PREVENTING HIV TRANSMISSION IN A POSITIVE WAY.
When you are newly diagnosed with HIV, there is a societal expectation that you become an instant expert in all matters related to HIV. However, people diagnosed with HIV come from diverse backgrounds and cultures and their capacity to understand HIV and educate others is very uneven.
Whilst education about protecting yourself and others is provided on an ongoing basis, for most people with HIV their role in prevention happens immediately after diagnosis as previous partners are informed that they may have been exposed to HIV. Most people with HIV willingly volunteer this information knowing that this leads to better outcomes all around and a reduction in unknown transmissions. The vast majority of people with HIV are responsible members of our community who recognise that risks have occurred and engage with testing services.
‘My confidence is shattered. I couldn’t protect myself so how can I protect others?’ is a common feeling expressed when diagnosed. For some people, avoiding any sexual contact and self imposed social isolation is their first response to intimacy with others. This strategy is often not sustainable or necessarily healthy, particularly as treatments extend life expectancy for people with HIV for 20 or more years. Eventually the desire to be intimate re-emerges, however returning to social interactions can be daunting and fear-inducing after a prolonged period of social isolation. Then there is the issue of disclosure….
Disclosure continues to rank amongst the top concerns for people with HIV. People with HIV often fear the negative reactions from their community if they disclose their status. These reactions can take the form of violence, rejection, social humiliation through gossip or being judged as ‘damaged goods’ or nasty. Unfortunately many people with HIV have been so damaged by negative reactions that they choose never to disclose again. Others may have diminished capacity to disclose (ie people with mental health or substance use issues) or practice safe sex. Thus, relying on people to always disclose their HIV status as a strategy for prevention can be very unreliable.
People living with HIV report that they feel an enormous relief when a sexual partner reaches for a condom. Asking ‘are you clean?’ communicates ignorance, potential humiliation and rejection. To prevent HIV transmission, responsibility to engage in safe sex and using condoms is required from both parties. I personally feel deeply concerned when any new transmission occurs, and like many others stand for a culture where gay men care for each other by reaching for condoms regardless of disclosure.
Human vulnerabilities are real, and we need to acknowledge this in ourselves and others ensuring that we behave in a mutually respectful way. The challenge to us as individuals and our communities is to prove that fears can be overcome by creating a community environment that is accepting, non judgemental and compassionate. We need to stand for a culture that cares, facilitates HIV prevention and promotes everyone’s well being.
