Working Effectively with People Living with, and affected by, HIV

Rahim Thawer (author) and Jordan Arseneault (collaborator)

This is a long read.

Suggested CitationThawer, R. (with J. Arseneault). (2025, March 16). Working effectively with people living with, and affected by, HIV. Medium. https://medium.com/@rahimthawer/working-effectively-with-people-living-with-and-affected-by-hiv-d485bd9f5a9e

Introduction

Imagine learning that your health status could not only change how others see you but also subject you to criminal prosecution. For many people living with HIV, this is a daily reality. As a mental health professional, understanding the context and depth of these experiences is essential to providing compassionate care and breaking down the stigma that hinders clients from seeking support.

This report is based on a 2022 presentation Rahim delivered to learners in the Queer and Trans-Affirming Professionals (QTAP) Certificate program, a network of psychotherapists, educators, and community activists dedicated to supporting LGBTQ+ and HIV-affected communities. The presentation drew on Rahim’s extensive experience in HIV outreach, counseling, and testing — work deeply embedded within interconnected circles of activists, healthcare providers, and advocates. Revisiting influential educational media and activist campaigns underscored the relational foundation of this work, leading him back to collaborator Jordan Arseneault, whose contributions have consistently shaped community-driven health initiatives in Quebec and across Canada.

Learning objectives

By the end of this reading, mental health professionals will be able to:

1. Understand and communicate HIV transmission facts to debunk persistent myths and misconceptions.
2. Collaboratively assess and discuss risk with clients using informed, empathetic approaches.
3. Analyze the links between systemic oppression and health disparities in HIV-affected communities.
4. Examine health equity issues in the availability, access, and quality of HIV treatment and prevention services.
5. Explore sexual health interventions and technologies, such as PrEP (Pre-Exposure Prophylaxis), PEP (Post-Exposure Prophylaxis), and U=U (Undetectable = Untransmittable), as they exist in 2024 across Canada and the USA.
6. Appreciate the psychological impacts of living with HIV, including trauma from stigma, criminalization of non-disclosure, and challenges related to intimacy and relationship-building.

Who is Affected by HIV?

HIV continues to be a significant public health challenge, disproportionately impacting certain populations while shaping policy and healthcare responses worldwide. In the U.S., over 1.2 million people are living with HIV, with 31,800 new infections reported annually[1]. However, disparities in healthcare access, stigma, and systemic inequality have deepened the epidemic’s impact, especially on marginalized communities.

Populations most affected by HIV include Black and Hispanic/Latino people, gay and bisexual men, transgender individuals, and people who inject drugs[2]. Systemic racism and socioeconomic inequalities have contributed to stark racial disparities in HIV diagnoses, disproportionately affecting Black and Hispanic/Latino communities. Although Black Americans make up just 12% of the U.S. population, they account for 39% of new HIV diagnoses[3]. Similarly, Hispanic/Latino individuals have seen a 24% increase in HIV diagnoses from 2010 to 2022, even as diagnoses overall declined[4]. Young people of color, particularly those within LGBTQ+ communities, also face heightened risk due to overlapping factors of poverty, discrimination, and limited access to health services[5].

HIV testing is a cornerstone of prevention efforts, yet inadequate access and awareness continue to hinder epidemic response efforts. Despite CDC recommendations that all individuals aged 13–64 undergo at least one HIV test, only 36% of nonelderly U.S. adults have ever been tested[6]. Lack of awareness and access to care contributes to new transmissions, as 13% of people with HIV are unaware of their status — a group responsible for nearly 40% of new infections[7].

Moreover, institutional homophobia and racism have historically hindered an effective public health response. The stigmatization of LGBTQ+ people has fueled mistrust in healthcare systems[8], and exclusionary policies have created generational health disparities that persist today[9]. These systemic issues require targeted action, including increased investment in culturally competent care, expanded prevention programs, and sustained advocacy to reduce the structural barriers that prevent equitable healthcare access.

In this paper, we will explore the historical and social contexts that shaped the HIV epidemic, the strategies for reducing transmission, the criminalization of HIV-related behaviors, and the psychosocial challenges of living with HIV. Through these sections, we aim to highlight both the ongoing obstacles and opportunities to achieve a world where no person is left behind in the fight against HIV/AIDS.

Pause and Reflect

1. How can you identify and address implicit biases that may affect your ability to provide care for clients from disproportionately impacted communities?
2. What steps can you take to build trust with clients who may mistrust healthcare due to historical and systemic discrimination?
3. How might you adapt your practice to increase HIV awareness and testing in communities with low testing rates?

History Lesson: Institutional Homophobia & AIDS

Institutional homophobia has been a driving force behind the public health failures that shaped the trajectory of the HIV/AIDS epidemic. This form of systemic discrimination refers to biases embedded within healthcare policies, government responses, and societal structures that marginalized LGBTQ+ people. For much of the 20th century, medical institutions pathologized LGBTQ+ identities — classifying homosexuality as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until the 1970s[10]. These classifications fueled negative public perceptions that depicted LGBTQ+ people as “deviant” and undeserving of care.

Joseph Nicolosi published this guide in 2002 and released another edition in 2017 before he died at the age of 70. Nicolosi was a founder and president of the National Association for Research and Therapy of Homosexuality (NARTH) — a decidedly harmful organization.

Legal and policy frameworks also contributed to institutional homophobia by criminalizing LGBTQ+ behavior. In many U.S. states, sodomy laws remained in place until the early 2000s, legitimizing discrimination and limiting access to medical and social services[11]. These laws created environments where LGBTQ+ people feared seeking healthcare for HIV prevention or treatment due to the risk of legal repercussions and public exposure. The combination of criminalization and stigma intensified health disparities, leaving LGBTQ+ populations more vulnerable to the spread of HIV.

When the first cases of AIDS emerged in the early 1980s, homophobic attitudes within both the government and healthcare systems delayed critical public health interventions. The disease, colloquially labeled “gay cancer,” was dismissed as a consequence of immorality rather than a medical crisis demanding urgent action. These stigmatizing narratives contributed to a systematic failure to mobilize resources, perpetuating high mortality rates within LGBTQ+ communities. Government inaction and healthcare neglect exacerbated the epidemic, further entrenching distrust among those most affected.

A Disease ‘Worse Than Alcohol’ was published in The Miami News Aug 13, 1954.

Continued — A Disease ‘Worse Than Alcohol’ was published in The Miami News Aug 13, 1954.

Neglect and Political Inaction

The early response to the AIDS epidemic was marked by political indifference and inadequate public health measures, with devastating consequences for LGBTQ+ communities. At the federal level, President Ronald Reagan’s administration exemplified this neglect. Despite mounting deaths and rising infection rates, Reagan did not publicly acknowledge the AIDS crisis until 1985 — four years after the epidemic had begun to claim thousands of lives. By this time, the epidemic had already spread rapidly, aided by a lack of public education, prevention campaigns, and funding for research and treatment.

Public officials, influenced by conservative fears of backlash, hesitated to allocate resources to what was perceived as a “gay disease.” Political leaders feared association with LGBTQ+ communities, whose identities were still heavily criminalized and stigmatized in many parts of the United States. This reluctance extended into healthcare institutions, where many providers refused to treat AIDS patients due to fears of contagion or moral judgments. Religious hospitals, in particular, often outright denied care to people living with HIV/AIDS.

The lack of urgency also influenced the structure of public health campaigns. Early initiatives were severely underfunded and often avoided explicitly addressing LGBTQ+ populations, undermining prevention efforts such as safer sex education and condom distribution. These omissions were not neutral but rooted in institutional homophobia that prioritized political expediency over saving lives.

[1] Altman, L. K. (1981, July 3). Rare Cancer Seen in 41 Homosexuals. The New York Times. https://www.nytimes.com/1981/07/03/us/rare-cancer-seen-in-41-homosexuals.html
[2] Byfield, Douglas. “Gay Cancer.” Toronto Life, December 1981.
[3] “Gay Men Scared.” Likely from The Sun or News of the World, UK tabloid press, circa 1980s.

Mistrust of Public Health Systems

The inadequate response to the HIV/AIDS crisis fueled deep mistrust between marginalized communities and public health institutions. LGBTQ+ people, particularly gay and bisexual men, observed how homophobia shaped both government inaction and healthcare neglect. President Reagan’s refusal to acknowledge the epidemic for years reinforced the perception that their lives were considered expendable. Meanwhile, hospitals and clinics often denied HIV-positive patients treatment, leaving many without access to basic care. Fear-driven policies delayed critical prevention measures such as condom distribution and safer sex education. These failures solidified a legacy of mistrust that persists to this day.

This erosion of trust is captured in Larry Kramer’s The Normal Heart. Dr. Emma Brookner, a physician tirelessly advocating for AIDS research, becomes enraged when a government panel rejects her funding request. She accuses them of allowing bureaucratic delays to exacerbate the epidemic:

“What am I arguing with you for? You do not know enough to study boiled water! How dare you come down here and judge me?”

Similarly, the TV series It’s A Sin, set in 1980s London, illustrates how fear and misinformation about HIV created barriers to public trust. In a scene at a club, Ritchie Tozer sarcastically refutes absurd conspiracy theories about AIDS, mocking claims that the disease was sent by God or created in a lab to kill gay men:

“Do you seriously think there’s an illness that only kills gay men? It can calculate that you’re gay and kill you but no one else?… How is a cancer gay? Is it pink? Where is it? Is it in the wrists?”

