Psychological impact of HIV
Being diagnosed with HIV can be extremely distressing, and feelings of anxiety or depression are common. Your HIV clinic can provide you with counselling so that you can fully discuss your condition and your concerns.
You may find it helpful to talk to a trained counsellor or psychologist, or to someone at a specialist helpline. Your HIV clinic will have information about these.
Some people find it helpful to talk to other people who have HIV, either at a local support group or in an internet chatroom.
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Telling people about your HIV
Telling your partner and former partners
If you have HIV, it's important that your current sexual partner or any sexual partners you've had since being exposed to infection are tested and treated.
Some people can feel angry, upset or embarrassed about discussing HIV with their current or former partners. Discuss your concerns with your GP or the clinic staff. They'll be able to advise you about who should be contacted and the best way to contact them, or they may be able to contact them on your behalf. They'll also advise you about disclosing your status to future partners and how you can reduce the risk of transmitting the virus to someone else.
Nobody can force you to tell any of your partners you have HIV, but it's strongly recommended that you do. Left untested and untreated, HIV can have devastating consequences and will eventually lead to death.
Telling your boss
People with HIV are protected under the Equality Act (2010).
There's no legal obligation to tell your employer that you have HIV, unless you have a frontline job in the armed forces or you work in a healthcare role where you perform invasive procedures (as you'll need to be monitored by your occupational health team and HIV doctor to ensure you're not putting your patients at risk of infection).
The Equality Act 2010 also places restrictions on the health questions that employers can ask during a job application process. Employers are allowed to ask health questions only after an offer of employment has been made, to help them decide whether you can carry out tasks that are essential for the job.
If you're asked a question that you think isn't allowed under the Equality Act 2010, you can tell the employer, or you can tell the Equality and Human Rights Commission. The GOV.UK website has more information about questions an employer can ask about health and disability.
If you're an employee with HIV, you may worry that if you tell your employer, your HIV status will become public knowledge or you may be discriminated against. On the other hand, if your boss is supportive, telling them may make it easier for adjustments to be made to your workload or for you to have time off.
If you have HIV and become pregnant, contact your HIV clinic. This is important because:
- some anti-HIV medicines can harm babies, so your treatment plan will need to be reviewed
- additional medicines may be needed to prevent your baby getting HIV
Without treatment, there's a 1 in 4 chance that your baby will develop HIV. With treatment, the risk is less than 1 in 100.
Advances in treatment mean that a normal delivery is now recommended for women who have an undetectable viral count and whose HIV is well managed. For some women, a caesarean section may still be recommended, and may also be indicated for other reasons not related to your HIV.
Discuss the risks and benefits of each delivery method with the staff at your HIV clinic. The final decision about how your baby is delivered is yours and staff will respect that decision.
If you have HIV, don't breastfeed your baby because the virus can be transmitted through breast milk.
If you or your partner has HIV, there may be options available that will allow you to conceive a child without putting either of you at risk of infection. You should ask your HIV doctor for advice.
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If your CD4 count drops below 200, you'll be at risk of developing many different types of infection. Infections that "take advantage" of an HIV-weakened immune system are known as opportunistic infections. However, if you stick to your HIV therapy, the likelihood of developing an opportunistic infection is low.
The 4 main types of opportunistic infections are:
- bacterial infections, such as pneumonia or tuberculosis (TB)
- fungal infections, such as oral thrush and pneumocystis pneumonia (PCP)
- parasitical infections, such as toxoplasmosis
- viral infections, such as shingles (herpes zoster)
People with advanced HIV also have a higher risk of developing some forms of cancer, such as lymphoma (cancer of the lymphatic system).
Bacterial pneumonia is more common in people with HIV, but also occurs in people without HIV, particularly those with chronic respitory conditions. It can develop as a complication of other infections, such as flu. Left untreated, pneumonia can be fatal because the infection can spread through your blood.
Pneumonia can be treated with antibiotics. There's also a vaccine that can protect you against many of the bacteria that can cause pneumonia. Annual flu vaccinations are also recommended for people living with HIV.
Tuberculosis (TB) is another bacterial lung infection. Globally, it's one of the leading causes of death for people who are HIV positive. TB can be treated using antibiotics, but some strains of bacteria have developed antibiotic resistance, and these can be more difficult to treat.
Candidiasis is a fungal infection that's common in people living with HIV. It causes a thick, white coating to appear on the inside of the mouth, tongue, throat or vagina.
Candidiasis is rarely serious but it can be both embarrassing and painful. It can be treated with antifungal creams.
Tell the staff at your HIV clinic if you have repeated bouts of candidiasis because it could be a sign of a low CD4 count.
Pneumocystis pneumonia (PCP)
Pneumocystis pneumonia (PCP) is a fungal infection of the lungs, which can be life-threatening if it isn't treated promptly. Before the advances in anti-HIV medicines, PCP was the leading cause of death among those with HIV in the developed world.
Symptoms of PCP include:
Report any symptoms of PCP straight away because the condition can suddenly worsen without warning. PCP can be treated with antibiotics and, if your CD4 count drops below 200, you may be given antibiotics to prevent a PCP infection.
People with advanced HIV have an increased risk of developing some types of cancer. It's estimated that someone with untreated late-stage HIV infection (AIDS) is 100 times more likely to develop certain cancers compared to someone without the condition.
The two most common cancers to affect people with HIV are lymphoma and Kaposi's sarcoma. Lymphoma is a cancer of the lymphatic system (a network of glands that makes up part of our immune system). Kaposi's sarcoma can cause lesions to grow on your skin, and can also affect your internal organs.
HIV treatment is important in reducing your risk of cancer and long-term conditions, such as cardiovascular and respiratory disease. If you smoke, giving up is also important in reducing this risk.
Money and financial support
If you have to stop work or work part time because of HIV, you may find it difficult to cope financially. However, you may be entitled to one or more of the following types of financial support:
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