To do or not to do

This is a difficult decision to make because disclosure (or
not disclosing) can have significant consequences. As with so many of the
important life decisions, there are no absolute answers that are right for
everyone. It takes time to adjust to being HIV positive. With that in mind,
it’s a good idea not to rush into disclosing your status without first giving
it some thought. Wanting to share this knowledge with someone else is a
perfectly natural reaction, especially when it’s new to you and you’re feeling
overwhelmed, vulnerable, and uncertain about your life and your future. The
reality is that people with HIV need to be selective about disclosing. They
need to be selective about who they tell and when they tell them. This process
of selection often involves uncertainty and can sometimes be an anguishing
experience.

Consider the benefits as well as the possible negative
consequences that disclosure may have for you as an individual. Plan ahead
before you disclose your HIV status so that you can feel in control of the
process. It may be better to disclose gradually – to your partner, or to one
trusted friend or to one member of your family you feel especially close to –
rather than to everyone at once. You don’t have to tell everyone. The choice is
yours about whom to tell. Be selective.

Be sure to consider these five words when thinking about
disclosure: who, what, when, where and why. Who do you need to tell? What do
you want to tell them about your HIV status, and what are you expecting from
the person you are disclosing to? When should you tell them? Where is the best
place to have this conversation? Why are you telling them?

Consider whether there is a real purpose for you to tell
this person or if you are simply feeling anxious and want to “dump”
your feelings. Telling people indiscriminately may affect your life in ways you
haven’t considered. Having feelings of uncertainty about disclosing is a very
common reaction in this situation. You have a virus. That doesn’t mean you’ve
done anything wrong. You don’t have anything to apologize for simply because
you are HIV positive.

Assess how much they know and understand about HIV. This
will help you to decide what you need to tell the person and how to tell them.
Being prepared will make disclosure less traumatic for both of you. Remember
that many people are ignorant about HIV and may need additional information to
help them understand your circumstances. When you do disclose your status to
anyone remind them that this information is deeply personal and cannot be
shared with others without your consent.

Openness about your HIV positive status may make it easier
to negotiate responsible sex and to prevent others being infected. Many men
find it very difficult to tell a potential new partner or lover that they are
positive because they fear rejection.  It
is often easier to tell someone upfront before you have sex with them – if you
tell them later they could feel that you betrayed them. Either way, being HIV
positive makes you responsible for never putting anyone else at risk of being
infected.

Some men find it easier to only have sex with other men who
are also HIV positive, but this doesn’t mean you can stop using condoms.
Sexually transmitted infections (STIs) such as syphilis, hepatitis or genital
warts can be very serious for HIV positive men and must be avoided. Learn as
much as you can about HIV, STIs and sexual health. Health4Men has an entire
series of brochures that you can read that will help you to make informed
decisions about sex and your sexual health. These you can get at any of our
sites or read them online on our website.

If you are the friend or the person being disclosed to,
remember that for this person it is an extremely difficult thing to do. Give
the person who is disclosing to you the opportunity to talk and to listen.
Asking questions about HIV is important as this will help you to learn and
understand but try and be supportive and not offensive.  “How did you get it?’’ for example should be
avoided and rather ask “Have you started treatment yet?” or “Have you found a
good doctor?” It will mean a lot to the person who is disclosing to you if you
reassure them that you are there for them and that you will respect
confidentiality. Remember that stigma is a by-product of fear and fear comes
from the lack of knowledge. Gaining knowledge is the key to understanding and is
a responsibility that everybody shares.

Avoid isolating yourself about your status. If you are still
not able to tell close friends, family members or other loved ones about your
HIV status, allow yourself to draw upon the support and experience available to
you, through organized groups in the HIV community. Disclosure can help you to
accept your own HIV positive status and can also help you to access the medical
services, care and support that you need.

Health4Men currently has support groups for gay and bi men
living with HIV in both Johannesburg and in Cape Town. For more information on
the Johannesburg support group please mail group@anovahealth.co.za or call 011
715 5880. For details on the Cape Town support group please call 021 421 6127
or email to office@health4men.co.za. Alternatively please visit the Health4Men
website on www.health4men.co.za and look under our psychosocial services
section.

Health4Men is a project of the Anova Health Institute NPC and
is funded by PEPFAR/USAID.