Both The Normal Heart and It’s A Sin expose the fatal consequences of public health failures rooted in homophobia and stigma. These cultural works emphasize how distrust in healthcare institutions was not irrational but a response to years of systemic neglect. This mistrust compelled activists to create grassroots care networks, ensuring that those affected by HIV had access to support when mainstream systems failed them.

Excerpt from The Normal Heart (by Larry Kramer — Premiered in 1985; Revival in 2011 and 2014):

Watch the video on YouTube

Dr. Emma Brookner: I am taking care of more victims of this disease than anyone in the world. We have more frozen blood samples, more data of every kind, and much more experience.

Examining Doctor: Dr. Brookner, the Government’s position is this: there are five million dollars in the pipeline, for which we have received over fifty-five million dollars worth of requests.

Dr. Emma Brookner: Five million doesn’t seem quite right for some two thousand cases. The Government spent three million investigating seven deaths from Tylenol. We’re entering the third year!

Examining Doctor : We’ve voted to reject your application for funding.

Dr. Emma Brookner : Oh. I’d like to hear your reasons.

Examining Doctor : The direction of the research you’re suggesting is imprecise and unfocused.

Dr. Emma Brookner : Oh, it is, is it? You don’t know what’s going on anymore than I do. Could you tell me, precisely, why you’re blocking my efforts?

Examining Doctor : Dr. Brookner, there are now other investigators. This is no longer only your disease, though you seem to think it is.

Dr. Emma Brookner : Oh, I do, do I? And you’re here to take it away from me, is that it? Well, I’ll let you in on a little secret, Doctor: you can have it. I didn’t want it in the first place. You think it’s a privilege to watch young men die? What am I arguing with you for? You do not know enough to study boiled water! HOW DARE YOU COME DOWN HERE AND JUDGE ME?

Examining Doctor : We’re only serving on this peer review panel at the behest of Dr. Murry.

Dr. Emma Brookner : Another idiot. And, by the way, a closeted homosexual doing everything in his power to sweep this under the rug. And I vowed I’d never say anything like that in public… How does it always happen that all of the idiots are always on your team? How can you refuse to fund my research? Or not invite me to participate in yours? Your National Institutes of Health received my first request for money two years ago. It took you one year just to print up application forms! It’s taking you three years from my first reported case just to show up here for a look. And the paltry amount of money you are forcing us to beg for, out of the FOUR BILLION DOLLARS you now receive each and every year to protect the health of the American people, won’t come to anyone before only God knows when. A promising virus has been discovered in France. Why do you refuse to cooperate with the French? Why are we told not to cooperate with the French? Just so you can steal a Nobel Prize? While something is being passed around that causes death! Women have been discovered to have it in Africa, where it is clearly transmitted HETERO-SEXUALLY. It is only a question of time! We could ALL be dead before you do anything! You want my data? You want my ideas? You want my patients? TAKE THEM! JUST DO SOMETHING WITH THEM! You’re fucking right! I am imprecise and unfocused and you are all idiots!

It’s a Sin (a British drama television miniseries written by Russell T Davies, set in London between 1981 and 1991)

Excerpt from It’s a Sin:

Ritchie Tozer : Oh, he said, she said, they said, they’re always saying something. But you want to know the truth? Do you know what it really is, AIDS? It’s a racket. It’s a moneymaking scheme for drugs companies. Do you seriously think there’s an illness that only kills gay men? It can calculate that you’re gay and kill you but no one else? Hmm. What about bisexuals? Do they only get sick every other day? And they say it’s a cancer, but you can’t catch cancer. Cancer is not a thing that can get caught. It’s not like a cold or a cough. It’s cancer. It doesn’t transmit. ’Cause imagine it. Gay cancer. How is a cancer gay? I mean, what does it look like? Is it pink? Where is it? Is it in the wrists? I mean, for God’s sake. You hear all these stories and all these rumors and all these nightmares because that’s what they want you to think, that lot. They want to scare us and stop us having sex and make us really boring basically because they can’t get laid. That’s the truth. ’Cause according to them, how does it work, this AIDS thing? Okay, they say it’s spread by poppers. They say it arrived from outer space on a comet. And they say that God created it to strike us dead. They say it was created in a laboratory to kill us. They say it’s the Russians. They say we got it from the jungle. They say it’s caused by friction!

[crowd howls]

Ritchie Tozer : They say it’s in the spunk. They say Freddie Laker spread it when he introduced cheap flights. They say there’s one patient zero spreading it wherever he goes. Whoo! They say it affects homosexuals, Haitians, and hemophiliacs, like there’s a disease which has targeted the letter H. Who’s it going to get next, people from Hartlepool and Hampshire and Hull? Don’t you see what all of these things have got in common?

[enters a club called Heaven]

Ritchie Tozer : They’re not true. And how do I know? How do I know it’s not true? Because I’m not stupid! Which means, I don’t believe it. I don’t believe it. I don’t believe a word of it! Now hit me with those laser beams!

Pause and Reflect

1. How can mental health professionals work to rebuild trust in public health systems for HIV-affected communities?
2. What role does cultural representation and inclusion play in mitigating distrust within healthcare environments?
3. How can cultural narratives, such as those portrayed in The Normal Heart or It’s A Sin, be used as tools to educate clients and the public about historical healthcare neglect?

Public and Medical Stigma

The pervasive stigma surrounding HIV/AIDS compounded the epidemic’s impact by creating barriers to care and fostering discrimination within healthcare institutions. Early media coverage sensationalized the crisis, focusing on misleading narratives like that of “Patient Zero.” This erroneous portrayal of Gaëtan Dugas as the source of the epidemic reinforced fears that HIV was a result of the “reckless” behavior of gay men. Such depictions dehumanized those affected, positioning them as threats rather than individuals in need of medical support.

Within healthcare settings, stigma manifested in the denial of treatment, breaches of confidentiality, and discriminatory practices. LGBTQ+ patients reported being turned away from hospitals and clinics, particularly those affiliated with religious organizations that viewed AIDS as a moral consequence. Surveys conducted during this period revealed that many medical professionals refused to provide care to people living with HIV due to fear of contagion or moral disapproval.

This stigmatization intensified fear and mistrust among marginalized groups[12], discouraging people from seeking testing and treatment. Community-based organizations sought to counter these attitudes by educating healthcare providers and the public about HIV transmission and prevention. Activist campaigns, such as Silence = Death, emphasized the deadly consequences of stigma and called for compassionate, evidence-based approaches to HIV care.

Pause and Reflect

1. What interventions can you use to reduce stigma for clients living with HIV in both healthcare and social contexts?
2. How does media portrayal of individuals living with HIV affect the stigma they face?
3. What strategies can you employ to promote non-stigmatizing communication about HIV within your practice?

The Myth of Patient Zero

The story of “Patient Zero” is one of the most damaging myths in the history of the HIV/AIDS epidemic. Popularized by journalist Randy Shilts in his book And the Band Played On, the term was mistakenly applied to Gaëtan Dugas, a French-Canadian flight attendant, who became a focal point in early studies of AIDS transmission in North America[13]. Initially identified as “Patient O” (for “Out-of-California”), Dugas was incorrectly recast as “Patient Zero” due to a typographical error, which led to the false narrative that he was the origin of the AIDS epidemic in the United States[14].

This error had severe consequences. Dugas was vilified in both the media and public discourse, with sensationalized stories portraying him as a reckless “superspreader” who knowingly infected others[15]. This narrative was not only factually incorrect but also emblematic of the broader stigmatization of LGBTQ+ individuals during the early AIDS crisis. In reality, Dugas was cooperative with epidemiologists, providing extensive contact-tracing information that helped map early networks of HIV transmission. The stigmata he faced exemplify how narratives surrounding disease outbreaks often reflect underlying biases rather than scientific evidence[16].

Historian Dr. Richard McKay highlights that the term “Patient Zero” oversimplifies complex public health issues and creates a toxic culture of blame and scapegoating. Instead of focusing on individuals, public health efforts should prioritize systemic factors and preventive behaviors that reduce disease transmission within communities. Contact tracing remains a vital epidemiological tool, but misusing terms like “Patient Zero” risks reinforcing harmful stereotypes and distracting from collaborative solutions[17].

The case of Dugas reminds us of the importance of using precise, non-stigmatizing language in public health narratives. Understanding the social context of disease can prevent the reification of “villains” in future epidemics, thereby fostering trust and cooperation between healthcare institutions and affected populations.

Community Resistance

Faced with systemic neglect and pervasive stigma, LGBTQ+ communities organized grassroots efforts to confront the crisis and advocate for their survival. Activist groups such as ACT UP (AIDS Coalition to Unleash Power) and the Gay Men’s Health Crisis played pivotal roles in challenging institutional homophobia. These organizations not only provided direct services — such as access to medical care, support networks, and prevention education — but also launched high-profile campaigns to force political leaders and healthcare institutions to act.

ACT UP became known for its dramatic and strategic protests, including die-ins and demonstrations targeting government agencies like the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). These actions exposed the federal government’s failure to fund life-saving research and hastened the approval process for experimental drugs. The slogan “Silence = Death,” popularized through these campaigns, captured the urgency of breaking societal silence around the epidemic.

