To tell or not to tell- that's the penultimate question! OK, this morning a friend wrote on my facebook wall a question which I'll summarize as : "and what do we do about those who do not disclose of their + status, who are going around with poorer, more vulnerable people & spread the disease?"
I'll respond to this here to share with you all, please comment if you want to. while am sharing this based just purely as my opinion, it is based on my past 6 years of advocacy work & meetings with groups of 100+ positive people & taken from my interactions with plhivs of all ages, nationalities & disclosure levels.
3 points:
1. Disclosure (and I don't care what the condition-unless it involves a serious life & death situation) should always be voluntary. You have no way of knowing the emotional & psychological turmoil such disclosure puts one in if they are not prepared for it.
2. Disclosure does not always have to be, nor is it always 100% public. All our advocacy efforts are NOT about people coming OUT publicly about their status. It is about getting plhivs to be sure enough that they count, that their lives matter & are accounted for, that their rights matter & are respected, such that they can continue to live meaningful lives in society, rather than sideline themselves or be victimized. So, in the case where one is marrying a person we know to be infected, what's our beef?! If you are close enough & have some locus standi/position in that relationship perhaps you can intervene to make sure this issue has been addressed- otherwise, it may be best to mind your own business! We are all responsible for the situations we get ourselves into.
3. There are myths out there that indicate 'responsible' people living with HIV are ''going around spreading the infection''. This is far from the truth. A well-known UK 2009 study indicates that contrary to public opinion, most 'responsible' people living with HIV actually go out of their way to ensure people they love are protected- by going on treatment, using condoms in all their sexual behaviour, avoiding sexual intercourse when in high transmissability phases; planning for nevirapine drugs when expecting a baby etc. 'Responsible' means have taken action to respond to their condition, are not sedated on any drugs or harmful substances & are not in any psychological distress/denial symptomatic phase in life. It is because most of these actions are taken in private, in less ''dramatic'' circumstances than those of ''male rapists who infect a teenager", for example, that we do not see their impact nor get affected by it. My experience with this in Malawi is that it is hard to protect your partner when you yourself haven't been tested. So we need to get the testing numbers higher up on the charts!
I'll go first: I am HIV+ & I am not having unsafe sex! (sex with other positives can expose you to other HIV strains/STDs...more on this later.)
We can remind those in our lives with HIV of the same: 'You're HIV+, please don't have unsafe sex!"
And then we can ourselves repeat this affirmation: 'I am unsure of my status. I will not have unsafe sex!"
But, let's not think of HIV as ONLY being sexually transmitted. Think of the children born with HIV, those who get it through blood transfusions or hospital errors (few but they exist). We must protect them too, & they too have every right to decide when they will tell & who they will tell & how they will tell of their 'condition.'