We need to talk about HIV, stigma and disclosure because, as treatments and scientific understanding have evolved, the landscape has changed dramatically to the point that HIV+ people no longer need to feel pressured into disclosing their personal medical history. That’s because, as evidence confirms, nobody who is HIV+, on medication and with an undetectable viral load can pass the virus on to somebody else.
Let’s make that absolutely clear … UNDETECTABLE = UNTRANSMITTABLE and U=U means that someone’s HIV+ status should be irrelevant to a sexual partner. And yet a recent report by the National AIDS Trust shows that only 16 per cent of the general population were aware that U=U. The percentage was higher among gay and bisexual men (46%) and even higher among young people. Unsurprisingly, awareness was highest among those who live with an HIV+ partner.
Being open about your HIV+ status helps to raise awareness and banish taboos: there is nothing wrong with being HIV+ and there never was. Only 3% of the general population say that they would be comfortable being in a relationship with someone who has HIV although LGBTQ+ people are twice a likely as heterosexuals to be okay with it. Age also plays its part: the older you are, the less likely you are to be comfortable about having an HIV+ partner.
Executive director of the HIV and AIDS charity NAM aidsmap commented: “Every party involved in a sexual act needs to take responsibility for their actions. It’s a wonderful thing to be able to be open about having an HIV+ status. It can be empowering. However, it shouldn’t be something expected, although it often still is.”
He continues: “People have embedded in their brains almost 40 years of awareness campaigns that highlight how HIV is the worst thing that could happen to them. All we can do is to dispel myths and disinformation. We won’t demolish stigma at once, but we can chip away at stigma every single day by putting forward a positive spin on what it’s like to live with HIV.”
I’ve been HIV+ since 2007, and I started Antiretroviral Therapy (ART) a year later. I became non-infectious in less than three months. I’ve spent most of the past 13 years disclosing my status to people who often didn’t appreciate the honesty and how brave it is to put yourself in a place of total vulnerability in front of individuals you often hardly know. I did it on dates, before sex, and even during sex to protect people from their naivety and lack of knowledge and understanding about HIV.
Reach for the lube
I no longer initiate a conversation about HIV if a person chooses to have condomless sex with me. What I will highlight is the risks of catching other STIs during sexual intercourse. When we reach for some lube, we can also grab condoms. If we don’t, that’s a silent and mutual choice of things to come. It means that both parties are accountable for their choices. However, there is still an expectation for HIV+ people to disclose their status even when the other person doesn’t ask questions about sexual health. I’d rather know if someone carries herpes or hepatitis C.
The stigma attached to HIV is still out there. Rejection happens, more than people would like to admit, either right away or more commonly soon after, when people can choose to ghost, ignore, or block thanks to technology. I will always reveal my status if people ask me directly or feel there is potential for more than sex. I am proud of where I am with life, and I have nothing to hide. I want to believe that everyone I am having this conversation understands the meaning of “being on medication and undetectable”.
We should all do better at communicating how we feel about HIV. Communication facilitates understanding and growth. Then, we should also try and put ourselves in other people’s shoes. That way, we’d be able to see things with empathy and compassion. We can remember where we come from and the sacrifices that took us all here as a community. After almost 40 years, one thing remains the same. We must have hope, faith, a love for life, and respect ourselves and one another.
This article is not a substitute for medical advice. If you know or suspect that you are HIV+, talk to a medical professional about your status and whether or not you can pass on the virus to a sexual partner.