What you can expect

Learning that one has been infected with HIV can cause emotional distress for the individual, as well as for sexual partners, friends and family who are aware of the individual’s status.  Even if a person is without symptoms, the person may have to cope with years of uncertainty about their future health and constant fear of developing AIDS.  The most common psychological reactions to being HIV positive are:

Anxiety

• Studies have shown that an individual who is diagnosed HIV positive seems to experience more anxiety than an individual who is already in the AIDS stage. One suggestion for this finding is that these individuals appear very concerned about their future health and have an intense fear of developing AIDS. These fears and anxieties tend to re-surface every time a change is experienced in their physical status.
• However, there are cases where certain people experience a sense of relief when diagnosed as being positive. The uncertainty of becoming infected was a cause of a great deal of anxiety. Unfortunately, in most of these cases the relief appears to be temporary as uncertainty about their future health increases.

Depression

• Depression is the most common psychological experience, after anxiety, following a diagnosis of HIV.
• Isolation from others (as a result of you withdrawing from others or when existing social support networks withdraw) is a common feature among people living with HIV.
• More than half of people with HIV and AIDS express fear about others negative reactions, and one-third prefer to remain silent rather than risk personal rejection (until the symptoms make it impossible to maintain any pretense of normality).
• The obvious disadvantage of self-isolation and nondisclosure is that you simultaneously lessen any possibility of receiving emotional support, which can contribute to depression.
• Signs of depression are:
  • Loss of interest in normal daily activities;
  • Feeling hopeless;
  • Feeling sad;
  • Crying more than usual or for no apparent reason;
  • Increased or decreased need for sleep;
  • Problem concentrating;
  • Difficulty making decisions;
  • Weight loss (loss of appetite) or weight gain (comfort eating);
  • Restlessness;
  • Irritability and easily annoyed;
  • Feeling worthless;
  • Feeling fatigued or weak;
  • Loss of interest in sex; and
  • Recurring thoughts of suicide or suicidal behavior.

Anger

• While anger is a common experience, the reasons may differ from person to person.
• Anger can result from a feeling of being a victim of the virus.
• Anger can be directed towards those who may have transmitted the virus to them.
• Uncaring reactions and social insensitivity may be encountered and can contribute to the feeling of anger.
• The inability of health care workers to provide immediate solutions and cures can become frustrating to many, resulting in anger.
• Many become angry with themselves for engaging in behavior that exposed them to the HIV viral infection.
• Anger can also result from feared progression from HIV to AIDS, social discrimination and stigmatization and the absence of any reassurance that medical solutions will emerge in the future.
• The experience intense anger can sometimes result in excessive drinking and drug abuse (as a form of coping).  This will contribute to deterioration of the client’s future health.

Somatization

• Many of the subjective symptoms detected by HIV positive clients reflect a preoccupation with the illness rather than any actual physical changes.
• Realistic concern about one’s health is reasonable and a common outcome of being HIV positive, but may alternate with exaggerated sensitivity and preoccupation with HIV.

Denial

• Denial may be self-protective in the short term because it reduces emotional distress. However, in the long-term denial precludes making the behavioral changes that will prevent further HIV transmission or repeated exposure to the virus (re-infection).
• If a person infected with HIV is in denial of the fact that he is positive, it could contribute to the deterioration of his health.  By not accepting the fact that you are HIV positive, you are denying yourself medical treatment that can contribute to your health and well-being. 

What you can do

• Managing your anxiety (and tendency to somatise): If concerned about any changes in your physical health then consult your doctor on a regular basis to allay your ongoing fears. Discuss your feelings with your doctor and be sure to get as much information as possible, even if you must ask the same question over and over again. Another option could be to go for counselling (with a counsellor you can relate to) to explore the cause of your anxiety and to learn better ways of managing your anxiety. Through counselling you could also learn strategies for managing stress and setting realistic goals. You may also find it helpful to start meditation, massage, yoga or Tai-Chi, which can bring enormous relief from anxious energy. There is no need to cope with anxiety on your own.
• Reducing Isolation: You do not need to disclose your HIV status to everyone. Instead start by identifying a small number of trusted people you know who will be supportive and helpful (such as a family member, friend, colleague, doctor, or counsellor). In addition, you could consider joining a support group. Research has shown that accessing and receiving support can reduce symptoms and prolong life. There is no need to be alone.
• Managing your depression: If you experience any signs and symptoms for more than two weeks then consult your doctor. Treatment is available. It may also be a good idea to speak to a counsellor, who could assist you with self-acceptance and self-care. Research has shown that a combination of medication and therapy are better than either on their own. Self-care is very important.  There is no need to cope with depression on your own.
• Managing your anger: If you are feeling constantly angry it may be a good idea to speak to a counsellor to assist you in processing and managing your anger. Some useful tips for managing anger include getting a boxing bag, regular exercise and meditation. Joining a support group could also help by giving you a safe space within which to vent.
• Overcoming denial: HIV is not a death sentence. By changing your lifestyle and living healthily you can live a normal life. By going for counselling after receiving a diagnosis, you will be able to work towards a level of acceptance that will motivate you to make the necessary changes that can benefit your life.
• In general: Accept, love, and spoil yourself. Do things that make you feel happy and good. Laugh more. Learn to communicate more effectively. Be more assertive. Replace negative self-talk with positive self-affirmations. Explore your spiritual life. Surround yourself with uplifting people.

