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The question of how to translate “living with HIV” might require a more complex answer than you’d expect. For a translated ad to receive promotional review committee (PRC) approval, we have to submit back translations into English along with the translations. If the back translation isn’t a word-for-word match to the original source copy, reviewers sometimes question why. They may want to edit the translation so that the back translation is a more literal equivalent to the source copy. In this post, we’re going to explore several common situations when linguistic differences between English and Spanish come into play in translation.

Present progressive/present participle

"Living with HIV since 2018" in a BIKTARVY presentation and our Spanish translation "Vive con VIH desde 2018"More and more, pharmaceutical advertising features real patients who use the medication being advertised instead of models. We’ve worked on several ad campaign materials featuring real patients. As part of those projects, we had to determine how to translate “living with HIV” as well as “living with multiple sclerosis.” You can see the source English and our Spanish translation for a presentation about the HIV drug BIKTARVY in the images at left. This translation didn’t elicit any feedback because the inclusion of “desde 2018” leaves little other option than to back translate the Spanish as “living with HIV since 2018” (an exact match to the source). When we submitted translations for a video about a multiple sclerosis medication, however, a client reviewer sent us the following comment:

We want to make sure that we are saying “Living with multiple sclerosis” and are concerned that “Vive con esclerosis múltiple” will translate as: “Live with multiple sclerosis.”

This is a fair concern. “Vive” is, in fact, the imperative (or command) form of the verb “vivir” (to live), when addressing a singular person informally. However, it is also the third person singular conjugation in the simple present tense. For example, the sentence “Guillermo vive en Puerto Rico” means “Guillermo lives in Puerto Rico.” So, “vive con esclerosis múltiple” can be translated as “Live with multiple sclerosis” and “Lives with multiple sclerosis.” Unlike in English, where the absence of a subject pronoun almost always indicates a command, Spanish often relies on the verb form to indicate the subject, rather than an explicit subject pronoun.

The reviewer’s suggested edit was to change “vive” to “viviendo,” to mirror the use of the present participle “living” in English. Our defense of the original translation was two-fold.

A screenshot from an informational video about a multiple sclerosis medication in Spanish that says "Maby / Vive con esclerosis múltiple" In the first place, the context supports reading the sentence as the third person singular simple present rather than the second person singular informal imperative. As you can see in the image at right, the patient’s name appears immediately above the line “living with multiple sclerosis.” This creates an association between the upper and lower text, to be read as “Maby vive con esclerosis múltiple.”

Furthermore, our translation team explained that the present progressive is used in Spanish for actions considered to be immediate or temporary. The simple present is used to describe habitual actions, general truths, and states or conditions that are perceived as more permanent or stable over time. They gave a very good illustrative example:

If I use the present progressive “Estoy viviendo con mis padres” (I am living with my parents), this is something that is happening now, but it is not habitual for me. Perhaps I am living with my parents because my own home is under construction, and I will move out of their house when the construction is finished. However, if I said, “Vivo con mis padres” (I live with my parents), it is understood that there is no plan to move out.

In the context of “living with multiple sclerosis,” this is not temporary but rather a long-term condition. According to our Spanish healthcare translations team, using the present progressive “(está) viviendo con EM” could imply that the condition is temporary or has recently changed. Therefore, the simple present tense “vive con esclerosis múltiple” is more appropriate as it conveys the permanence of the condition and aligns with the general use of the present tense in Spanish. We aim to ensure that the translation is not only accurate but also culturally and linguistically appropriate for the audience.

Personal pronouns

A screenshot from the BIKTARVY.com homepage in English and in SpanishAnswering how to translate “living with HIV” or “living with multiple sclerosis” demonstrates that Spanish and English have different rules around not only the present progressive, but also subject pronouns. These two languages also have different attitudes about certain relative pronouns. Several of BIKTARVY’s informational materials include the affirmation “Because HIV doesn’t change who you are.” We translated this as “Porque el VIH no cambia lo que usted es” and the corresponding back translation we submitted was “Because HIV doesn’t change what you are.” The client reviewer was concerned by the use of “what” rather than “who,” as this could be perceived as dehumanizing and stigmatizing.

Again, this is a valid concern from an English-speaking perspective. In English, we use “who” to ask about or refer to people (though sometimes we use “that” instead), and “what” to ask about or refer to things. For example:

The salesperson who told you that price was mistaken.

What I needed at the store was sold out.

