It is important that you have people who you can talk with about being HIV positive, but it is a good idea to keep some control over where that information goes. Unfortunately, there is still ignorance about and stigma attached to HIV infection, so you may be concerned about how people will react. Many people find that family, close friends and partners are very supportive and understanding.
When you are thinking about whom to talk to, it may be helpful to consider the following questions.
- Can I trust this person with this information?
- Will they offer me support?
- Are they likely to judge me?
- Will they respect my privacy?
You may find it useful to discuss these issues with a counsellor or social worker. Some women decide to keep their HIV status fairly private but want to be able to discuss it with a few trusted friends. In this situation, it is a good idea to give anyone you tell permission to talk to another specifi c person. This is a practical way of keeping the information private, while recognising that the people you tell may also need some support.
If you are in a relationship with a HIV- negative partner(s) who does not know you are positive, you will need to discuss and practice safe sex with them. The legal obligation to tell your HIV status to partners varies between states, but the outcome should be always to protect your partners from infection and yourself from STIs[Sexually Transmissible (or Transmitted) Infection] Infections spread by the transfer of organisms from person to person during sexual contact. Also called venereal disease (VD) (an older public health term) or sexually transmitted diseases (STDs). . It is up to each woman to weigh up the advantages and disadvantages of disclosure, and if or when she will tell her partner(s).
It is difficult to disclose and the longer you leave it, the harder and more complex it may be. However, it is better if you have your partner’s support and understanding to help you to live with HIV. You may be afraid that your partner(s) will be angry, accusing or judgmental. It may help to know that almost all of the women who took part in recent Australian research and were currently in relationships had disclosed to their partner. The majority of these women reported that their partners were very supportive, or that their HIV positive status “didn’t make a difference” to how their partner felt about them.
Your partner(s) may certainly be scared or confused. You might be scared that he or she will leave you. It can be as big a shock to your partner(s) as it was for you, to learn that you are HIV positive. It is often helpful to have a doctor or HIV counsellor available to support you and answer questions when you tell people close to you. Your partner(s) may need to consider having a HIV test. You will probably find that your partner(s) can come to terms with you being HIV positive and, in fact, it may strengthen your relationship.
It’s up to you when you want to tell children that you are HIV positive. This is one of the main issues that arise for women with children after diagnosis. Talking with other positive women, particularly those with children, can be really helpful for exploring different approaches you might take. This is also an issue that you can discuss with a counsellor or health care professional if you would like some guidance on what might be best for your particular family circumstances.
Some women decide to talk to their children straight away, whereas others decide to wait until the children are older. It very much depends on the family situation and your judgment. You know your children and are in the best position to make this hard decision.
When you decide to tell your children, it may be a good idea to tell some other people who can provide support for the child — maybe a relative or a good friend whom your child trusts. Older children may feel angry, particularly if they feel that important information has been withheld. Some states have HIV family support services that can assist at this time.
There are people you do not have to tell
If you are HIV positive, you do not have to disclose your HIV status to:
- your friends;
- your employer;
- your work colleagues;
- doctors, dentists or other health care professionals.
Having said this, it may be wise to tell any doctor treating you — particularly over the long term or for serious conditions — that you have HIV. To help you make the best decisions about your health, your doctor will need as full a picture as possible. It is also a good idea to tell your dentist, since HIV can affect your gums. If you do tell a doctor, dentist or any other health care provider, they cannot refuse to treat you or manage your care; this would be discrimination and against the law.
Circumstances in which the law may require disclosure
Generally, you are not obliged to tell anyone you are HIV positive. However, in some circumstances, the law may require that you disclose.
- In some states , HIV positive people are legally obliged to tell any sexual partner, even if they intend to have safe sex;
- The Department of Immigration requires anyone applying for permanent residency in Australia to be tested for HIV; and
- When applying for superannuation or life insurance, you will probably need to answer questions about your HIV status. These companies are legally allowed to refuse to insure you if you are HIV positive or you refuse to tell them your status. Your AIDS council or PLWHAPerson (or People) Living with HIV/AIDS. group may be able to give you information about HIV-friendly superannuation and insurance companies.
Occupations that require HIV testing
HIV testing is mandatory in the Australian defence force. Health care workers who perform ‘exposure-prone procedures’ such as surgery (including dental surgery) are required to know their HIV status and must not perform such procedures if they are HIV positive (or hepatitis C PCR positive) .
If you are refused service
If you are refused any service or believe you have been treated unfairly because you are known or presumed to be HIV positive, this may be a case of discrimination. It is against the law to discriminate against people because of their HIV status. If you would like more information about how to deal with HIV-related discrimination, there are a number of services which can assist. The HIV/AIDS Legal Centre (in NSW) is one of these. The AIDS council in your state or territory will be able to provide more information or refer you to an appropriate person or service.
 PCR stands for polymerase chain reaction. A PCR tests checks for the presence of the actual virusA small infective organism which is incapable of reproducing outside a host cell. in the blood, rather than the antibodies to a virus.
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