Disclosure Workshop - Telling Others

posted: 24/06/2010

Come along and take part in this interactive workshop about the who, why, when and how of telling people about your HIV status. The evening will be an opportunity to learn from other people’s experiences of disclosure - and to share what you’ve learned from telling others about having HIV.

• Who should I disclose to?
• When should I tell?
• Why should I tell?
• How should I tell others?
• Where is a good place to tell?
• What are the advantages and disadvantges? 

This interactive workshop will be led by Colin Armstead and Daniel Murphy, both Service and Development Managers at George House Trust.

Wednesday July 7
5.30pm (for light refreshments) to 8pm

There will be NO CRÈCHE at this workshop.

TRAVEL EXPENSES will be available to people who qualify.

This Disclosure Workshop is for ALL George House Trust service users.

For more information please email Colin or Daniel - or ring Colin or Daniel on 0161 274 4499

Psychologists and Confidentiality

posted: 08/03/2010

A 20 page booklet of guidance from the British Psychological Society advises psychologists working in the NHS how to deal with HIV confidentiality where people may be exposing their partners to HIV. The guidance – ‘Criminalisation of HIV Transmission – guidelines regarding confidentiality and exposure’ has best practice guidelines, sections on dealing with police enquires and on disclosing information to partners, and what the various codes of ethics and types of professional guidance say.

These guidelines on HIV confidentiality and disclosure were developed to help clinical psychologists where HIV-positive clients have not disclosed their status to their sexual partners and there is a significant risk for HIV transmission. They have also been developed to assist clinical psychologists when clients believe they have contracted HIV under these circumstances.

This 2009 booklet costs £4.70 to people who are not members of the British Psychological Association.
 

Stigma and Supporting Disclosure

posted: 16/11/2009

How much do our friends and family influence our lives? Living with HIV, we rely on our social network for advice, emotional support, and information. But to get this HIV support, we have to disclose our HIV-positive status. Disclosing status almost always has some risk. We might be rejected, or experience their discomfort about HIV.
 

Practice makes telling easier
The advantages of telling others about being HIV positive status are well known, and one advantage is the "practice effect." The more we successfully tell others, the easier it becomes. Even if it didn’t go well, we still learn from the experience and will be more prepared next time. Positive experiences in telling others encourage us to do it again.
 

But negative experiences like rejection, and sometimes even physical abuse, may reinforce the social stigma we feel. What we feel and think about HIV stigma is based on what we know about the reality of HIV stigma and discrimination, the actual or potential social disenfranchisement, limitation of opportunity, and negative change in social identity.
 

Internalising stigma and the telling moment
Perceived stigma may lead to various outcomes, including negative changes in self-concept and emotional reactions toward those who may invoke the stigma. HIV-positive people tend to tell significant other people about HIV once they think the rewards of telling will outweigh the possible costs and risks.

Disclosing benefits
Telling others can lead to receiving more and better emotional, physical, and social support. The emotional benefits include

• social support,
• relief that comes from sharing a burdensome secret, and
• the reward of educating others about HIV.

Reasons for secrecy
Reasons for not telling people are

• fear of rejection,
• fear of stigma,
• privacy,
• self-blame, and
• risking the opportunity of sex.

We want to avoid serious negative consequences, so we avoid taking the risk of telling.

How do HIV stigma and social support influence telling partners?
This study gave people different situations and they were asked to say how willing they would be to tell the partner then about HIV. The study tried to discover what encourages HIV disclosure to sex partners, and what discourages disclosure, from the perspectives of HIV-positive gay men.

The study was of gay men using a Chicago, USA, HIV support organisation. The men were between the ages of 18 and 63, gay, 90% white, and 60% were diagnosed over 4 years. 80% of the men were on treatment.

"I've told all but family, who have issues."
The men had a wide range of views on stigma. Feeling socially supported didn’t seem to make this sample of men more ready to tell others. As earlier studies have shown, other things that predict telling sex partners include

• type of sexual relationship and
• adult romantic attachment style.

Social support might not have made the difference in telling for these men because it is possible the partners were part of the men’s existing HIV+ support networks. Many gay men with HIV have many positive men in their friendship networks.

The more socially supported and networked the men are, the less stigma hurts and harms them. Social support allows people to cope better with HIV stigma. Boosting social support therefore could be a way to improve how well people cope with HIV stigma.

