"Honey, I'm living with HIV!" - Talking about HIV in psychotherapy and relationships

What is psychotherapy and when is it helpful?

Nobody can do anything about their infection with HIV. However, it is your responsibility to deal with it as well and responsibly as possible and to know with whom, when and how you want to talk about your diagnosis. Psychotherapy can be useful here. Psychotherapy is a process in which a patient and a therapist work together using various methods to address the factors that cause psychological problems. This can be the case, for example, if you feel sad, anxious, have difficulties dealing with the HIV diagnosis or want to be able to talk about it better. Psychological counseling can also help if you are having problems in relationships, dating or at work. In psychotherapy, you learn new ways of dealing with your actions, feelings, experiences and thoughts. This can lead to stabilization and improvement of emotional problems. The aim is for patients to learn how to help themselves psychologically and become experts in their own well-being. Psychotherapy can be a long process before a person feels better, as the restructuring of thinking and feeling takes time.

It is important that people with HIV have the opportunity to talk to a sympathetic person about their problems, fears and worries without prejudice. For this reason, it may be necessary to try out several therapists until you find a suitable person with whom you feel comfortable. There are many topics that can be helpful for people with HIV to talk about in psychotherapy. Here are a few examples.

Diagnosis

A diagnosis of HIV infection can lead to strong emotional reactions, including anxiety, depression, anger and sadness. Psychotherapy can help you process these emotions and find ways to cope with the diagnosis. It is not possible to say how long these feelings have to be present before you should undergo psychotherapy. Rather, it depends on how distressed you feel by these symptoms.

Dealing with prejudice and rejection

People with HIV can feel isolated and alone due to prejudice and rejection. Psychotherapy can help to deal with prejudice and rejection and maintain a healthy self-esteem.

Relationships

HIV infection can have an impact on interpersonal relationships, be it in a partnership, in friendships or in the biological or chosen family. Psychotherapy can help to improve communication, overcome conflicts and find support in the social environment.

Better quality of life

Psychotherapy can help to improve the overall quality of life of people with HIV. It can help them to cope with stress independently using positive strategies and to lead a fulfilling life with the infection.

Taking medication regularly

Treatment with appropriate antiretroviral drugs (ART) is crucial for the health of people living with HIV. Psychotherapy can help to recognize barriers and develop strategies to take the medication better and receive regular medical care.

Self-stigmatization

Self-stigmatization, i.e. devaluing and rejecting oneself, is a significant issue for many people living with HIV. The diagnosis often leads to inner conflict and negative self-images that are influenced by prejudices and stereotypes about HIV. This can lead to people with HIV feeling ashamed, isolated and keeping their infection a secret. This is where psychotherapy can help to improve the relationship with oneself.

Self-acceptance

Being able to accept yourself with an HIV infection is important for your emotional and therefore also your physical well-being. By promoting self-acceptance, people with HIV can learn to see themselves as valuable individuals. This helps them to lead a fulfilling life.

With whom, how and when to talk about the diagnosis?

It is important to emphasize that there is no "right recipe" for telling others about your HIV infection. But knowing who, how and when to tell about your infection can be important. This can have a major impact on your emotional well-being and relationships with others.

In principle, no one is obliged to tell others about their diagnosis. People living with HIV can decide individually who they want to talk to about their illness and how. It is often difficult for people living with HIV to get to know people and to date, as they fear being rejected because of their HIV infection. Many people are afraid of how their partner will react if he or she finds out about their HIV infection. Fears include, for example, that their partner will end the relationship or that the relationship will change.

It can therefore be helpful to think about how the other person might react before the conversation in order to be better prepared for possible reactions. It can also be useful to think about certain sentences or phrases beforehand. It can also help to imagine how you would like to deal with a negative reaction before a conversation. Some people therefore like to role-play with people who know about the infection to test how they come across and how they can best respond.

How can you prepare well for a conversation?

One example of how you can prepare for an open conversation is Anna. Anna is a 35-year-old woman who found out about her HIV infection two years ago. Anna was afraid to talk about her diagnosis because her family reacted badly when she disclosed her HIV infection. This led to her becoming more and more withdrawn, devaluing herself because of the diagnosis and thinking badly of herself. She became unfocused at work and her boss approached her about it. She quickly decided to go to psychotherapy as she was becoming increasingly sad. Her therapist helped her to overcome her fears and build up her self-confidence. When she was feeling better, she met a new partner online. She was worried about how her new partner would react if she told him about HIV. In conversations with her good friend and the therapist, she practiced how she could tell him and what information was important for her partner. In particular, she practiced how to explain to her partner that the HIV virus is not transmissible under successful treatment - even when having sex without a condom.

Anna dared to talk to her partner about the infection. Anna's openness and clarity meant that her partner knew more about HIV, that he supported her and that their relationship was strengthened. Her partner now shares his knowledge about HIV with his friends. It is important to Anna to only tell people about her diagnosis if she already knows them well. This helps her to weed out those people who are not ready to accept her and her HIV infection.

It is important that people living with HIV take good care of themselves and, if necessary, protect themselves, especially when talking to others, and distance themselves and break off the conversation if they make unpleasant and hurtful statements. Talking to therapists, doctors and friends can help you to better deal with your own problems and learn how to talk about the diagnosis and when or how far you want to open up in relationships - romantic, friendly, familial or otherwise.