Community-based advocacy also focused on reshaping public health narratives. Activists pushed for widespread education on prevention strategies, debunking myths about HIV transmission, and promoting safe sex practices. By reclaiming public spaces and fostering solidarity within LGBTQ+ networks, these efforts provided hope and resources to people living with HIV. The establishment of alternative care networks demonstrated the resilience of affected communities in the face of institutional inaction.

Through sustained resistance, these grassroots movements achieved critical victories, including increased funding for HIV research and the development of more equitable healthcare policies. Their legacy underscores the importance of community-driven action in combating both public health crises and systemic discrimination.

Pause and Reflect

1. How can the activism and advocacy strategies of groups like ACT UP inform modern approaches to supporting clients living with HIV?
2. How might peer-led support networks and community resources be integrated into mental health care to enhance client well-being?
3. What role do mental health professionals have in supporting advocacy efforts that address healthcare inequities

Risk Reduction & Living Pozitively

HIV Transmission

HIV transmission occurs when specific body fluids — such as blood, semen, vaginal and rectal fluids, or breast milk — enter another person’s bloodstream. Unprotected anal or vaginal sex and sharing needles are the most common routes of transmission[18]. Yet transmission is not guaranteed in all circumstances. Advances in HIV research have shown that viral load — the amount of virus present in the blood — is a critical factor. Individuals who achieve and maintain an undetectable viral load through antiretroviral therapy (ART) cannot transmit HIV to sexual partners, a principle known as U=U (Undetectable = Untransmittable)[19].

Other biological factors, such as mucosal tears or the presence of other sexually transmitted infections (STIs), can increase the risk of transmission[20]. However, social and structural factors also play a crucial role. Stigma, lack of access to healthcare, and misinformation often prevent people from seeking prevention or treatment services, exacerbating transmission risks in marginalized communities[21].

While scientific understanding of transmission dynamics has evolved, many people remain unaware of key prevention advancements like U=U and PrEP (pre-exposure prophylaxis). Expanding public awareness about these biomedical strategies — alongside traditional methods like condom use — can help empower individuals to take control of their sexual health and prevent new transmissions. The fight against HIV transmission thus requires not only medical interventions but also efforts to dismantle stigma and promote health equity for those most at risk.

Pause and Reflect

1. How can mental health practitioners support clients in managing anxiety or fears related to HIV transmission despite biomedical advancements like U=U?
2. What role can mental health professionals play in educating clients about prevention strategies like PrEP and PEP?
3. How might you address the emotional and relational factors influencing clients’ risk-related behaviors?

HIV Testing

HIV testing is a cornerstone of prevention, early treatment, and epidemic control. Knowing one’s HIV status empowers individuals to make informed decisions about their health and enables early access to life-saving antiretroviral therapy (ART). The CDC recommends that all individuals aged 13 to 64 be tested for HIV at least once as part of routine medical care[22]. However, despite this guidance, only 36% of nonelderly adults in the United States report ever having been tested for HIV[23].

Testing can also reduce new transmissions. Around 13% of people living with HIV in the U.S. are unaware of their infection, yet they account for nearly 40% of new transmissions[24]. Early detection is essential because individuals with undiagnosed HIV are less likely to take preventive measures to reduce the spread of the virus.

Testing methods include rapid tests, which provide results within 20 minutes, and laboratory-based tests that detect HIV earlier through advanced diagnostic techniques[25]. Self-testing kits are also available for those who prefer privacy and confidentiality. However, barriers such as stigma, fear, and distrust of medical institutions continue to deter many people from seeking testing, especially in marginalized communities.

Public health initiatives have increasingly sought to integrate HIV testing into routine healthcare to normalize it and combat stigma. Efforts to expand access through community organizations, mobile clinics, and at-home testing are also crucial. By reducing structural barriers and promoting culturally sensitive outreach, these programs aim to increase testing rates and ensure that more people are aware of their HIV status.

How To Get Tested

Getting tested for HIV is simpler and more accessible than ever before, with multiple options designed to meet diverse needs and circumstances. Testing is available through healthcare providers, community health organizations, sexual health clinics, and increasingly through self-testing kits[26]. Rapid HIV tests can provide results in as little as 20 minutes, while laboratory-based tests may take longer but are capable of detecting HIV at an earlier stage of infection[27].

For those facing privacy concerns or stigma, community organizations often offer confidential or anonymous testing. Self-testing kits allow individuals to test themselves in private and can be ordered online or obtained from pharmacies. These kits typically involve a cheek swab or a finger prick and provide results within minutes. However, a follow-up test from a healthcare provider is recommended to confirm a positive result[28].

Expanding access to HIV testing, particularly in underserved communities, is critical to reducing transmission rates. Initiatives such as mobile testing units, pop-up clinics at community events, and partnerships with local organizations aim to bring testing services closer to people who may not otherwise seek care. Integrating HIV testing into routine healthcare services can also help normalize the process and alleviate fears associated with it.

Ultimately, increasing awareness about testing options and reducing barriers to access are key strategies in ensuring that more people know their HIV status. Early detection remains one of the most effective tools for both personal health management and the prevention of new infections.

The following video is an engaging, educational, and slightly playful dramatization of the HIV testing process, aimed at demystifying what happens during an HIV test produced by the Alliance for South Asian AIDS Prevention (ASAAP).

Watch the video on YouTube
How to Get Tested by ASAAP — Jun 27, 2014
 https://www.youtube.com/watch?v=Cq83QgfResI

Video Description

The video opens in a clinical waiting room, where a friendly staff member greets a visitor coming in for an HIV test. They explain the simple process of filling out a form requiring only a name and date of birth. The setting emphasizes anonymity and confidentiality, designed to make viewers feel at ease.

A person named Mark is called in for his test. The counselor introduces themselves (jokingly as “Amitab,” after their favorite actor) and engages in a casual, non-judgmental conversation to gather sexual health history. The discussion includes:

• When the last potential HIV exposure occurred.
• Sexual partners and practices.
• Basic HIV transmission education.
• Information about PEP (Post-Exposure Prophylaxis) if someone has a recent high-risk exposure.

The counselor explains how the rapid test works, what the results mean (one dot for negative, two dots for reactive), and reassures the client that support and next steps will be available no matter the result.

The tone of the video shifts to a lighter, almost cheeky commentary, directly addressing the audience. The narrator compares getting an HIV test to something as nerve-wracking as trying a new hair salon but stresses the importance of knowing one’s status.

‘Risky’ Behaviour

Condomless sex isn’t inherently risky. When a heterosexual couple says they’re “trying to have a child,” they are usually applauded. So, if gay men say they’re “trying to feel connection,” why do we get so concerned? This question challenges public health narratives that have long moralized gay men’s sexual practices. Research shows that gay men often navigate risk through non-condom-based strategies such as serosorting (choosing partners with the same HIV status), strategic positioning (taking the insertive role), and relying on undetectable viral load to reduce HIV transmission risk[29].

By JJ Levine. More here: https://postervirus.tumblr.com/post/68235202296/barebacking-everybody-does-it-jj-levine-the-term

However, risk is deeply contextual. While many men maintain a general commitment to “safe sex,” situational factors influence their decisions. For example, trust and intimacy play significant roles in how men assess risk. One man explained, “I trust the partners I’m with, possibly naively. So, there is little sex that I have that I consider unsafe”[30]. In relationships, especially those that are serodiscordant (where one partner is HIV-positive and the other is negative), couples may rely on viral suppression to maintain both intimacy and safety[31].

Despite these strategies, many still experience anxiety and regret after taking perceived risks. Others, however, express fears so strong that they avoid most sexual contact altogether. One respondent noted, “Just getting blown is as safe as I feel I can be, short of getting blown in a condom,” highlighting how the legacy of fear-based messaging continues to limit sexual freedom for some men[32].

Risk reduction strategies must therefore meet people where they are — offering both clear information and support for the emotional and relational factors that shape decision-making. Public health efforts should emphasize that while risk is real, it can be managed through multiple approaches, including PrEP, viral suppression, and open communication between partners. Empowering individuals with choices that reflect both their desire for safety and connection is key to reducing stigma and improving sexual health outcomes.

Pause and Reflect

1. How might judgments about ‘risky behavior’ differ between communities disproportionately affected by HIV and all other groups?
2. Consider how social workers and healthcare providers can address biases to ensure equitable treatment for all communities.

Risk Reduction Strategies

Risk reduction strategies for HIV prevention encompass both behavioral and biomedical approaches. Traditional prevention methods, such as consistent condom use and regular STI screenings, remain crucial. However, many individuals now use additional strategies tailored to their specific needs and circumstances. These strategies include harm reduction programs, such as syringe exchange services for people who inject drugs, and sexual risk management tactics, including serosorting and strategic positioning[33].

Biomedical advancements have significantly expanded risk reduction options. Pre-exposure prophylaxis (PrEP), a daily medication, reduces the risk of HIV acquisition by over 90% when taken consistently[34]. Post-exposure prophylaxis (PEP) involves taking antiretroviral drugs within 72 hours of potential exposure and is highly effective when administered promptly[35]. Additionally, people living with HIV who adhere to antiretroviral therapy can maintain an undetectable viral load, meaning they cannot sexually transmit the virus — a principle known as U=U (Undetectable = Untransmittable)[36].

