What Is HIV-related Stigma?

HIV-related Stigma refers to inaccurate and unfair judgment about PLHIV. Stigma can lead to discrimination. What are some of the unfair assumptions made about PLHIV?

• PLHIV are sinful.

• PLHIV are sexually promiscuous.

• PLHIV can transmit HIV via holding hands with others.

What Is Discrimination?

Because of stigma, discrimination can result. Discrimination refers to unfair treatment of a person who has been stigmatised. Discrimination is extremely harmful and painful to persons who receive such treatment. Persons can sometimes be denied specific rights and freedoms as a result of discrimination.

What Types Of Discrimination Can PLHIV Experience?

In some cases, PLHIV may be:

• Denied casual contact from friends, family members and community members

• Referred to “positives” and “HIVers”

How Can Stigma And Discrimination Affect Treatment And Care For PLHIV?

Stigma and discrimination can affect one’s mental health and lead to conditions such as depression and anxiety. Furthermore, these mental health conditions can result in non-adherence to treatment and care.

How Can PLHIV Cope With Stigma And Discrimination?

It is important to find healthy ways to address the effects of stigma and discrimination. Firstly, a healthy support network is important. These are people that you can share distress with. Additionally, you can speak to your social worker at your treatment site.

You may want to step a bit further and work with organizations that work to address stigma and discrimination. Many of these are NGOs that have served the community for many years.

It is also helpful for us to hear stories from others who have overcome stigma and discrimination.

Who Do I NEED To Tell?

It is very important to share your status with your sexual partner(s) and any persons with whom you may be sharing injection needles. While we know that this may be scary, to stop the virus, we must protect those around us by letting them know if they should get tested.

If you feel that you may not be safe to tell your partner(s), you can take them to your health care provider to have additional support when you share this information.

To get more information on where to get your partner tested for HIV, speak with someone on the National HIV Helpline call 800-4HIV or 800-4448. (This is a toll-free number.)

You are not alone. #youarenotalonett

Remember that you can still enjoy a healthy and beautiful sex life once you use protection and take your medication as advised by your medical team. Taking your medication as prescribed helps you to attain your U=U status.

It is also important to share your status with your regular doctor so that you can receive the best possible health care. It can be intimidating to share your status,, but doctors especially need to be informed about your medications to be sure that you will not experience any bad reactions from medications used together incorrectly.

Who Does Not Need To Know?

The chart below provides you with a brief snapshot of some members of your treatment team.

Although it is important for some key persons in your life to know, your employer is not one of them. It is important to remember that other than sexual partners, people with whom you share injection equipment and health care providers, no one is obligated to know your HIV status until you are ready to share with them. If you decide to inform your employer, please know it is against the law of Trinidad and Tobago for an employer to discriminate against you based on your HIV status. This is outlined in the Equal Opportunities Act, where HIV is covered under Section 3 which addresses physical conditions.

For children or adolescents who are HIV positive, teachers, classmates, and other school staff do not need to know a child’s HIV status.

Remember S.U.P.P.O.R.T

People often choose to disclose their status to close friends and family members whom they trust. For many, telling those closest to them provides them with both emotional and practical support. Be sure to only share with persons who can give you the type of support that you truly deserve. Be sure to tell persons who can be confidential.

If you would like some more information about disclosure, please take a look at the videos below from Eswick Padmore who is the Founder of Friends for Life and Cyrus Sylvester who is the Vice Chairman of the Patient Advocate Mission. In these videos, you will learn more about how to disclose and what support you can possibly receive from the NGO sector.

A note about Insurance companies Many insurance companies will ask you to disclose your HIV status when applying for certain policies such as Life Insurance and Critical Illness Policies. Some may also ask you to take a HIV test. If you are not provided with a test, they may simply ask you to indicate your status. Sadly, if you indicate that you are negative while being positive, and the insurance company is made aware of this, they may void your policy.But there are options. Some Insurance Companies and Credit Unions offer indemnity plans which mimic life insurance plans.

Pwn And What They Do

PAM And What They Do

Your Relationship With Your Doctor And Nurse

• How much experience do you have in treating people living with HIV?

• How often do I need to come to the clinic?

• Can I speak with you between appointments?

• Will you conduct a physical examination?

• If you are not available and I have an issue, which doctor would I see?

Taking HIV Medication For The First Time

The chart below provides you with a brief snapshot of some members of your treatment team.

• How do you decide which medications I should be taking?

• What kind of side effects can I expect for medications?

• Are there side effects? or What are the side effects?

• What can I do to deal with side effects?

• How long do side effects last when I start a new treatment?

• Is there any other therapy or medication that I should take?

Changing Medication/Treatment

• Will I experience side effects with a medication change?

• Why do I have to change medication?

• Can I take herbal medicine to cure HIV?

What Happens At A Treatment Site?

A treatment site is a facility with an established team of healthcare workers who provide prevention, treatment, care and support services to people living with HIV (PLHIV). These services include HIV testing and counseling, clinical management and patient monitoring, as well as other services.

You may be worried that the cost of these services may be very expensive. Here is the good news: Treatment at these sites are free of charge to both nationals and non-nationals.

