Dear Dr Laura,
I’m 24 and I’m with my family for Christmas and New Year and I want to tell them I’ve just been diagnosed HIV. How do I go about doing that?
Thank you for your question. My first piece of advice is to consider whether now is the right time. If you’re just diagnosed and spending the festive season with your family I assume you’re well? Clearly if you’re sick there will be concerned questions but otherwise that’s highly unlikely. Of course HIV is nothing to be ashamed of and your news should be greeted with love and support but, sadly, that’s not always the case. There’s still unacceptable stigma, often driven by lack of knowledge, which could affect the reactions of your loved ones – especially at the start.
Christmas can be a stressful time. People feel pressured to make everything perfect, family members are crammed together and tensions can build over the smallest issues. Unless you are confident that they will react supportively you may be better deferring the discussion to a less fraught time. If anyone reacts negatively there’s little room for escape and I’m not convinced the claustrophobia of Christmas is the ideal setting. If you are just diagnosed I imagine this is still a time for adjustment so maybe you’d be best focussing on yourself for now.
In my experience of seeing people newly diagnosed with HIV it’s quite common to feel an urge to tell family straightaway. Some people experience guilt that they’re keeping something important hidden, others feel as if they must share the news or someone will guess or find out another way. This is your diagnosis and there’s no pressure to share that until you are ready. If you’ve already started medication you can put your pills in a vitamins container if you prefer and modern medications are unlikely to cause side effects that are noticeable to others or affect your ability to celebrate. Some medications must be taken with food but that’s unlikely to be an issue at this time of year!
Have you spoken to friends? Or is there a family member you’re particularly close to? Chat to them first about when is the best time to tell your wider family. Also, if you decide Christmas is the right time, having a family member primed with the right knowledge to reassure the others will be helpful.
When you do tell your family, now or later, do it when everyone is together, without distractions and say you want to discuss something important. I would not recommend warning them in advance that you have news or they’ll worry.
Thankfully we have good evidence to support a very optimistic message for your family. U=U (undetectable=untransmissible meaning people on treatment with an undetectable viral load CANNOT transmit HIV to their sexual partners) combined with the fact that people with well treated HIV have the same life expectancy as the general UK population, are important in destigmatising HIV.
You can tell your family that you will need to take tablets every day but the side effects are much improved and there are many new developments on the way. It may help to take some information leaflets or tell them which websites are helpful (the NAM booklets on aidsmap.com are invaluable: aidsmap.com/booklets). Sadly, one recent survey showed some of the general public still believe you can get HIV from a family member. We may have come a long way but there is still far to travel.
If you want help phrasing the news you can speak to staff at your clinic (if they have Health Advisers they can be very helpful) or seek peer support, within your clinic or from an organisation like Positively UK or Terrence Higgins Trust. Speaking to a friend living with HIV can also help.
Ultimately this is your diagnosis, and your news, to share when, how and with who you want to…
The Boyz Doc is Dr Laura Waters, an HIV and sexual health consultant at the Mortimer Market Centre in central London. Dr Laura answers your questions every week in Boyz. If you have a question for Dr Laura please email her at firstname.lastname@example.org