Mixed-status couples, where one person is HIV positive and the other is negative, referred to in research as ‘serodiscordant’ or ‘sero-different’ couples, tend to determine communication about HIV status and prevention important enough to spoil date night. Mixed-status couples often have very clear discussions about the prevention methods they will use, such as condoms, to protect the negative partner from contracting the virus. Being open about HIV status can lead to safer sexual practices because both partners are aware of the risks involved and can take steps to minimize them.

Effective risk reduction also requires comprehensive communication. Research shows that strategies like serosorting and relying on viral suppression are most effective when partners openly discuss their sexual health status and prevention preferences. However, access to accurate information and support is not equitable across all communities. People of color, transgender individuals, and those living in poverty often face greater barriers to prevention services due to systemic inequities and healthcare discrimination[37].

To maximize the impact of these strategies, public health programs must provide culturally relevant education and expand access to prevention resources. Promoting a range of prevention options — rather than relying solely on condom-based approaches — empowers individuals to make informed choices that align with their circumstances and desires.

PEP, PrEP, & U=U

Biomedical advancements have transformed the landscape of HIV prevention, with PEP (Post-Exposure Prophylaxis), PrEP (Pre-Exposure Prophylaxis), and U=U (Undetectable = Untransmittable) emerging as key tools.

• PEP involves taking antiretroviral medication within 72 hours of potential HIV exposure. The regimen lasts 28 days and is highly effective at preventing transmission if initiated promptly[38].
• PrEP is a daily medication that offers over 90% protection against HIV for individuals at high risk of exposure, such as those with HIV-positive partners or those who engage in condomless sex[39]. PrEP requires ongoing medical monitoring and adherence to maintain its effectiveness.
• U=U represents a breakthrough in both science and stigma reduction. Research has confirmed that people living with HIV who maintain an undetectable viral load through antiretroviral therapy cannot transmit the virus to sexual partners[40]. This discovery not only offers peace of mind but also combats fear-based narratives about HIV-positive individuals.

These interventions have become cornerstones of modern HIV prevention strategies but require greater public awareness to reach their full potential. Misinformation and lack of access remain significant barriers, particularly in marginalized communities. Many people are unaware that PrEP is available or that U=U has been scientifically validated, contributing to continued stigma and fear surrounding HIV[41].

Effective prevention efforts must therefore prioritize education and access. Expanding community outreach, improving healthcare provider training, and addressing systemic barriers to care are critical to ensuring that more people benefit from these life-changing advancements. By promoting these strategies alongside other risk reduction measures, public health initiatives can further reduce transmission rates and improve health equity.

Pause and Reflect

1. What systemic barriers exist that prevent access to PrEP for marginalized communities?
2. How might community outreach help improve awareness and reduce stigma around PrEP usage?

Risk Reduction for PLWH

Source: https://www.pwatoronto.org/english/pdfs/poz-prevention-service-provider-manual.pdf

For people living with HIV (PLWH), risk reduction strategies center on maintaining both physical and emotional well-being to enhance health outcomes. Achieving and sustaining an undetectable viral load through consistent antiretroviral therapy (ART) is a critical prevention strategy that not only protects one’s health but also prevents sexual transmission (U=U)[42]. However, effective risk reduction for PLWH requires more than just adherence to ART — it also involves addressing mental health, communication, and relationship dynamics.

Partying and drug use can pose significant challenges for PLWH, especially when it involves sexualized drug use, often referred to as chemsex or party and play. It’s crucial for those living with HIV to maintain their treatment regimen even if they choose to engage in such activities. This means planning ahead to ensure they take their medication consistently, stay hydrated, eat properly, and get enough rest. Achieving and maintaining an undetectable viral load is a goal for many, as it is not only better for their health but also reduces the risk of transmitting the virus to others.

Legal issues surrounding HIV are complex and can lead to additional stress for PLWH. In many places, including Canada, there are laws that criminalize non-disclosure of HIV status before engaging in activities that could put another person at risk of infection. These laws can create anxiety and fear of rejection, which can be especially challenging for those who are trying to navigate relationships and disclosure. Discussing these concerns is an important part of the therapeutic process for PLWH.

Research emphasizes the importance of emotional well-being interventions. These programs help individuals cope with diagnosis-related anxiety, build self-efficacy for treatment adherence, and clarify personal goals[43]. Participants in a recent intervention reported that emotional support helped them manage stigma and develop strategies for maintaining ART adherence, such as reducing alcohol consumption and improving sleep routines[44]. These behavioral adjustments contribute to better long-term health by improving immune function and mental stability.

Open communication between sexual partners is also essential. For PLWH, concerns around stigma and disclosure can complicate intimate relationships. Emotional well-being counseling has been shown to empower individuals to discuss their HIV status on their own terms, leading to stronger, more trusting relationships[45]. Additionally, managing other risk factors — such as quitting smoking, reducing drug use, and maintaining a healthy diet — can mitigate comorbidities like cardiovascular disease and certain cancers, which are more common among PLWH[46].

Ultimately, comprehensive risk reduction involves a combination of medical care, behavioral support, and community-based resources. Programs that integrate physical health care with mental health services, peer support, and educational tools create a holistic approach that improves overall quality of life for PLWH.

Capacities for Communication

The ability to communicate about HIV within gay men’s communities varies greatly. Back in 2007 in Toronto, there was a campaign that highlighted the assumptions people make about condom use and HIV status. For example, some might think, “If we don’t talk about condoms, and he doesn’t ask, maybe we’re both positive.” Others might believe, “If I’m negative and we don’t talk about condoms, it’s the other person’s responsibility to tell me if they’re positive.” This “Assumptions Campaign” showed that these beliefs are often not about a lack of communication skills but are more about fear of rejection, shame, stigma, and making assumptions that aren’t always true. People might feel comfortable with a partner and believe that translates into a lower risk of HIV, but that’s not a scientific way to assess risk. You can’t tell someone’s HIV status just by looking at them, and the idea that you can is based on outdated beliefs about the illness. Today, there are still misunderstandings and a need for guidance to help people have open and honest conversations about HIV, especially where it is prevalent.

The Assumptions Campaign (2004/2005)

More here: https://www.cbrc.net/prevention_revived_evaluating_the_assumptions_campaign

Campaigns have also worked to challenge the stigma around being HIV positive. In Toronto, a controversial campaign conveyed the message, “I party, I bareback, I’m positive, I’m responsible,” which aimed to redefine the perception of people living with HIV. It advocated for the understanding that many who are HIV positive are not reckless or uninformed but are actively having important conversations, disclosing their status appropriately, and adhering to the norms of their communities. The campaign emphasized that people living with HIV can be responsible about their health and sexual practices, and it’s crucial to avoid thinking of them as merely vectors of disease.

Read More:
https://menshealthproject.wixsite.com/mikiki/i-party-i-bb-i-m-ive-i-m-responsibl

Creating a routine around taking HIV medication can help people feel that it’s just a part of their daily life, similar to taking a vitamin. However, starting medication can be difficult for some, as it might make their HIV status feel more real, and daily medication can be a reminder of something they might blame themselves for. Understanding these feelings is essential for healthcare providers and support networks, as the meaning of medication and the experience of living with HIV can vary greatly from one person to another.

Open and honest communication about HIV remains one of the most effective strategies for reducing transmission, yet it is often hindered by stigma and fear of rejection. Many people living with HIV, particularly gay and bisexual men, experience profound social pressure to conceal their status due to fears of being judged, ostracized, or even physically endangered[47]. These fears are exacerbated by both enacted and internalized stigma within healthcare settings and social spaces[48].

Stigma and Criminalization

Healthcare interactions frequently reinforce communication barriers. Jaspal’s research in Finland found that subtle cues such as medical professionals’ avoidance of direct eye contact or their dismissive attitude toward concerns about sexual health created environments where patients felt devalued and unwelcome. Such treatment discourages open conversations about preventive behaviors and treatment adherence[49]. López et al. (2022) reported that for Latino gay and bisexual men, this type of stigmatization intersects with ethnic discrimination, leading many to withdraw from discussions about HIV prevention and care altogether[50].

Additionally, stigma manifests within social networks. Studies by Grimm and Schwartz show that gay men on PrEP (pre-exposure prophylaxis) are sometimes labeled promiscuous or careless by their peers. These negative perceptions create a chilling effect, discouraging open conversations about sexual health and risk reduction strategies[51]. In sexual contexts where verbal negotiation is limited — such as bathhouses — Elwood et al. found that communication norms favor non-verbal cues over explicit conversations about risk, further complicating efforts to promote condom use and safer practices[52].

Despite these barriers, peer-based and culturally tailored interventions have proven effective in improving communication capacities. Emotional well-being programs that empower participants to take control of their narratives can reduce both internalized stigma and communication anxiety[53]. Similarly, healthcare providers trained to engage empathetically and without judgment foster environments where patients feel safe discussing their sexual health and HIV status[54].

Public health strategies should therefore prioritize not only education about prevention options like PrEP, PEP, and U=U but also initiatives that challenge harmful communication norms. Creating safe spaces for conversations — whether through peer support groups, community outreach, or healthcare interactions — can dismantle stigma and promote more effective dialogue about risk reduction.