Upon diagnosis, your local health center can direct you to any of the treatment sites throughout Trinidad and Tobago, where you can receive any support that you may need at this time. For example, if you live in the St. Joseph area and you attend the St. Joseph Enhanced Health Center, you will be directed to the Eric Williams Medical Sciences Complex for treatment. In this way, care is easy and accessible to you. Please note that you are not mandated to attend any specific treatment site. In other words, you can access a treatment site in any part of the country regardless of where you live.

At the treatment site, the staff will support you in starting treatment, and will schedule regular visits to observe and manage the progression of the infection. This is not all. The staff understands the additional physical, emotional and social challenges that you may face. They will assist you in areas such as counseling, family planning and peer support.

Who Is Your Team At These Sites?

The chart below provides you with a brief snapshot of some members of your treatment team.

A doctor. Your physical wellbeing is extremely important. Preserving your immune system and avoiding opportunistic infections are key to a long and healthy life with HIV. Your doctor will assist you in managing this. At your visits, the doctor reviews your status, and gives you recommendations. She/he/they may also revise your treatment plan as your body regains more control over your immune system. The doctor also helps you to manage how various non-HIV medications will interact with Antiretroviral Therapy (ART), and can answer any questions or concerns you may have.

A pharmacist. A doctor’s job could never be complete without the support of a reliable pharmacist. At treatment sites, your pharmacist provides you with medication after you visit the doctor. They also provide clear guidance about how to take your medication. Just like your doctor, your pharmacist can answer your questions and concerns about the drugs and possible side effects. It is important to tell your doctor and pharmacist about all of the medicines and supplements that you are currently taking to be healthy. This includes natural therapies, prescription drugs and over the counter drugs.

In Trinidad and Tobago, some persons are often tempted to blend other forms of therapy, such as natural therapy (bush/herbal medicine), with medication. Please do not engage in this without advice from your medical team. Acting without their advice can result in harmful consequences.

A nurse. You also have the support of a nurse! The nurse at the clinic or treatment site will counsel you on your treatment regime and also act as the contact that checks your medication. The nurse can also provide answers on your treatment routine and support you on this journey. If you would like the nurse, doctor or pharmacist to speak to a trusted loved one about what is required for your medical care, they can assist with this as well.

A phlebotomist. You may be thinking :” What is a phlebotomist and why are they needed?” This is the person who takes a blood sample from you to check the levels of HIV in your blood or check for other signs of illness in your blood. In our sections above, we mentioned that the doctor needs to monitor you. This cannot be done without blood samples from the phlebotomist. The doctor can then see how well the treatment is working and the additional steps that are required.

A social worker. You may find it helpful to speak to someone that you can trust about the emotional and social effects of your diagnosis and the way forward. Social workers are there for this. A social worker will speak with you about your treatment plan, emotional wellbeing, and the support that you are receiving from family and friends. Additionally, a social worker can also refer you to organizations to receive financial support, housing or additional therapeutic support. Social workers in Trinidad and Tobago are trained to honour the following principles: confidentiality, non-judgmental attitude and acceptance. As such, you will be heard and given the ability to share in a safe space. If you would like to learn more about social work in Trinidad and Tobago, please feel free to check out the Trinidad and Tobago Association of Social Workers.

Patient / Peer Advocate Communicating with the treatment sites can be a challenge at times. You may feel afraid or they may not understand what you mean. You need an advocate! An advocate can assist to explain HIV-related information to you in better detail, or identify with your point of view and ensure you are understood. Luckily, at the treatment sites, you can have access to patient advocates. They may also be known by other terms, such as peer navigator or treatment supporter. They are all there to help you better understand your diagnosis and assist you on your treatment and care journey. A patient advocate is a person who helps PLHIV communicate with their healthcare providers so they get the information they need to make decisions about their care. If you would like to learn more about what patient advocates do, you can check out the following videos from Eswick Padmore, Founder of Friends for Life and Cyrus Sylvester, Vice Chairman of Patient Advocate Mission.

Some sites also offer peer advocates. These individuals are similar to Patient Advocates, but they are usually other PLHIV (People Living with HIV) that can relate to your current journey and support you in what you are feeling and saying. They are all there to support you.

Administrative Staff. We have listed so many groups. Sometimes, this can get confusing. You should not worry. The administrative staff at these sites help to guide you through the process of seeing each of these members of your team as smoothly as possible. They also do tasks such as schedule your appointments and follow up on your support at home and from your team.

Where Can We Find These Sites?

You are in good hands! There are various treatment sites in Trinidad and Tobago. Let’s take a look at the map below to see where they are located.

If you are not already going to a treatment site and wish to access any of them, their contact information is listed below.

For more information on where you can get Tested for HIV visit: https://health.gov.tt/services/hiv-counselling-and-testing-sites

To speak with someone on the National HIV Helpline call 800-4HIV or 800-4448. (This is a toll-free number)

You are not alone. #youarenotalonett

You may feel very vulnerable when you are newly diagnosed. However please remember that wherever you are getting HIV care, you have rights as a patient. To learn more about these rights, click here. 

Sometimes, in order to reduce the feelings of vulnerability mentioned above, you may want to share with others. If you would like to learn more about how to talk to your friends and family about your HIV diagnosis, visit the disclosure page.