Being diagnosed with HIV is no longer the end of a life. For those with access to appropriate treatment, being HIV positive is the beginning of a life with different challenges.
As a psychotherapist, I have seen how these challenges affect the mental health of those who live with HIV. Using my experience, I outlined the mental health issues these people tend to deal with. By learning about them, you can — if you live with HIV — improve your mental health or more effectively support people who live with HIV.
Dating and Relationships
For those who are newly diagnosed as HIV positive, dating is complicated territory. How soon do you tell your status to someone? Should you put it in your online dating profile up front? What if that decreases the size of your dating pool? There are no easy answers.
I once worked with a young man who had been diagnosed for several years. For the large part of his life after diagnosis, he had been celibate, although not by choice. He talked of horrible reactions to him disclosing his status to potential sexual partners. He often oscillated between giving up on dating altogether or disclosing his status immediately.
As a gay man his already limited dating pool became even smaller. He wasn’t sure if there was anything he could do to keep moving forward.
Regardless of gender or sexuality, there are unique challenges that one must face when dating as an HIV positive person. I recommend reading this short guide to dating with HIV.
Dealing with Depression, Guilt, Shame and Denial
Many folks I have worked with who have disclosed being HIV positive talk about the impact to their mental health. I once worked with a young woman who was diagnosed during our time in therapy together. At first she refused to acknowledge how her life was changing. Then she was wracked with guilt and shame.
As a young woman, she had her whole life ahead of her and felt like she was being punished for her risky sexual behavior. The depression was crippling at times. Working through her depression was a large focus of our time in therapy. Other clients I have worked with have reported similar feelings such as a powerful sense of shame and guilt.
It is this shame and guilt that often hinders HIV positive folks from testing and getting access to appropriate medical care. After engaging in risky behavior, the fear and guilt of having done so presents an emotional hurdle to meeting with medical professionals to address the issue. Unfortunately this denial can sometimes lead to further risky behavior and declining health.
Battling Cultural Stigma
One of the biggest challenges of living with HIV is battling the cultural stigma associated with the virus. Due to stereotypes around ways of contracting the virus and cultural stigma surrounding sexuality, stigma about HIV is palpable.
I’ve met with more than one client who spoke of the hesitancy to face their diagnosis due to not wanting to be labeled as ill or “infected.” Society has often marked people living with HIV or AIDS as being “less than” or less valuable than HIV negative people. Many clients have also heard others talk about people living with HIV as being reckless and promiscuous.
When someone is diagnosed as positive, they quickly realize they not only have to deal with their own emotional reaction to the diagnosis, but also the reactions of others who may focus on placing blame and lack compassion.
Accessing Medical Care and Exploring Options
When we talk of the issues facing those living with HIV or AIDS as a society, we often focus on transmission of the disease. But what happens after someone is diagnosed? The process of accessing appropriate medical care can be both scary and daunting. The realization that one might have to take medication daily for the rest of their lives is not a welcome idea.
I worked with a young man once who delayed starting treatment for months after finding out he was positive. He often presented himself as unbothered by his recent diagnosis, but in our sessions I often perceived him as feeling scared and doing the best he could to battle through the shame, guilt and stigma associated with living as an HIV positive person.
After the initial shock wore off, he was then faced with a mountain of tasks. He had to think about his health and medical care in a whole different way. He had to be intentional about working with a doctor who was familiar and worked with HIV-positive patients. He had to educate himself on the condition itself. He had to learn what his treatment options were.
At times this process was so overwhelming that he would opt out of being present in his life altogether by not showering or leaving his apartment for days. The work was overwhelming.
What HIV Positive People Can Do to Improve Their Mental Health
If you are living with HIV, there are options to help you move forward and live a happier life. Local HIV/AIDS organizations offer a wide range of resources such as health education, social support, and medical and mental health treatment. States around the country also offer HIV hotlines you can call for resources and support.
While doctors often provide basic counseling about the condition following diagnosis, it may also be helpful to work with a therapist on a more ongoing basis to deal with the longstanding effects of a positive diagnosis, including navigating disclosures, relationships and exploring how to best cope.
It is important to remember that no matter your status you deserve to live a life with filled with peace and joy. We all deserve that.