time in the profession. I have the opportunity to impact it as it grows from certification to licensure state by state.

A mentor shared with me a wisdom shared with her a few years ago, “You cannot take a client further than you have gone yourself.” I find this truth applicable to me personally, professionally and to the profession Addictions Counseling. I am challenged every day by my work to continually grow. My clients deserve nothing less. I deserve nothing less.


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