This particular study of well-networked positive gay men did not find evidence that better social support encourages telling sex partners. Telling sex partners you have HIV is important because it alerts partners to the risks but telling partners does not automatically lead to changes in sexual risk taking. Some men confident about safer sex might ‘do’ the safer sex to avoid disclosure. Not telling, but using safer sex, seems to be doing enough morally.

Social support supports safer sex

The study did find social support helped men to have safer sex. Having safer sex and not telling suggests past experiences of sexual rejection after disclosure, and not being willing to risk such sexual rejection.

Social support from other HIV-positive gay men encourages men to initiate safer-sex, but didn’t, in this study, increase disclosing to sexual partners. The researcher speculates that most of the gay men probably knew each other already (including their shared HIV status) through using the same HIV support organisation for over four years. Probably for most of the positive gay men, there was simply nothing to say about both men having HIV.

Perhaps social support made no difference to telling sex partners partly because positive gay men often deliberately seek out other positive gay men as sex partners. Perhaps simply coming to a HIV+ social support group improves men’s communication skills and confidence about managing safer sex, with or without disclosure.

Feeling better after a good tell
Disclosing HIV may help improve psychological well-being if the response is good and positive. The value of a HIV support group comes from sharing information, and physical and emotional experiences and learning. For example, HIV-positive gay men can provide others with emotional support and reassurance that one is loved and valued despite HIV-positive status. HIV-positive gay friends can also provide empathy, familiarity and trust.

Telling other positive people does not, however, always help people tell people who, we assume, doesn’t have HIV.

Source

Help with telling people including a video from Terrence Higgins Trust

Secrets and Lives Triumph

posted: 27/08/2009

As those of you who attended last night's event will know, Secrets and Lives was a huge success.
Approximately 140 people attended, and the Frog and Bucket comedy club was really buzzing. There was a real sense of activism and energy around stopping HIV stigma, and everyone went away with a clear message that we all need to take whatever action we can to stop it.

Intimate, honest and challenging, this event, part of the Manchester Pride festival, aimed to open eyes to the reality and diversity of HIV positive people’s lives in the UK today.

It's no secret that gay men are disproportionately affected by HIV, and this has been the basis of some of the ugliest and most reprehensible homophobia 'justifications' that the community has faced.

It asked - what about today? As a community are we still as united in our activism around HIV and in our support for positive people?

Why are are so many positive gay and bisexual men so afraid of being open about their status? Is HIV the new closet?

Telling their stories

The Positive Speakers gave fantastic speeches, both very moving and thought provoking. It was bold and courageous to be out to such a large audience of people from their own community, which was a first for Positive Speakers. Before they have spoken mainly to school and college audiences.

The three accompanying acts, Chloe Poems, Zoe McVeigh, and The Cocquettes were brilliant and provided a great variety to the evening, and they gave their time for free.

Colin was compere extraordinaire, and has earned himself the compere gig for future events with his enthusiasm, humour and sensitivity.

Vox pop interviews on Canal Street

James and Kath produced a fantastic professional vox pop movie of interviews of people along Canal Street in Manchester about HIV and stigma. We'll be showing this on our expo stall over the coming Pride weekend and for future events.

What was telling is that the vast majority of people who Kath and James asked about HIV and stigma refused to be interviewed. One of the main messages of Secrets and Lives is we MUST all talk about HIV to end HIV stigma on the gay scene.

Kath (the Positive Speakers coordinator) did an amazing job at putting the whole event together - we haven't done something like this for a long time and she organised it in style. The event showed us as the professional and committed organisation that we are.

£400 and up

We've raised over £400 from the event, made a couple of great networking contacts, changed people's attitudes, and energised people to take action to stop HIV stigma.

Swiss Court Frees HIV+ Man

posted: 10/03/2009

In the first ruling of its kind in the world, the Geneva Court of Justice has freed a man given 18-months prison for exposing someone to HIV.The court ruled that the risk of HIV transmission while the man was on treatment was far too low to justify the conviction.

In Switzerland, public health law effectively made it a crime simply for people with HIV to have any  unprotected sex. However this court has now changed this. It accepted expert testimony from Professor Bernard Hirschel – one of the authors of the Swiss Federal Commission for HIV/AIDS consensus statement on the effect of treatment on transmission – that the risk of sexual HIV transmission during unprotected sex on successful treatment is 1 in 100,000. It ruled that this level of risk was far too low to keep unprotected sex a public health crime.

The case began in Lausanne in 2007, when a court sentenced the HIV-positive man, originally from the Democratic Republic of the Congo, to a suspended 28-month sentence for having unprotected sex, without telling his woman partner his HIV status.