The Spanish word “quién” means “who,” so it seems like it would be an obvious choice for Spanish BIKTARVY messaging. According to our translation team, however, it is more natural in Spanish to say, “lo que usted es” instead of “quién usted es”. In Spanish, “que” can be used for people or things. They confirmed that “que” is a relative pronoun that refers to the previously mentioned person, just like “who,” and so using “que” violates neither meaning nor sense. You may wonder why the back translator didn’t translate the Spanish as “who you are.” The most direct translation of “lo que” in English is “that which.” But “HIV doesn’t change what you are” is a much more natural construction than “HIV doesn’t change that which you are.”

Possessive pronouns

In English, possessive pronouns are used when referring to body parts: I brush my teeth, I wash my hands, and I paint my fingernails. Most of these verbs are reflexive in Spanish, which means that a reflexive pronoun is “attached” to the verb. This reflexive pronoun serves the same purpose as the possessive pronoun in English. “I wash my hands” in Spanish is “me lavo las manos.” “Las” is a definite, but not a possessive, pronoun. The “me” in front of “lavo” indicates that the action is performed on the speaker.

Possessive pronouns are also typically used in English when referring to certain actions like testing blood sugar. A definite pronoun is generally used in Spanish instead. Here’s a line from a Novo Nordisk brochure for high schoolers with diabetes, along with our Spanish translation:

Checking your blood glucose throughout the day is the best way to know if your insulin plan is working with your activity and meal plans.

Medir los niveles de glucosa en la sangre durante el día es la mejor manera de saber si tu régimen de insulina funciona con la actividad que haces y tus planes de alimentación.

Although the Spanish above uses “los niveles” rather than “tus niveles,” it is implicitly understood that the person is measuring their own blood glucose in this scenario. Especially since later in the sentence “your insulin plan” is defined by the possessive “tu,” there’s not really any other way to interpret the sentence. This isn’t to say that Spanish never uses a possessive pronoun in a similar context. Here’s another example from the same brochure:

When you have type 1 diabetes, taking insulin is a major part of managing your blood glucose levels.

Cuando tienes diabetes tipo 1, usar insulina es una parte importante de mantener controlados tus niveles de glucosa en la sangre.

Sometimes Spanish might rely on the verb form instead of a possessive pronoun:

Never drive if your glucose levels are low.

Nunca conduzcas si tienes un nivel bajo de glucosa en la sangre.

The back translation of the Spanish here would be “Never drive if you have a low level of blood glucose.”

Verb + object concordance

Since we translate so many patient education materials, we often work with copy about treatment adherence. The phrase “taking a treatment” led to some interesting dialogue between our translation team and a client reviewer recently.

We typically translate “take/taking a treatment” as “seguir un tratamiento.” “Seguir” literally means follow, which English speakers are more accustomed to hearing as part of the phrase “follow up” or “following a treatment plan.” Becuase of this, the client reviewer wanted to replace “seguir” with “tomar.” “Take” is one of several ways that “tomar” can be translated in English.

According to our translation team, however, it is not natural in Spanish to say “tomar un tratamiento.” If the intent is to emphasize the adherence to a treatment plan, “seguir” would be the preferred verb. If the focus is on the act of taking the medication itself, then “tomar” is appropriate with the addition of the specific treatment mechanism (such as “medicinas,” “pastillas,” “píldoras,” or “medicamentos”). With that being said, “tomar” is only appropriate for a medication that is ingested (rather than injected, infused, etc.).

A sample of collocations with the word "get" in EnglishHonorable mention here goes to the verb “[to] get.” We love using this verb in English! Here are a few examples that demonstrate the wide variety of scenarios in which English speakers use “get”:

  • I get a new charm for my bracelet every year for my birthday.
  • I hope I don’t get the flu this winter.
  • I’ll get the check.
  • We’ll get the bus.
  • He gets good grades.
  • They really get me.

And that last one can really mean two things. Do they understand me, or do they make me laugh? Context is key and there’s no one-size-fits-all equivalent in Spanish. If your source copy uses “get,” it’s highly unlikely that your back translation will be an exact match.

In her 2017 TED talk “How language shapes the way we think,” Lera Boroditsky asserts that every language creates its own cognitive universe. The seemingly simple question of how to translate “living with HIV” opened a conversation about situational permanence and perceptions of context. For our healthcare translations, we’re always thinking about outcomes. What is the most accessible way to present this information while remaining true to the source text? If you’re looking for a translation partner who will be like a member of your team, we’d love to talk to you.