Disclosure to New Partners

Deciding when (and if) to tell new partners that you have HIV can be a really daunting prospect. The fear of rejection or negative reactions is often a real and understandable barrier in talking honestly and openly with new partners.

Counsellors, health advisers, specialist nurses and other HIV support workers can be helpful in talking through feelings about disclosure, helping to formulate a plan for telling people your HIV status and dealing with any issues that arise after disclosure.

HIV services in Sheffield can offer advice and support on issues of disclosure.

Contact either:

• The Health Adviser / Specialist Nursing Team at The GUM Clinic on 0114 276 6928
• The Specialist Nursing Team in E3 Outpatients Service on 0114 271 1882 or 0114 271 1900 (ask for bleep 2096)

Talking to people who are also HIV positive may be useful. Sharing experiences, anxieties, concerns and solutions with other people in a similar situation can really help. You may find the forums and blog pages on this site a useful way of discussing issues around disclosure with other people who are living with HIV.

Who needs to know?

Although you don’t have to tell everyone (or anyone) that you are HIV positive, it is advisable to inform current, past and future sexual or injecting partners of the potential of infection. Research tells us that people who are HIV negative (or do not know their HIV status) often expect people to tell them they have HIV before having sex or sharing injecting equipment and that they generally assume that someone is HIV negative unless told otherwise. If you do not feel able to inform partners yourself, a health adviser can help and even do this on your behalf without mentioning your name. More information on disclosure to sexual partners is given later on this page.

It is also advisable to share information about your HIV status with your GP and other health care workers. They can then offer you the best and most appropriate advice and treatment taking into account factors including immune system functioning and any HIV medication you may be taking.

If you are a health care worker, you are obliged to inform Occupational Health of your HIV status. They will not inform your manager or colleagues, but will ensure that you do not undertake exposure-prone procedures. HIV is covered by the Disability Discrimination Act, so your employer is obliged to make reasonable adjustments to your work if it is not appropriate for you to continue in your current work role.

Disclosure to sexual partners

There is no legal obligation to tell sexual partners that you have HIV but people have been prosecuted for reckless transmission when they knew they had HIV, did not tell their partners, had unprotected sex and their partners became infected as a direct result of this. As with any area of law, the law in relation to disclosure to sexual partners can change when new cases are brought before the legal system. What we do know, however, is that the balance of responsibility in terms of disclosure has shifted towards people who are living with HIV even in cases where condoms/ femidoms are used and/or no HIV transmission took place. This can make navigating a path between safer sex and disclosure extremely difficult. Talking this issue through with a specialist HIV Health Adviser can be really helpful in planning for when and how to disclose your HIV status to partners and also how to better negotiate sex that is safer for everyone involved.

Although disclosing your HIV status to sexual partners can be very difficult to do (especially if you are unsure how people may react) there can be some real benefits to doing so. In particular, disclosing your HIV status to current partner(s) – whether that is in a long term or developing relationship or a more casual sexual relationship – can be important for a number of reasons:

• It can help you to talk honestly and openly about making the sex you have safer and, therefore, reduce the risk of HIV transmission to others
• It can then make you more relaxed and at ease about sex. If we are relaxed and at ease then we are more likely to enjoy sex more
• Disclosure to partners can mean not having to live with the stress of keeping HIV a secret

Even though it may be a difficult decision to make, ideally, you should disclose your status to sexual partners even if you are having protected sex with them. This allows your partner to make their own risk assessment and means that your partner can access PEP treatment if you have unprotected sex or a condom breaks/ comes off during sex.

Tips on disclosure (adapted from shetoshe.org website)

Although people can’t plan for others reactions, having a disclosure plan and a good support system (this may be a key healthcare worker or close friend etc.) can be really helpful before, during and after disclosure.

When planning to disclose it can be useful to consider the following:

• Think about and ask yourself why you want people to know. Do you want or need a specific kind of support from the person that you have decided to tell?
• What agreement would you like to make about them telling other people? How will you feel if they tell others?
• Plan what you are going to say, rehearse with a friend, a health-care worker or someone else who is HIV positive
• You may want to bring information, leaflets, magazines, websites to show the person you are telling, or to leave for them to read
• Make sure you do it in a safe place so that everyone is comfortable and in an environment where you can have an honest discussion
• Let a friend or support worker know so that they can check that you are okay and give post disclosure support
• Think about how disclosure will affect the person you are telling and think about the support they could also get from HIV healthcare professionals and how they might access this
• Maybe think about disclosing first to a stranger – for instance when visiting a different town. This can be a good way to have a “trial run”
• Talk with other people who are HIV positive (maybe visit a local HIV peer support group) about different ways to disclose to others

Remember that there is absolutely no right or wrong way to do it. The methods of disclosure that you want to use are personal to you and should be what’s best for you. The really important thing is that you have control over who you tell, when you tell, how you tell and if you tell.

Whatever the reaction you get from disclosure to another person there is support available to help you plan and prepare for disclosure and to talk through how it went – whether you get a positive and supportive outcome or not quite the response that you had hoped for.

Other useful information

• NAM Aidsmap website
• My HIV website
• HIV & The Criminal Law – booklet available to download from NAM

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