In this country, gay men still make up the majority of people with HIV. We know from research that gay men are almost four times more likely to experience some sort of mental distress than their straight counterparts. Things that contribute to this include common and subtle forms of stigma and discrimination throughout our lives, the lack of positive representations of ourselves and our lifestyles in everyday life and the difficulties of merely being different from the majority of the population. Coming out, which we have to do on a quite regular basis, brings with it subtle anxieties; how will they react? Will they treat me differently?

Stigma and discrimination within LGBT communities

Add HIV to the above and it can create a double whammy of stressors. Stigma and discrimination towards people with HIV can show itself in various subtle and not-so-subtle ways within the gay community itself. “Avoid hanging out with X, everybody knows he’s got HIV and people will think you’ve got it too”. “People with HIV don’t care, they’ll shag anyone without a condom”. Urban myths abound about people taking their anger about having HIV out on others by infecting them deliberately. “HIV-positive dole scroungers”; “It’s their own fault they got it, they shouldn’t have been such a slag/have been so stupid” and other negative assumptions. It’s rarer now to hear such things being said openly in gay venues, however, the impact of hearing such things (and others more subtle) can be very distressing for a person with HIV. In reality, most gay men have unprotected sex at least once in their lives. We men with HIV may be just the unlucky ones.

Many of us with HIV, especially when newly diagnosed, feel really bad about ourselves. We blame ourselves; feel dirty, stupid, bad, toxic. These bad feelings can last for years. We very often take on board the negative stereotypes of people with HIV, either that we already believed ourselves or hear from others. This can lead to low self-esteem, lack of self-confidence, or depression. This does not even take into account the effects of the prospect of living with a chronic disease for the rest of our lives or the effects of taking quite hefty and demanding medications.

There seems to be a general belief that since the use of the new combination therapies in the late 1990s that living with HIV becomes merely living with a manageable chronic disease like diabetes. Despite combination therapies being very effective, there has been an increase in suicides among men with HIV since they came into use. In fact, men with HIV have a very high suicide rate.

When you tell someone that you have diabetes I imagine that most people will act in a reasonable but possibly uninformed way (for example, saying inaccurate things about sugar). When you tell someone that you have HIV, it’s like coming out all over again: how will they react? Will they treat me differently? Negative reactions will reinforce any negative feelings we may have about ourselves and especially so if we are experiencing some level of depression at the time. Sometimes it’s easier not to tell people about our HIV status because we don’t think we can handle a possible negative reaction. If we don’t tell people, or choose not to let some people know, this can sometimes lead to high levels of anxiety: in case they find out from someone else; a permanent vigilance in case we give it away; watching what we say, making sure we’re not seen going into the clinic; trying not to say or do things that might give away our status and so on.

People with HIV who experience mental-health difficulties (either those that existed before their HIV diagnosis or that came after their diagnosis) experience stigma on at least two levels. The stigma of having HIV and the stigma of having a mental-health difficulty – this stigma is experienced both inside and outside the LGBT community. The third level of stigma is experienced in everyday life – the stigma of being gay. Stigma and discriminatory behaviour lead to isolation.

MindOut

All of MindOut’s services are open to people with HIV who identify as LGB or T and identify as having mental-health issues. MindOut offers advice, information and advocacy; groups; and a range of activities for LGBT people who identify themselves as having mental-health difficulties.

Contact us on 01273 739847 (confidential answerphone)

info@lgbtmind.com

www.lgbtmind.com