Rejection and the Realities of Stigma

HIV-related stigma significantly impacts the social and legal lives of people living with HIV (PLWH). Criminalization of HIV non-disclosure reinforces negative stereotypes, portraying PLWH as deceptive, dangerous, and deserving of punishment. This stigma intersects with long-standing cultural narratives that associate sexual risk with deviance, particularly among gay men and other marginalized groups[55]. In many cases, legal policies have perpetuated this stigmatization by failing to reflect current scientific understanding of HIV transmission risks[56].

Historically, laws policing sexuality, such as those targeting sodomy and “gross indecency,” framed queer individuals as a criminal underclass whose behaviors required legal control. De Orio’s research on Texas illustrates how laws criminalizing same-sex intimacy were designed to stigmatize gay men, establishing a legacy of distrust between LGBTQ+ communities and legal institutions[57]. Kirkup argues that this legacy persists today through laws that criminalize HIV non-disclosure, borrowing from these earlier frameworks to maintain tropes of sexual pathology and promiscuity[58].

This stigmatization deters PLWH from disclosing their status. Mykhalovskiy found that HIV criminalization laws contribute to fear and mistrust in healthcare, with many patients avoiding conversations about their status to protect themselves from potential legal consequences[59]. In Louisiana, Barney’s analysis shows that HIV exposure laws were designed around misinformation, such as unfounded fears that HIV could be transmitted through spitting or biting. These laws continue to disproportionately harm LGBTQ+ and racial minority communities[60].

To counter these effects, public health efforts focus on dismantling criminalization frameworks that stigmatize PLWH. Campaigns advocating for greater awareness of U=U (Undetectable = Untransmittable) and scientific advances in prevention aim to replace fear-based narratives with facts. By promoting supportive environments and challenging punitive laws, these initiatives seek to reduce both social and legal exclusion of PLWH[61].

More here: Adam, B. D., Murray, J., Ross, S., Oliver, J., Lincoln, S. G., & Rynard, V. (2011). hivstigma.com, an innovative web-supported stigma reduction intervention for gay and bisexual men. Health education research, 26(5), 795–807. https://doi.org/10.1093/her/cyq078

This poster is from a 2008–2010 campaign by the Gay Men’s Sexual Health Alliance in Ontario questioned the onus placed on HIV-positive people, suggesting that even with disclosure, they might face rejection, contributing to a cycle of silence and stigma.

This conversation is not just theoretical but has real-life consequences. People living with HIV have experienced violence upon disclosing their status in intimate settings. Others have been charged by law enforcement following disclosures, further entrenching the fear and stigma associated with the disease. These legal and social dynamics create a climate where HIV-positive individuals must constantly navigate the risk of stigmatization and criminalization, often leading to psychological distress and a sense of isolation.

Creating a supportive environment is crucial in helping people living with HIV navigate these challenges. It’s about empowering them to have open conversations about their status and making sure these conversations are not had on their behalf without consent. Campaigns and movements like “Silence = Death” and “Think Twice” have sought to combat the criminalization and stigma surrounding HIV, advocating for a more compassionate and sensible approach to public health that respects the dignity and rights of those affected.

Source: https://postervirus.tumblr.com/post/35974194219/silence-sex-the-new-equation-by-jordan

These issues highlight the importance of empathy and understanding in how we, as a society, respond to those living with HIV. It’s a call for greater sensitivity and awareness, for legal reforms that protect rather than punish, and for an unwavering commitment to the human rights of all individuals, regardless of their health status. Despite the strides made in HIV treatment and prevention, the specter of stigma continues to loom large, affecting not only personal relationships but also access to healthcare and legal injustices. The criminalization of HIV non-disclosure serves as a poignant example of how fear and misinformation can lead to policies that further marginalize those living with HIV. Through a therapist’s lens, Thawer explores the psychological toll of navigating a world where seroconversion can lead to both internal and external battles with stigma, rejection, and the constant negotiation of one’s identity in health settings.

Pause and Reflect

1. How do current HIV criminalization laws affect your clients’ willingness to disclose their status or seek mental health services?
2. How can mental health practitioners advocate for reforms to laws that criminalize HIV non-disclosure?
3. What support systems can be put in place to protect clients from the psychological impacts of criminalization and rejection?

From Criminalizing Gay Sex to HIV Non-Disclosure

The criminalization of HIV non-disclosure is rooted in historical efforts to police and pathologize LGBTQ+ sexuality. Throughout much of the 20th century, laws such as those targeting sodomy and “gross indecency” framed same-sex intimacy as criminally deviant behavior. These laws sought not only to punish consensual sexual acts but to establish a broader social narrative in which queer people were cast as threats to public morality[62]. Even after legal reforms ostensibly decriminalized certain sexual behaviors, LGBTQ+ communities continued to face targeted policing and surveillance in public spaces, such as bathhouses and parks[63].

The shift from criminalizing same-sex intimacy to criminalizing HIV non-disclosure represents a continuation of these punitive frameworks. Kirkup explains that contemporary HIV non-disclosure laws are often justified by outdated fears of sexual danger, borrowing from earlier legal tropes of queer deviance[64]. These laws frequently ignore advances in medical science, such as the near-zero transmission risk for individuals with an undetectable viral load or those who use protective measures like PrEP[65]. Instead, they frame PLWH as inherently deceptive, particularly in sexual contexts, reinforcing distrust between LGBTQ+ communities and legal institutions.

Research by Barney highlights how HIV-specific laws, such as Louisiana’s “intentional exposure” statute, were drafted without scientific basis. These laws criminalized behaviors like spitting and biting despite negligible transmission risks, further entrenching harmful stereotypes about PLWH as vectors of disease[66]. Legal scholars, including Mykhalovskiy, have criticized these laws for perpetuating stigma and undermining public health goals by deterring individuals from HIV testing and disclosure[67].

In Alexander McClelland’s work on the criminalization of HIV in Canada, the background section illuminates Canada as a country with a notable record of criminal prosecutions for alleged HIV non-disclosure. It points to a public health approach that conflicts with human rights perspectives, impacting marginalized populations disproportionately. The research underscores the compounded effect of criminalization on individuals’ lives, highlighting stories that convey the profound personal, social, and legal ramifications of HIV criminalization. McClelland stresses the need for a shift in the legal framework, advocating for an approach that balances public health interests with the rights and dignities of those living with HIV. His call is for a moratorium on new charges and a review of past convictions, aiming to ensure that HIV transmission is not equated with criminal intent without considering the complexities of transmission and the lived realities of those involved.

Activists and legal reformers continue to advocate for the decriminalization of HIV non-disclosure, emphasizing that punitive laws exacerbate stigma and fail to prevent transmission. Efforts to repeal or amend these laws have gained momentum, particularly in jurisdictions that now recognize the importance of basing policy on scientific evidence rather than fear-driven narratives. Reframing legal approaches to HIV around public health and human rights is essential to dismantling the lingering legacy of criminalization faced by LGBTQ+ communities.

Before Calling the Police, THINK TWICE

Criminalization laws often perpetuate stigma, creating fear and distrust that discourage people from seeking testing or disclosing their status. In Canada and other jurisdictions, HIV non-disclosure is prosecuted as a serious crime, often classified under charges of aggravated sexual assault. This can result in life imprisonment and mandatory sex offender registration, even when no transmission occurs and protective measures, such as condom use, are employed. The criminalization of non-disclosure disproportionately affects marginalized groups, including gay men, trans men, and other men who have sex with men, contributing to heightened stigma and legal consequences.

In response, advocacy organizations have developed educational campaigns to promote alternative approaches to handling HIV non-disclosure cases. AIDS ACTION NOW! (AAN) launched the Think Twice[68] social media campaign, which targets potential complainants — particularly gay, bi, queer, and trans men — and urges them to reconsider pressing charges in non-transmission cases. The campaign highlights the complexity and consequences of Canada’s expansive legal framework, which criminalizes HIV status disclosure without adequately accounting for modern prevention methods like viral suppression and U=U (Undetectable = Untransmittable).

Watch the video on YouTube
More on the campaign (2012/2013): Calling all Gay, Bi, and Trans Men who have SEX with other Men |. (2016). https://www.aidsactionnow.org/p_1149/

A key component of the campaign is a series of 42 short videos created by community members in Toronto. These videos share diverse perspectives on how criminalization fosters fear and alienation within LGBTQ+ communities and call for more compassionate approaches to conflict resolution. Rather than relying on punitive measures, Think Twice emphasizes the importance of dialogue, education, and shared responsibility in navigating situations where disclosure may not occur.

Public health advocates argue that criminal prosecutions discourage people from seeking HIV testing and treatment, thereby undermining prevention efforts. Addressing HIV stigma and decriminalizing non-disclosure are critical steps toward fostering trust between healthcare providers, legal systems, and affected communities.

Emotional Realities of Seroconversion

Seroconversion — the experience of learning one is HIV-positive — often initiates a complex emotional response marked by shock, fear, and deep anxiety. These feelings are compounded by pervasive HIV stigma and social narratives that position people living with HIV (PLWH) as socially deviant or sexually irresponsible. Many newly diagnosed individuals report facing intense isolation, mental health struggles, and fear of rejection from both sexual and non-sexual social networks[69].

Owusu’s study on newly diagnosed individuals reveals that the psychological toll of seroconversion is frequently underestimated, as many are burdened by thoughts of their mortality and the anticipated loss of future opportunities, particularly in intimate relationships[70]. Philpot et al. emphasize that this impact is heightened among migrants, who may already be navigating systemic barriers to care and support. Migrant gay and bisexual men often contend with compounded forms of exclusion, including xenophobia, sexual stigma, and limited access to culturally competent services[71].

