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Friends and peers. The responses in this subcategory represent the difficulties the participants have experienced in their relationships with friends and/or peers within the context of HIV. Self-isolation and distancing from friends appear to be common themes voiced by the participants. This distancing appears self-protective in that by avoiding friendships the participants can avoid the pain that may be inflicted by friends who are unsupportive of their HIV status. "Since I was diagnosed, I never usually interact with people that much, I interact but not on a friend to friend basis ... I don't keep a lot of friends." "So, by being positive, you look at people a lot different ... now I know I really need to get my life together and start looking at my friends ... the kind of stuff so-called friends have used hurts you."
Families. Responses in this subcategory reflect the difficult experiences that the participants have had with either their own family members or their significant other's family. Rejection by family members appeared to be a theme for the participants. Some participants felt exiled, either from their own families or the families of their significant others. "I think maybe, well, everybody [in my family] is turning against me and trying to push me away," said one. Another commented, "[His mother] loved me at first ... then once she found out, she didn't want me in her house anymore. It's like I'm killing her son."
Intimate/dating partners. These responses reflect the difficulties that the participants have had either in contemplating or establishing intimate relationships. One theme that appeared concerns infecting a partner. This concern might reflect the participant's fear, or perhaps the participant is being told by those around him or her that he or she should not become sexually involved with a partner. "I mean, personally, I don't want to get in no relationship, especially that I'm HIV positive and can infect somebody. I don't want no relationship at all." "The difficult part of it is, okay, it's like I found somebody but certain people are trying to stop us from being together [because of HIV], and that's difficult for me."
Finally, one theme questions whether anyone would be willing to be in an intimate relationship with an HIV-infected person. One participant mentioned the difficulties inherent in such a relationship, as well as the risks.
Psychological Burden of HIV
HIV and stress. These responses allude to the stressful nature of living with a life-threatening illness. Participants indicated that life was stressful before they found out they were HIV-positive; the HIV diagnosis either created stress or compounded the stress they were already experiencing. "I was going through a lot of stressful things and then I found out I was HIV positive, that just made it harder for me." Another response was, "I got an attitude problem now ... I guess with all the stress and everything."
HIV and negative affect. This theme encompasses some of the psychological responses to HIV, particularly those that create negative affective states. Negative-affect responses can include depression, anxiety, loneliness, and helplessness. Most of the participants report having experiences with these emotions. Some of those responses were: "My life was different, it wasn't a lot different, but it was different because I didn't have to think about this, to take special care and stuff like that ... when I found out about this, I was depressed and stuff like that, that make it worse." "I mean, it's kinda, it's not, it doesn't really give you a headache, but when you think about this life that you have now and your life that you had before, it was, well, it was just so much easier, that other life." "I think I'm more tolerant toward certain things ... it definitely changed my views of sickness ... I understand that kind of helplessness," and "You know, I don't want to stay alone all my life. I want to stay with somebody. Yeah, friends or relationship, or somebody. I don't want to stay alone."
Reflection Exercise #4
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“I don’t know a single Black person who is sleeping properly these days” tweeted Dr Crystal Fleming in New York City the other night. As a black British woman this is my new reality. Each morning I wake up with a twist of fear about how I’ll keep my family safe and what new horrors I’ll hear about being unleashed on my community.
At NAM we share information, so that individuals can live longer, healthier, better lives. This information enables individuals and communities affected by HIV to protect themselves, care for others, advocate for better services and challenge stigma and discrimination.
People from sub-Saharan Africa who are now settled in Europe put themselves at some risk of acquiring HIV in their country of residence and when they travel abroad, whether to other parts of Europe or to Africa, according to a study published in PLOS ONE. Dr Christiana Nöstlinger of Antwerp and Professor Sónia Dias of Lisbon led a study of 1508 sub-Saharan migrants in Belgium and Portugal which found that those who travel tend not to use condoms regularly in their country of residence or in the countries they visit, potentially putting them at risk of HIV.
Black people with HIV were significantly more likely to be admitted to a major London hospital with COVID-19 than other people with HIV, while in Madrid, researchers found that COVID-19 was diagnosed more often in people with HIV who had underlying conditions than others with HIV.
People with chronic liver disease admitted to hospital with COVID-19 are dying at a much higher rate than the rest of the population, figures collated by liver specialists in Europe, Asia and North America show. Advanced cirrhosis greatly increased the risk of death, the study found. People with severe cirrhosis were almost 30 times more likely to die after a COVID-19 diagnosis than people with chronic liver disease without cirrhosis, the figures show. The overall death rate in people with chronic liver disease was 39% among reported cases.