The time of the undetectable non-transmitter and the stigma
In an era of generalized treatment of HIV and undetectable viral load, stigma remains a persistent feature in the lives of almost half of people living with HIV diagnosed in the UK, according to reports from people living with Stigma of HIV. Search UNITED KINGDOM 2015 reported on 21 International Conference on AIDS (AIDS 2016) in Durban, South Africa last week; I remember Durban in the year 2000 and a memorable speech by Nelson Mandela. Although most people living with HIV score highly on measures of psychological resilience that enable them to deal better with stigma.
A total of 1576 people recruited from 120 community organizations and 47 HIV clinics across the UK have completed an anonymous online survey. Participants broadly represented the demographics of people accessing HIV in the UK. In addition, 40 semi-structured interviews were performed with a sub-sample.
Stigma prediction cases (the person with HIV expects someone to have a poor opinion or a bad reaction to them) have been reported during almost all in-depth interviews. For example, a woman said:
"In my church I never really alluded to HIV, because I do not know how they would think."
Anticipating stigma was more often experienced when considering talking about HIV status with a potential sexual partner.
"It's amazing that despite advances in treatment, people's attitudes are still exactly the same. The same as that of a long distant time ago. "
However understandings of the impact of antiretroviral treatment on infectivity had powers over some people.
"I think it is given to people living with HIV more confidence. A lot more people are now saying, I'm not infectious, good, so I'll go ahead and be a bit more confident in trying to find someone for a date. "
Researchers from the resilience of the participants evaluated this aspect of the pandemic using ten questions and a validated scale. For example, in response to the statement "I tend to shy away from difficulties", 63% stated that this was often or almost always true. Regarding "I am able to deal with unpleasant or painful feelings", 52% stated that this was often or almost always true.
Globally, 27% of respondents had little resilience, 39% had an average level of resilience and 34% had high resilience.
Those with low resilience were more likely to experience stigma and report on the negative experiences of those living with HIV.
Specifically they were more constant in this regard than people with high resilience:
- Because he was diagnosed with depression (71% vs 22%),
- Experienced social discrimination (46% vs 23%),
- Experienced anxiety (53% vs 24%)
- Or avoided social engagements or sexual experiences (54% vs 32%).
The thematic analysis of life experiences of participants with HIV was identified that those with low resistance most commonly reported social isolation and negative experiences, whereas those with high resilience focused on adopting healthier behaviors and empowering experiences.
Resilience was an important theme during in-depth interviews:
"I do not feel they require others" of acceptance or approval. I do not feel this state fundamentally changes the person I am, but my will to believe in myself as irreducible has demanded of me to dig deep and to be brave. "
"I was diagnosed with a CD4 count from 10. My CD4 was in between life and death and it was a fine line ... Life is wonderful, I do more than I do. "
Health care remains an important stigma. Researchers found that 40% of respondents had negative treatment in a health setting, including overuse of barrier protection, negative observations and being given the last appointment of the day. Past problems have been associated with being concerned about the future of interactions with health professionals (anticipation) and avoiding the stigma of care, more often in a GP or dentist.
Compared to white British or an Irish participant, people of other ethnicities experienced greater problems with disclosure and discrimination. Among people of other ethnicities, 21% had not disclosed their HIV status to someone out of health compared to 12% of British or Irish whites. When the disclosure had taken place, it was less likely that they felt they had received adequate support.
Among people of other ethnicities, 19% reported experiences of gossip 16% sexual rejection, 10% verbal harassment and 5% of social exclusion or family reunions.
Women also reported more instances of stigma than men. They were especially likely to have concerns about the potential for gossip or sexual rejection (predicting stigma).
Maybe as a result, 29% had avoided sex and 10% had avoided family gatherings.
"I did not feel comfortable not being open about it ... I found it really hard not being able to be totally honest with people."
Trans women (19 who participated) reported high levels of discrimination in care settings.
Editor's note: "I am taking care of the ZAP, which is on the website, from Monday to Friday in general terms, and I note this stigma and disrespect to the person with HIV, with the clinic still open, with 15 minutes to finish. expedient they refused to attend a serious case of liver failure in PEP and I had, for the first time in my life, given a "medical opinion" and suggested to the person who would do with the PEP. It was the third day of treatment and her eyes were like an egg yolk, and I sensed that if she took another dose, she would eventually die, and so I chose to risk seeing her (even if she hated me later ) alive and with HIV than dead. Luckily her test gave non-reagent and God knows the weight that went out of my back with this exam "....
Posted in: 28 July 2016
Thorley L et al. Stigma in the age of undetectability. 21st International AIDS Conference, Durban, abstract TUPED373, 2016.
Kirwan P et al. The impact of resilience upon experiences of stigma: findings from the STIGMASurveyUK 2015. 21st International AIDS Conference, Durban, abstract THPED393, 2016.
Crenna-Jennings W et al. HIV-related stigma and discrimination in healthcare: findings from the STIGMASurveyUK 2015. 21st International AIDS Conference, Durban, abstract TUPED399, 2016.
Lut I et al. HIV-related stigma within GP practices in the UK: findings from the STIGMASurveyUK 2015.21st International AIDS Conference, Durban, abstract TUPED401, 2016.
Ocala SG et al. Experiences of disclosure and discrimination among black and other ethnic minority groups in the United Kingdom: findings from the STIGMASurveyUK 2015. 21st International AIDS Conference, Durban, abstract THPED396, 2016.
Crenna-Jennings W et al. HIV-related stigma and discrimination among women: findings from the STIGMASurveyUK 2015. 21st International AIDS Conference, Durban, abstract THPED416, 2016.
Have you received your diagnostic reagent and are you scared? Do you think your life is over? Are you having thoughts "of the type clueless"?
You need to get your hopes up!
Understand that my resilience was built one day at a time, one illness after another, one SUSAN AFTER THE OTHER!
Resilience is not something you are born with! You ROW IT! One fall after another. For every fall inevitably follows a new rebound!
Shake the dust off!
And Turn Around!
Your doctor, your doctor can do a lot for you!
Your family, if you have any, because there is not one left for me, they can or can not do something for you.
God could do everything for you!
But it's up to you to decide to go ahead or sit on the curb!
Do you think I talk too much? Please read my outdated medical history! 🙂 It may take a little while!
And as for Health, it is a Right of All and a Duty of the State