5.7. HIV infection among LGBT people
There is some similarity in the psychology of perception and acceptance of one’s own homosexuality and HIV diagnosis. Psychologists usually distinguish several stages: shock when any thoughts on this subject are blocked, a person is stuporous and confused; the stage of chosenness, when a reason is found to classify oneself as belonging to a specific group of people, and various kinds of activities in this context emerge; and finally, acceptance, when the diagnosis becomes a reality, a fact of life, and transformation of values when one starts to appreciate more his life, health and the support of loved ones.
Discussion of issues of life with HIV among people with different sexual orientation requires a trusting and comfortable relationship with counseling specialists. It is not always easy to talk about one’s sexual relationship to a stranger, especially if for a LGBT person. Here it is important to understand that services in HIV prevention organizations are always confidential and one should not be afraid of discrimination.
Many infected individuals do not know how to approach telling their partner or relatives of their HIV status and are afraid to do so. In this situation, communication with other HIV-positive people in support groups or counselling with a specialist can help. Psychologists recommend that a person begin to discover his/her status after a person has accepted diagnosis and stopped feeling fear, guilt and shame.
The HIV status in one of the partners does not mean that he/she should refrain from sex or relationships. Sex is practiced without using a condom quite often. If you've had unprotected sex with an HIV-positive person who is taking the highly active antiretroviral therapy (HAART) and has an undetectable viral load, the risk of the virus transmission is reduced to zero. This has been proven by large-scale international studies HPTN 052 (https://hptn.org/research/studies/33) and PARTNER (http://www.chip.dk/PARTNER). However, sexually transmitted diseases (STDs) should not be forgotten. Certainly, these infections are treatable, but every new infection puts an additional burden on the immune system, which should be avoided for people living with HIV. One should also avoid cross-contamination of other HIV types/subtypes. Therefore, it is recommended to always use condoms.
It is very important for maintaining a healthy relationship that not only the individual with HIV, but also his partner be screened regularly and followed-up by a doctor. Both partners must also be honest with himself and each other, talk about their feelings and be able to listen to each other to prevent HIV infection from negatively affecting the relationship.