What you can expect

The vast majority of people living with HIV are in the prime of their working lives. This fact has critical implications for businesses and national economies, as well as for individual workers and their families.  HIV/AIDS is a critical workplace issue for many reasons. Stigma and discrimination can threaten the fundamental rights of employees living with HIV. The loss of workers, skills and experience can increase the burden on the remaining workforce, lowering morale and reducing productivity.

What you can do

There are advantages if you do inform your section head or line manager that you are HIV positive. Everybody doesn’t need to know that you are positive, but informing your section head or line manager confidentially can ensure employer support. If you were to feel sick and can’t be productive on a specific day, your employer will at least know why this is happening. Your employer could support you in other ways by encouraging more effective coping mechanisms, providing support against occupational stressors and help reduce symptoms of occupation stress.

If you experience any unfair discrimination in the workplace contact the AIDS Law Project for further assistance. Their web address is www.alp.org.za

What you can expect

Being HIV positive may lead to extreme changes in your energy and physical health.  You may experience pain, breathlessness, a change in your body image and a feeling of general tiredness.  The following symptoms may also be experienced frequently:

• Fever and sweats;
• Headache;
• Enlarged glands;
• Lack of energy;
• Weight loss;
• Persistent of frequent yeast infections;
• Skin rashes or flaky skin;
• Short-term memory loss; and
• Some people develop frequent and severe herpes infection that can cause mouth, genital, or anal sores, or a painful nerve disease called Shingles.

What you can dO

• Follow a balanced diet.
• Avoid junk foods, caffeine, alcohol, smoking and drugs as these will suppress your immune system.
• Take a good quality multivitamin (an immune booster) – check with your doctor before commencing with any new medication.
• Get enough rest and sleep – constant fatigue will also suppress your immune system.
• Get regular exercise.
• Always practice safer sex to prevent re-infection.
• Find an appropriate doctor skilled in HIV management.
• Go for regular check-ups to maintain good health.
• At the onset of any illness or infection get immediate medical treatment.
• Talk to your doctor about Anti-retroviral (ARV) Treatment. If already on ARV’s make sure that you adhere to the regimen – poor adherence could result in developing a resistance to the ARV.
• If you use herbal medical treatment, discuss it with your doctor – some herbal remedies may interact with ARV’s.

What you can expect

Individuals with HIV are often frightened of the rejection, betrayal, and discrimination that can follow the disclosure of their status.  When diagnosed with HIV, an individual is immediately faced with difficult decision of whom to tell and when to tell.  They often struggle with realistic fears about how others will react to the news. In some cases they may be deserted or rejected by friends, lovers, or family members. These losses may occur at a time when people need stability, comfort and safety most in their lives.

Other social difficulties stem from avoidance or fear of others, which increases the individual’s sense of isolation. Anxiety, depression and anger are often detrimental to interpersonal relationships. In addition, the individual may want to withdraw from any social contact, but this is likely to contribute to more stressors. Most people that are HIV positive feared that the HIV exposure would negatively affect established relationships.  However this is not always the case.  A strong network of family and friends can be important in helping a person living with HIV to cope with this adjustment.

What you can do

If you have tested positive, it is important to build on your personal support group (consisting of family, friends, colleagues, peers etc) and to try to live as normal as possible. This might not be easy after the diagnosis, but the sooner you start socializing, the better it will be for yourself and your health. Ask your Health Care Professional about a HIV support group. By joining a support group you can interact with other HIV positive clients. This is not only for support, but you can experience firsthand what other clients have already experienced and learn how to cope with these issues.

What you can expect

HIV positive individuals often contemplate the meaning and purpose of life and death and may examine the role of spirituality or religion in their lives. These concerns are triggered by learning of a life-threatening disease. People deal with these spiritual concerns in different ways. Some try to reconnect with the religion or religious institution that they were previously with. Others turn to other religions that are new and appropriate to them.

Spirituality is seen as a broader category within which religious beliefs may or may not function. A broader kind of spirituality usually entails some of the following:

• A feeling of connectedness and belonging in the universe.
• A belief in some kind of power or spirit outside of one’s self.
• The belief that life has a purpose and meaning and that a person can therefore search for ultimate and personal truths.

What you can do

You can live positively if you remember the following:

• People are not machines and nobody is perfect. People sometimes do take risks or act incautiously.
• We can choose to stay angry with other people (or with ourselves) and spoil the rest of our lives but that will not change what has happened to us.  However, you can change the rest of your live by choosing to live positively and by helping others.

Prayer can heal. Science can’t explain how this happens but it does. Important things that you should know about prayer:

• Have faith. Faith is not about thoughts and words. It is about feelings. When you pray pretend that you have already received what you are praying for (be realistic). Be thankful for already having it.
• Don’t worry about how it will happen.  Fear and doubt stop prayers from working (don’t think about whether or not something will happen).
• Ask for what you want and not for what you want to be taken away.  For example, pray for health, not for your illness to be taken away.
• Ask for exactly what it is you would like, or say exactly what you are grateful for.  Be willing to be surprised at how the prayer will be answered.  Believe that you deserve what you are praying for – be ready to get what it is you asked for.