Social support plays a critical role in mitigating these emotional challenges. Lindayani et al. found that for MSM in Indonesia, emotional resilience is closely tied to the availability of peer support and community acceptance. Those who lack these networks frequently experience self-stigma and a decline in self-esteem, hindering their engagement with HIV care and adherence to antiretroviral therapy[72]. Similarly, dating and hookup apps often serve as both sources of connection and sites of further stigma. Zhang et al. report that MSM who disclose their status on these platforms may encounter rejection or discrimination, reinforcing fears of ostracization[73].

Despite these challenges, interventions designed to affirm identity and build emotional resilience have shown promise. Programs that emphasize community solidarity, mental health support, and education about U=U (Undetectable = Untransmittable) can significantly alleviate fears and promote more positive self-concepts for PLWH. Chan and Lok’s research highlights that dating platforms could reduce stigma by integrating safer spaces for conversations about HIV status, thus fostering trust and meaningful connections[74].

Public health strategies must therefore address both the psychological and social realities of seroconversion. By centering emotional well-being and dismantling structural stigma, these efforts can enhance quality of life and promote sustained engagement with healthcare for newly diagnosed individuals.

Racism and Health Disparities

Structural racism is a driving force behind the health disparities observed in HIV infection rates among racial and ethnic minorities in the United States. Black and Hispanic/Latino communities experience disproportionately high rates of new HIV diagnoses, as well as lower access to prevention, testing, and treatment services. Black Americans, who constitute 12% of the U.S. population, account for 39% of new HIV diagnoses[75]. Similarly, the rate of infection among Hispanic/Latino individuals has seen a 24% increase in recent years, despite overall declines in other demographic groups[76].

These disparities are rooted in historical and systemic inequities that have shaped access to healthcare, housing, education, and economic opportunity. Generations of discriminatory policies, such as redlining and unequal access to public services, have contributed to poor health outcomes in communities of color. The KFF timeline on racial health disparities highlights how inadequate investment in healthcare infrastructure in predominantly Black and Latino neighborhoods created enduring barriers to care[77].

Furthermore, stigma and discrimination within healthcare settings often discourage individuals from seeking HIV-related services. Research has shown that Black and Latino gay and bisexual men frequently encounter racist stereotypes and sexual stigma when engaging with healthcare providers, contributing to delays in both testing and treatment[78]. Nguyen and Han describe how gay men of color, including Vietnamese Americans, experience compounded marginalization through both racial exclusion and sexual objectification in LGBTQ+ spaces, further limiting their access to peer support and affirming care environments[79].

Transgender individuals of color face particularly severe health disparities, with trans women of color experiencing both heightened HIV risk and inadequate healthcare access. According to a recent KFF issue brief, structural racism intersects with transphobia to exacerbate these vulnerabilities, contributing to elevated rates of poverty, housing insecurity, and medical mistreatment[80].

Efforts to address these disparities must focus on dismantling the structural barriers that perpetuate inequality. Expanding culturally competent care, improving representation within the healthcare workforce, and investing in community-based prevention and treatment programs are critical steps toward health equity. Additionally, public health campaigns tailored to the lived experiences of marginalized populations can help rebuild trust in healthcare institutions and promote engagement with HIV services[81].

Pause and Reflect

1. How can intersectionality guide your approach to providing care for clients who experience overlapping stigmas related to race, gender, and HIV status?
2. What strategies can you implement to counteract healthcare discrimination faced by Black, Hispanic/Latino, and transgender clients?
3. How can culturally competent care improve health outcomes and reduce disparities in HIV prevention and treatment?

Dating & Relationships

Navigating dating and relationships as a person living with HIV (PLWH) involves confronting both external stigma and internalized fears of rejection. Disclosure of HIV status remains one of the most significant challenges, with many fearing negative reactions from potential partners. Studies by Chadwick et al. reveal that some men who have sex with men (MSM) opt for non-verbal status disclosure on dating apps, assuming that listing their status on their profiles is enough to inform partners. However, misunderstandings about this form of “passive” disclosure often lead to uncomfortable or hostile encounters[82].

For gay men of color, these challenges are compounded by experiences of sexual racism, where racialized stereotypes influence how they are perceived and treated by potential partners. Nguyen and Han document how gay Vietnamese American men report being fetishized or excluded in both in-person and app-based interactions. This racial discrimination further diminishes their self-worth and willingness to disclose sensitive information like HIV status[83].

Watch the video on YouTube
What Dating Is Like When You’re HIV-Positive (Dec 2016)

Dating app environments exacerbate these dynamics. Zhang et al. found that MSM using safer sex functions on apps — such as filters for HIV status or PrEP use — experience heightened stigma and microaggressions, often from those who question their sexual health practices. These interactions can discourage users from relying on digital platforms to build meaningful connections[84]. Chan and Lok describe this phenomenon as “hyperpersonal failure,” where technology designed to facilitate intimacy instead creates barriers for sexual minorities by reinforcing exclusionary norms[85].

Despite these obstacles, supportive networks and affirming partners play crucial roles in fostering resilience. Programs that promote peer-led education and empowerment, such as mentorship initiatives for newly diagnosed individuals, have been shown to improve relationship confidence and reduce the emotional burden of disclosure[86]. Encouraging open conversations about U=U (Undetectable = Untransmittable) can also help challenge misconceptions about HIV transmission, creating opportunities for more trusting and affirming partnerships.

Addressing these barriers requires both systemic and community-driven efforts. Public health interventions that focus on destigmatizing HIV and combating racial and sexual discrimination are essential to promoting healthier, more equitable dating environments. Additionally, partnerships between dating platforms and health organizations can foster safer digital spaces that encourage empathy, respect, and accurate health information[87].

Pause and Reflect

1. How can you help clients navigate the challenges of disclosing their HIV status in dating and relationship contexts?
2. What interventions can support clients in developing resilience against stigma and rejection?
3. How might mental health professionals collaborate with dating platforms or community organizations to promote positive narratives around HIV?

Intergenerational Experiences of Loving with HIV

Living with HIV presents unique relationship and emotional experiences across generations, shaped by evolving medical advances, cultural stigma, and historical trauma. Older generations, especially those diagnosed during the height of the AIDS epidemic, often grapple with unresolved grief and post-traumatic stress from witnessing mass mortality and intense societal rejection. Younger individuals, although less likely to view HIV as a life-threatening condition, continue to face stigma within dating contexts, compounded by a lack of understanding about advances like U=U (Undetectable = Untransmittable) and the preventive antiretroviral treatment PrEP (Pre-Exposure Prophylaxis).

According to Nevedal et al., older African Americans living with HIV rely on resilience narratives, often framing their survival as a triumph over systemic discrimination and health inequities. These narratives highlight a sense of duty to educate younger generations, urging them to avoid high-risk behaviors and seek peer support to navigate their diagnosis. Younger PLWH, by contrast, often express fear of disclosure, noting that stigma from both potential partners and the broader LGBTQ+ community can lead to isolation and anxiety about intimate relationships[88].

In the narrative from Pose, Pray Tell embodies the emotional and physical toll of the AIDS crisis during its peak. His reflections capture the essence of a generation grappling with an unprecedented epidemic, underscored by fear, stigma, and a dire lack of resources. Pray Tell’s interactions in a hospital setting, juxtaposed with his memories of freedom and joy before the crisis, underscore the drastic changes in his life and the lives of his community. The depiction of hospital life, alongside the attempts to bring joy and dignity to those suffering, highlights the resilience and solidarity within the HIV-positive community, despite overwhelming challenges.

Watch the video on YouTube
Billy Porter as Pray Tell in POSE S1 E6 (2019, FX Networks)

The second (Buzzfeed) video offers a more contemporary perspective, emphasizing the continued presence of stigma and the personal struggles of those diagnosed with HIV in recent times. The individual’s story of diagnosis, the impact on personal relationships, and the evolution of treatment from a multitude of pills to a single daily pill illustrates significant advancements in HIV treatment and management. Yet, the narrative also brings to light enduring challenges, including stigma, fear of rejection, and the psychological toll of living with a chronic condition. The comparison of past and present experiences reveals both progress and persistent obstacles in the fight against HIV/AIDS.

The intergenerational dialogue presented in these narratives underscores a crucial message: while significant strides have been made in the medical treatment of HIV, the social and emotional experiences of those affected remain complex and multifaceted. The stories of Pray Tell and the contemporary individual highlight the importance of compassion, understanding, and ongoing support for people living with HIV. With well over 1 million views each as of the time of publication, the TV episode and video dialogue similarly emphasize the value of bridging generational gaps and sharing experiences. Both videos foster didactic connections for the viewers to combat stigma and promote a more inclusive and supportive society for those affected by HIV.

Watch the video on YouTube
BUZZfeed “A newly diagnosed HIV carrier sits down with an HIV survivor from the AIDS crisis to talk about their experiences.”

Pause and Reflect

1. How can you facilitate intergenerational dialogue between clients to promote mutual understanding of HIV experiences across age groups?
2. What strategies can you use to address trauma experienced by older generations who lived through the height of the AIDS epidemic?
3. How can lessons from past activism and community resilience be integrated into current mental health support for younger clients?

