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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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New HIV diagnoses in gay and bisexual men fell by 20% after the implementation of a publicly funded PrEP programme in Scotland, while HIV incidence in a large cohort of men attending sexual health clinics fell by 43%, Professor Claudia Estcourt of Glasgow Caledonian University and colleagues report in AIDS.
A study of gay and bisexual male participants in the first large implementation study of HIV pre-exposure prophylaxis (PrEP) in Australia has found that although rates of bacterial sexually transmitted infections (STIs) were high, they did not increase in the two years after starting PrEP. In contrast, they increased significantly in the year before men started PrEP.
People with HIV with CD4 counts below 350 were almost three times more likely to experience severe COVID-19 symptoms than people with higher CD4 counts, confirming warnings by the British HIV Association and the European AIDS Clinical Society that immunosuppressed people with HIV are likely to be at higher risk of serious illness.
We are excited to announce the sixth edition of our HIV & sex booklet, updated from 2016. This latest edition of HIV & sex represents a distinct shift from the previous one, with significant changes throughout. HIV & sex is available through our patient information scheme as an online booklet (PDF). Members can access it here: clinic.nam.org.uk
As part of routine HIV care in many high-income countries, genetic resistance testing is done prior to starting treatment to ensure that a person’s virus is not resistant to a chosen antiretroviral medication. However, in addition to identifying potential drug resistant mutations, phylogenetic analysis of an individual’s virus is also carried out – when compared to other viruses, this provides information about how different viruses are related.