When my daughter, who has chronic hepatitis B, packed for her freshman year of college, I peppered her with warnings about the need for standard precautions and condoms. I suggested wording for a future conversation where she would disclose her infection and negotiate safe sex with a potential partner.
I hoped these verbal dress rehearsals would empower and protect her, especially if that potential boyfriend turned her down. I wanted her to know that any rejection would not be about her or her hepatitis B, it would be about his fears.
Years have passed, and youthful passions being what they are, no one ever rejected her after her hepatitis B disclosure.
When I asked her recently about how she has handled disclosing, she gave me the condescending but kind look that young adults give their parents. “I’ve always disclosed my infection,” she said. “Once I know they are someone I would like a relationship with, I start out by asking if they’ve been immunized for hepatitis B and explain that I have it. I guess I’m lucky, because nearly everyone my age has been vaccinated.”
Her first partner didn’t care and assumed he had been. (That’s not very reassuring, I told her.) The second one, refreshingly cautious in one so young, dug out his immunization papers just to make sure. Her current boyfriend is positive he was immunized.
“I’m lucky because my viral load is undetectable and as far as I know no one has ever caught it from me,” she explained in youthful, misguided optimism. I take a deep breath and remind her that hepatitis B rarely causes any noticeable side effects and she must consider herself capable of infecting others despite her low viral load.
“I know, I know,” she replied. “I know this would be harder if I had a high viral load, or if the guy I was dating wasn’t vaccinated.”
I suspect her low viral load has freed her from constant worry about infecting others, as well as the fact that nearly all of her peers have been vaccinated. She attended a college that mandated hepatitis B immunization in all students. She never told her college roommates about her infection, but trained since youth, she was careful to cover any cuts with bandages and not share razors, earrings or nail clippers.
I tell her about a woman I know who was older, her age group had missed universal immunization by a couple of years. She waited until after she had sex with a man she really liked before telling him about her hepatitis B. He broke up with her, he didn’t think he could trust her because she hadn’t told him about her infection before they had sex.
“That’s harsh,” my daughter commented. “You can’t let your hepatitis B totally define you entirely, or else you’ll be too afraid to tell someone in a situation like that because the stakes will be too high.”
She recalls an exercise in a psychology class. Everyone was supposed to write down 10 words that defined them. “I remember I wrote down the ten words, but a lot of them weren’t positive. Afterwards, I realized I had forgotten to write down that I was creative and artistic. I think about my hepatitis B like that now, it’s just one part of me, but there is so much more.”
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