Generational differences in perceptions of HIV risk and prevention further complicate communication and relationship-building. Research by Hawkinson et al. found that older men who have sex with men (OMSM) frequently view PrEP with skepticism, believing it encourages risky behavior among younger men. Conversely, younger MSM perceive older generations as overly fearful and uninformed about contemporary prevention strategies, which undermines opportunities for meaningful intergenerational dialogue on sexual health and risk reduction[89].

Intergenerational tensions are often exacerbated by racial and cultural discrimination. Semler et al. report that Black and Hispanic PLWH often encounter compounded stigma due to their race and HIV status, which can manifest in healthcare settings and social interactions. This dual discrimination limits access to affirming relationship experiences and erodes trust in support systems, including peer networks designed to foster solidarity among PLWH[90]. Similarly, Yapo et al.’s findings emphasize the importance of psychological well-being programs that validate both historical trauma and contemporary struggles, offering tailored support to older PLWH through storytelling, community events, and mentorship initiatives[91].

Despite these challenges, peer-led interventions and support groups have shown promise in bridging generational gaps. Programs that facilitate open conversations about HIV, particularly in contexts that emphasize lived experiences and U=U, help foster mutual respect and understanding. Wells et al. highlight how peer mentorship programs, especially those involving recently diagnosed individuals, create environments where both younger and older PLWH can build social connections and reduce internalized stigma. This community-oriented approach encourages individuals to reclaim their narratives and establish trust in their relationships[92].

Addressing these generational divides requires both systemic and grassroots interventions. Health promotion campaigns should focus on dismantling stereotypes about HIV risk behaviors while highlighting shared experiences of resilience across age groups. Additionally, integrating culturally responsive mental health services can offer emotional support that addresses both intergenerational trauma and current relationship challenges. Through such comprehensive strategies, PLWH can cultivate stronger, more affirming connections across generations.

A Call to Action

The ongoing fight against HIV is an interlocking set of challenges both biomedical and psychosocial, demanding empathy, awareness, and systemic change. As we navigate the complexities of supporting people living with and affected by HIV, it becomes clear that our roles must extend beyond providing treatment. We need to actively work towards dismantling the barriers that prevent equitable access to healthcare, challenge the stigmas perpetuated by misinformation, and advocate for policies that protect and empower marginalized communities.

To truly make a difference, each of us must reflect on how we engage with HIV-related issues at the community level. This involves examining our biases, adopting inclusive language, and creating spaces where open and honest conversations can thrive without fear of judgment or discrimination. Whether we are healthcare providers, educators, advocates, or allies, we all have a part to play in fostering a supportive environment where individuals feel safe to seek care, disclose their status, and live with dignity.

The progress made in prevention technologies, such as PrEP and U=U, has opened new avenues for reducing transmission and fighting stigma. However, these advances mean little if they are not accessible to all. We must push for broader education campaigns, community-based testing initiatives, and policy reforms that make these life-saving tools available to those most in need. Addressing systemic inequities in healthcare, especially those rooted in homophobia, racism, and poverty, is crucial for achieving our collective goals.

As we move forward, let us commit to transforming both the healthcare landscape and cultural sphere surrounding HIV. By promoting awareness, challenging stigma, and supporting meaningful community engagement, we can contribute to a future where people living with HIV are empowered, respected, and afforded the same rights and opportunities as anyone else. This is not just a a moral imperative for creating a just and equitable society, it is also a professional responsibility.

Author and Collaborator Bios

Rahim Thawer is a registered social worker, psychotherapist, and community organizer with extensive experience in HIV activism and LGBTQ+ mental health. Rahim has worked in frontline services, providing mental health support to people living with HIV, and has been actively involved in public education and advocacy initiatives aimed at reducing stigma. His work is grounded in intersectional approaches, focusing on how systemic oppression impacts marginalized communities, and he frequently collaborates with grassroots organizations to push for inclusive public health practices.

Jordan Arseneault is a health educator, advocate, and performance artist known for his contributions to by-and-for projects that foster HIV awareness. Jordan has played a key role in designing community-based knowledge dissemination tactics and campaigns that unpack stigma, particularly regarding HIV disclosure (and its unjust legal onus). Often collaborating with Toronto-based artist Mikiki (Disclosure Cookbook), his artistic and relational tools cater to LGBTQ+, new arrivals, and people living with sometimes invisible disabilities. Through his work in public engagement and translation, Jordan uses creative media and various lexicons (from epidemiology to epistemology to irony) to claim space for HIV-positive health, justice, and mutual aid. .

Endnotes

[1] KFF. (2024, August 16). The HIV/AIDS epidemic in the United States: The basics. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-hiv-aids-epidemic-in-the-united-states-the-basics/

[2] KFF. (2024c, September 9). The impact of HIV on Black people in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-impact-of-hiv-on-black-people-in-the-united-states/

[3] Ibid.

[4] KFF. (2024d, October 15). The impact of HIV on Hispanic/Latino people in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-impact-of-hiv-on-hispanic-latino-people-in-the-united-states/

[5] KFF. (2017, November 30). For young people of color, HIV remains a significant concern for self and community. Retrieved from https://www.kff.org/hivaids/press-release/for-young-people-of-color-hiv-remains-a-significant-concern-for-self-and-community/

[6] KFF. (2024a, May 29). HIV testing in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/hiv-testing-in-the-united-states/

[7] Ibid.

[8] KFF. (n.d.). LGBTQ+ health policy. Retrieved from https://www.kff.org/health-policy-101-lgbtq-health-policy/

[9] KFF. (n.d.). How history has shaped racial and ethnic health disparities: A timeline of policies and events. Retrieved from https://www.kff.org/how-history-has-shaped-racial-and-ethnic-health-disparities-a-timeline-of-policies-and-events/

[10] KFF. (n.d.). LGBTQ+ health policy. Retrieved from https://www.kff.org/health-policy-101-lgbtq-health-policy/

[11] Health Policy 101. (n.d.). LGBTQ+ health policy. Retrieved from https://www.kff.org/health-policy-101-lgbtq-health-policy/

[12] KFF. (2024b, August 16). The HIV/AIDS epidemic in the United States: The basics. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-hiv-aids-epidemic-in-the-united-states-the-basics/

[13] McKay, R. (2020, April 1). Patient zero: why it’s such a toxic term. University of Cambridge. Retrieved from https://www.cam.ac.uk/stories/patientzero

[14] Ibid.

[15] Ibid.

[16] Ibid.

[17] Ibid.

[18] KFF. (2024b, August 16). The HIV/AIDS epidemic in the United States: The basics. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-hiv-aids-epidemic-in-the-united-states-the-basics/

[19] Race, K. (2003). Revaluation of risk among gay men. AIDS Education and Prevention, 15(4), 369–381.

[20] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[21] Dawson, L., Kates, J., Sparks, G., & KFF. (2023, September 28). Trans people in the U.S.: Identities, demographics, and wellbeing. Retrieved from https://www.kff.org/other/issue-brief/trans-people-in-the-u-s-identities-demographics-and-wellbeing/

[22] KFF. (2024a, May 29). HIV testing in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/hiv-testing-in-the-united-states/

[23] Ibid.

[24] Ibid.

[25] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[26] KFF. (2024a, May 29). HIV testing in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/hiv-testing-in-the-united-states/

[27] Ibid.

[28] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[29] Race, K. (2003). Revaluation of risk among gay men. AIDS Education and Prevention, 15(4), 369–381.

[30] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[31] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[32] Ibid.

[33] Race, K. (2003). Revaluation of risk among gay men. AIDS Education and Prevention, 15(4), 369–381

[34] KFF. (2024b, August 16). The HIV/AIDS epidemic in the United States: The basics. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-hiv-aids-epidemic-in-the-united-states-the-basics/

[35] Ibid.

[36] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[37] Dawson, L., Kates, J., Sparks, G., & KFF. (2023, September 28). Trans people in the U.S.: Identities, demographics, and wellbeing. Retrieved from https://www.kff.org/other/issue-brief/trans-people-in-the-u-s-identities-demographics-and-wellbeing/

[38] Prestage, G., Brown, G., Down, I. A., Jin, F., & Hurley, M. (2012). “It’s hard to know what is a risky or not a risky decision”: Gay men’s beliefs about risk during sex. AIDS and Behavior, 17(4), 1352–1361.

[39] KFF. (2024b, August 16). The HIV/AIDS epidemic in the United States: The basics. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-hiv-aids-epidemic-in-the-united-states-the-basics/

[40] Ibid.

[41] Dawson, L., Kates, J., Sparks, G., & KFF. (2023, September 28). Trans people in the U.S.: Identities, demographics, and wellbeing. Retrieved from https://www.kff.org/other/issue-brief/trans-people-in-the-u-s-identities-demographics-and-wellbeing/

[42] Shalit, P. (2017). Living with HIV: Tips for living healthier and smarter, whether you’re newly diagnosed or not. Positively Aware, September/October issue.

[43] Bartels, S. M., Guzmán Guevara, K., Pajarito Rompich, Y., & Barrington, C. (2022). Narratives of change from gay and bisexual men living with HIV in an emotional well-being intervention. AIDS Education and Prevention, 34(1), 53–68.

[44] Ibid.

[45] Ibid.

[46] Shalit, P. (2017). Living with HIV: Tips for living healthier and smarter. Positively Aware, September/October issue.