Swiss HIV Law

Under the public health parts of the Swiss criminal law, Article 231 allows prosecutions against HIV-positive individuals for having unprotected sex, with or without disclosure. The UK doesn’t have a public health criminal law about disease exposure. Prosecuting and criminalising public health was dropped in the UK because it goes against the principle of encouraging people to come for testing and treatment. Criminalising public health drives people with health needs underground and protecting public health becomes far more difficult.

People with HIV in Switzerland can also be prosecuted under Article 122, for an attempt to engender grievous bodily harm. This makes it an attempted grievous bodily harm to have unprotected sex, even if there is no HIV transmission. People with HIV in Switzerland are jailed simply for having unprotected sex. This can't happen under English law. Here HIV transmission has to take place before the charge of "grievous bodily harm" can be made. There is no English crime of attempted grievous bodily harm.

Deborah Glejser of Swiss community HIV organisation, Groupe SIDA Genève, explains that although this public health law could be used even more harshly, to prosecute unprotected sex even when HIV status has been disclosed, in practice, the Swiss only prosecute HIV exposure without disclosure. Suspended sentences are normal so this man’s imprisonment was unusual.

Trial judge refused to consider Swiss statement

A second complaint last year led to the man standing trial again in Geneva in November 2008. According to a report in The Geneva Tribune, an expert medical witness had testified that although treatment greatly reduces the risk of transmission, there remained a residual risk. Although the man's lawyer had put forward the statement by the Swiss Federal Commission for HIV/AIDS as evidence, and Geneva's deputy public prosecutor wanted to suspend the hearing to consult with the Swiss HIV Commission, the lower Geneva court refused to allow this. This made it his second conviction so he was sent to jail for 18 months, in December 2008.

This clearly annoyed the deputy Public Prosecutor who felt justice was not being done or being seen to be done. The court refused to consider the evidence even the prosecutor thought was relevant. We are left with the suspicion that a white Swiss native would have not been jailed for 18 months like this black African migrant. The British pattern of a disproportionate numbers of migrants being jailed for HIV crimes is found across much of the globe

It's Super-Public-Prosecutor to the rescue

Late in February the deputy public prosecutor came to the rescue and told the Geneva Court of Justice that he was convinced by the Swiss Federal Commission for HIV/AIDS that the risk of transmission for an HIV-positive individual on successful treatment was less than 1 in 100,000. Under the circumstances he wanted to appeal so as to withdraw the charge and for the court to cancel the conviction.

On Monday, the Geneva Court of Justice acquitted the man, who was freed  after almost three months in prison. Geneva’s deputy public prosecutor, Yves Bertossa, called for the appeal, told the newspaper Le Temps that although there is still some debate regarding the slight risks of transmission in people on successful treatment this should not be used unfairly: "One shouldn't convict people for hypothetical risks,” he said.

Swiss statement did what it set out to do

Professor Hirschel said that he was very pleased with the outcome. It was, he said, the main reason that he and his colleagues issued their January 2008 statement of advise for courts and prosecutors.

The Swiss panel has had enormous global attention and a great deal of criticism for openly talking about and applying the lessons of modern HIV treatment to the lives of people living with HIV. Swiss HIV clinicians wanted to put a stop to much of the jailing of people with HIV - simply for having unprotected sex without any HIV transmission.

Deborah Glejser of Groupe SIDA Genève added that Monday’s ruling means that, in Switzerland, HIV-positive people on treatment which is working properly should no longer be prosecuted for having unprotected sex. She hopes that this ruling will help people in other countries that prosecute HIV exposure – and she’s been contacted by many already.

Hopes for fall in global prosecutions

Last May, a five member US Court of Appeals for the Armed Forces panel rejected, but only by a narrow majority, an appeal by an HIV-positive soldier who had previously pleaded guilty to HIV exposure, following unprotected sex with two women without disclosing his HIV status. And last July, a Canadian court considered and rejected the Swiss statement in the case of a man charged with having unprotected sex with six women.

Following Monday's ruling, however, Geneva’s deputy public prosecutor, Yves Bertossa, believes it is only a matter of time before other jurisdictions realise that prosecutions for HIV exposure should not take place when the accused is on successful antiretroviral therapy. He told Radio Lac: “There are some medical advances which can change the law. I think that in other [parts of Switzerland] or in other countries, the same conclusions should apply to their laws."

source