My patient, who I’ll call Josh, is 17 years old. He is a gay man, was diagnosed with an HIV infection, and was not “out” to his family about his sexuality.

Josh had no privacy at home, as he shared his bedroom with three brothers and an uncle; his only private space was his high school backpack where he kept his books.

Yet, despite the odds about keeping his sexuality and his new HIV diagnosis private, he said, “Doc, my life is different now. I want to take the [HIV] meds.” Upon receiving them, he started the regimen and stuffed the pill bottle with cotton so the pills wouldn’t rattle in his backpack.

He set his watch for a daily alarm for his medications, but told his mother it was to help him remember to get up for school. The medications turned his eyes yellow, so he started to wear glasses to hide that. He suppressed his virus. Josh eventually came out to his family about his sexuality, but never about his HIV infection.

This is a success story as the virus was suppressed, but stigma around an illness such as HIV is an omnipresent barrier to health.