[47] Jaspal, R. (2020). Stigma and HIV concealment motivation among gay men living with HIV in Finland. Journal of Homosexuality.

[48] Ibid.

[49] Ibid.

[50] López, D. J., Yuan, Y., Booth, J., Wei, K., & Friedman, M. R. (2022). Discrimination and rejection: The effects of ethnic and sexuality-based discrimination against Latino gay and bisexual men. Journal of Homosexuality.

[51] Grimm, J., & Schwartz, J. (2018). “It’s like birth control for HIV”: Communication and stigma for gay men on PrEP. Journal of Homosexuality.

[52] Elwood, W. N., Greene, K., & Carter, K. K. (2003). Gentlemen don’t speak: communication norms and condom use in bathhouses. Journal of Applied Communication Research, 31(4), 277–297. https://doi.org/10.1080/1369681032000132564

[53] Bartels, S. M., Guzmán Guevara, K., Pajarito Rompich, Y., & Barrington, C. (2022). Narratives of change from gay and bisexual men living with HIV in an emotional well-being intervention. AIDS Education and Prevention.

[54] Ibid.

[55] De Orio, S. (2017). The Invention of Bad Gay Sex: Texas and the Creation of a Criminal Underclass of Gay People. Journal of the History of Sexuality, 26(1), 53–87. https://doi.org/10.7560/jhs26103

[56] Mykhalovskiy, E. (2011). The problem of “significant risk”: Exploring the public health impact of criminalizing HIV non-disclosure. Social Science & Medicine, 73(5), 668–675. https://doi.org/10.1016/j.socscimed.2011.06.051

[57] Ibid.

[58] Kirkup, K. (2020). The Gross Indecency of Criminalizing HIV Non-Disclosure. University of Toronto Law Journal, 70(3), 263–282. https://doi.org/10.3138/utlj.2019-0054

[59] Mykhalovskiy, E. (2011).

[60] Barney, J. L. (2020). Louisiana’s Intentional Exposure to HIV Policy: The Social Construction of Target Populations. Social Work in Public Health, 35(3), 100–113. https://doi.org/10.1080/19371918.2020.1743220

[61] Ibid.

[62] De Orio, S. (2017). The Invention of Bad Gay Sex: Texas and the Creation of a Criminal Underclass of Gay People. Journal of the History of Sexuality, 26(1), 53–87. https://doi.org/10.7560/jhs26103

[63] Kirkup, K. (2020). The Gross Indecency of Criminalizing HIV Non-Disclosure. University of Toronto Law Journal, 70(3), 263–282. https://doi.org/10.3138/utlj.2019-0054

[64] Ibid.

[65] Mykhalovskiy, E. (2011). The problem of “significant risk”: Exploring the public health impact of criminalizing HIV non-disclosure. Social Science & Medicine, 73(5), 668–675. https://doi.org/10.1016/j.socscimed.2011.06.051

[66] Barney, J. L. (2020). Louisiana’s Intentional Exposure to HIV Policy: The Social Construction of Target Populations. Social Work in Public Health, 35(3), 100–113. https://doi.org/10.1080/19371918.2020.1743220

[67] Ibid.

[68] “Canada: Social Media Campaign ‘Think Twice’ Uses Video to Ask Gay Men to Reconsider Pressing Charges for HIV Non-Disclosure.” 2014. HIV Justice Network. https://www.hivjustice.net/news/canada-social-media-campaign-think-twice-uses-video-to-ask-gay-men-to-reconsider-pressing-charges-for-hiv-non-disclosure/

[69] Lindayani, L., Ridzki, M. P., & Purnama, H. (2024). Self-esteem among men who have sex with men living with HIV: A qualitative study. Jurnal Promkes, 12(2), 247–253.

[70] Owusu, A. Y. (2022). Experiences of new diagnoses among HIV-positive persons: Implications for public health. BMC Public Health, 22(1).

[71] Philpot, S. P., Aung, E., Templeton, D. J., Stackpool, G., Varma, R., Power, C., et al. (2022). Experiences of recently HIV‐diagnosed gay and bisexual migrants in Australia: Implications for sexual health programmes and health promotion. Health & Social Care in the Community, 30(6).

[72] Lindayani, L., Ridzki, M. P., & Purnama, H. (2024).

[73] Zhang, H., Sanchez, T., Zlotorzynska, M., Baral, S., & Hecht, J. (2023). Experiences of stigma and HIV status associated with awareness and usage of safer sex functions in dating apps among MSM. AIDS and Behavior, 27(11), 3603–3611.

[74] Chan, L. S., & Lok, D. (2024). How dating apps fail sexual minorities: Hyperpersonal failure as a framework for understanding challenges in developing long-term relationships. Journal of Social and Personal Relationships, 41(9).

[75] KFF. (2024c, September 9). The impact of HIV on Black people in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-impact-of-hiv-on-black-people-in-the-united-states/

[76] KFF. (2024d, October 15). The impact of HIV on Hispanic/Latino people in the United States. Retrieved from https://www.kff.org/hivaids/fact-sheet/the-impact-of-hiv-on-hispanic-latino-people-in-the-united-states/

[77] KFF. (n.d.). How history has shaped racial and ethnic health disparities: A timeline of policies and events. Retrieved from https://www.kff.org/how-history-has-shaped-racial-and-ethnic-health-disparities-a-timeline-of-policies-and-events/

[78] KFF. (2017, November 30). For young people of color, HIV remains a significant concern for self and community. Retrieved from https://www.kff.org/hivaids/press-release/for-young-people-of-color-hiv-remains-a-significant-concern-for-self-and-community/

[79] Thuận Phước Nguyễn, & Winter Han, C. (2024). Who’s eating rice? Gay Vietnamese American men’s experiences with (sexual) racism. Sociological Perspectives. https://doi.org/10.1177/07311214241242074

[80] Dawson, L., Kates, J., Sparks, G., & KFF. (2023, September 28). Trans people in the U.S.: Identities, demographics, and wellbeing. Retrieved from https://www.kff.org/other/issue-brief/trans-people-in-the-u-s-identities-demographics-and-wellbeing/

[81] Ibid.

[82] Chadwick, S. B., Antebi-Gruszka, N., Siegel, K., & Schrimshaw, E. W. (2023). “I assumed that he knows because he’s seen my profile”: HIV status disclosure and condom use decisions among MSM using hookup apps and websites. AIDS and Behavior, 27(12), 3992–4009. https://doi.org/10.1007/s10461-023-04114-z

[83] Thuận Phước Nguyễn, & Winter Han, C. (2024). Who’s eating rice? Gay Vietnamese American men’s experiences with (sexual) racism. Sociological Perspectives.

[84] Zhang, H., Sanchez, T., Zlotorzynska, M., Baral, S., & Hecht, J. (2023). Experiences of stigma and HIV status associated with awareness and usage of safer sex functions in dating apps among MSM. AIDS and Behavior, 27(11), 3603–3611. https://doi.org/10.1007/s10461-023-04074-4

[85] Chan, L. S., & Lok, D. (2024). How dating apps fail sexual minorities: Hyperpersonal failure as a framework for understanding challenges in developing long-term relationships. Journal of Social and Personal Relationships, 41(9). https://doi.org/10.1177/02654075241244482

[86] Lindayani, L., Ridzki, M. P., & Purnama, H. (2024). Self-esteem among men who have sex with men living with HIV: A qualitative study. Jurnal Promkes, 12(2), 247–253.

[87] Ibid.

[88] Nevedal, A., Neufeld, S., Luborsky, M., & Sankar, A. (2017). Older and younger African Americans’ story schemas and experiences of living with HIV/AIDS. Journal of Cross-Cultural Gerontology, 32(2), 171–189. https://doi.org/10.1007/s10823-016-9309-x

[89] Hawkinson, D. E., Operario, D., Hess, S., & van den Berg, J. J. (2023). Bridging the age gap: Intergenerational communication of HIV risk and prevention among younger and older men who have sex with men. AIDS Care, 35(4), 538–544. https://doi.org/10.1080/09540121.2022.2085865

[90] Semler, M., Pax, L., McNamara, K. F., Joyce, C., Shore, J., Morey, C., Gawne, E., & Clark, N. M. (2023). Reported HIV-related stigma according to race and ethnicity. AIDS Care, 35(8), 1251–1258. https://doi.org/10.1080/09540121.2023.2206097

[91] Yapo, F. C. D., Villanueva, A. R., Pariñas, J. L. G., Godoy, J. J. J., Lopez, M. A. G., Blanco, J. A., Torrero, K. A. D. C., & Tus, J. (2024). Don’t cry, don’t die: A case study exploring the psychological well-being of people living with HIV. Psychology & Education: A Multidisciplinary Journal, 22(1), 1–20. https://doi.org/10.5281/zenodo.12735739

[92] Wells, N., Philpot, S. P., Murphy, D., Ellard, J., Howard, C., Rule, J., Fairley, C., Prestage, G., Brown, G., Jin, J., Kaldor, J., Guy, R., Grulich, A., Mao, L., Donovan, B., Persson, A., Medland, N., Clifton, B., Hilton, P., & Hammoud, M. (2022). Belonging, social connection and non‐clinical care: Experiences of HIV peer support among recently diagnosed people living with HIV in Australia. Health & Social Care in the Community, 30(6). https://doi.org/10.1111/hsc.13886

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This essay was first published on Medium on March 17, 2025.