TO TELL OR NOT TO TELL

“Each player much accepts the cards life deals him or her. But once they are in hand, he or she alone must decide how to play the cards in order to win the game.”-Voltaire

In April 2009, Nadja Benaisa a German singer with a favorite all-female pop band was arrested and formerly charged in February 2010 with causing bodily harm by German police for having unprotected sex with three men between 2004 and 2006 without informing them of her HIV positive status, allegedly infecting one of her partners with HIV.
During her trial which commenced in August 2010, Ms. Benaissa admitted not telling her sexual partners she was HIV positive, she however denied intending to infect anyone with the virus.
“I’m so sorry; no way did I want my partner to be convicted” Ms. Benaissa told the court.

On 26th August 2010, she was found guilty of one count of causing grievous bodily harm and two counts of attempted bodily harm and was given a 2-year suspended sentence and 300 hours of community service.
Ms. Benaissa’s story brings to light the ramifications that people living with HIV could face for not disclosing their HIV status. It also gives you an idea about how lack of disclosure can end up exposing and getting someone else infected with the Virus hence making ‘disclosure’ an integral aspect of HIV prevention.

Back at home part IV of the Kenya HIV and AIDS Prevention and Control Act has provisions that could see one- if proven guilty of similar crimes- convicted to a fine not exceeding five hundred thousand or imprisonment for a term not exceeding seven years or both.

The most difficult thing anyone living with HIV may ever have to do is tell anyone they have HIV. Whether you have been recently diagnosed with HIV or have been living with HIV for while, you may well feel anxious about telling people about your status.
Disclosing your HIV diagnosis is difficult but sometimes necessary. Hard as it may be, there is no manual for disclosure, perhaps because it is such a multifaceted issue. Disclosing to a friend is very different from telling parents or disclosing to your child or marriage partner. But perhaps the hardest disclosure would be telling a potential sexual partner.

Disclosure surrounding HIV&AID means telling someone you are HIV positive. Who you tell and what you tell them can be very difficult and therefore is ones personal decision. You need to be sure you are doing it for the right reasons as who you tell and how you give the information may have a far reaching impact on a loved one and ultimately on your life.
When one mulls over disclosure So many emotions come into play as one psychologically asks themselves many questions. One wonders on many things for example; when this must be done or how exactly do I say it, do I show any emotions or not, or how will they react when they find out, will they hate me or blame me? Will they leave me? Will I end up facing this alone? Will they still love me? Will they shun me? Do I really have to do this!
Before disclosing ones status, one needs to consider a number of things which I like to call the ‘5W’s of disclosure.’

Who to disclose to
Who you tell your HIV status is very important. It isn’t news to be told to every walking person in the planet. When you are first diagnosed, it is probably wise to only tell the people you trust and believe will give you the support you need for example your doctor, a counselor, a support group for PLHIV or a close family member.

At this point you don’t need to tell your employer unless for some reason you need a shift in your job description.
You have no need to disclose to your potential landlord or workmates as people may treat you differently.
Shouting “I have HIV” to everyone can have its repercussions. Not everyone is as welcoming or as tolerant to issues around HIV&AIDS and as much as stigma levels have remarkable reduced in Kenya, not everyone gets to be received with open arms to disclosure.

Why disclose:
One needs to be certain they have a reason for disclosing their status. Once the question of ‘who’ it is you are telling is answered, ask yourself why you need to tell them. Is it because you need some kind of help from whoever you are disclosing to in terms of referrals for treatment and care?, or is it because the person you are telling is your sexual partner and therefore they need to know so that the two of you explore safer sexual practices or need to have them tested as well?
In some countries, there are certain professions where someone would have to let their employers know they are HIV positive for example surgeons.
In the case of a parent considering disclosing to their children, ask yourself why you want to tell them. Is it because they will be annoyed if you keep it a secret? Or do they suspect something or are you sick, or have they asked you if you have HIV or maybe its a child who was born HIV positive and needs to know why it’s important to take their medication.
It’s recommended that one discloses their positive HIV status to a potential sexual partner because in failure to do so has legal ramifications in certain countries.

Where to disclose;
You don’t want to be disclosing your status in a noisy restaurant after three drinks with someone you are on a first date with. Similarly disclosing to a violent spouse or partner when you are alone in the house with them could be dangerous. The news that one is HIV positive is always received with shock, pain, anger or any similarly related emotion. Different venues would work for different situations. You need to know who you are telling and how where you chose to tell would work for you. Remember you need to be comfortable with your surrounding to enable you easily answer all the questions that your family, friend, child (ren) or partner may have after you disclose.
If you are disclosing to an intended sexual partner, please ensure you are in an open place. A quiet restaurant with people around you.
If it’s a violent partner then its encouraged that you seek help with disclosure. There are a number of social workers or healthcare providers who can assist you with this.
In case one is disclosing to children, do it at a place they would feel most safe as they may have a lot of follow up questions for you.

When to disclose;
At what point do you tell your partner, your friends, your parents, your children or your colleagues of your HIV status? You need to consider this as you may have to tell these different people at different times depending on the situation you are in.
The best time to disclose your status is when you are ready. You need to adjust to the news of your HIV status first. For some people that may be a week, for other people it may be a year. But only disclose your HIV status when it's appropriate, and only when you're comfortable with yourself to do so.

It’s very important to inform your sexual partner of your HIV status as soon as you find out so that they can get tested as well and that the both of you can get help on how to live a healthy life.
My advice would be that you take sometime and process the news before you begin to tell it out to others. You do not want to be crying or in an emotionally unstable form when you talk to people about your HIV status.

This will scare them and make them feel like they are losing you.
Children could pick the insecurities that come with you not being okay with your HIV status and panic and this could affect them in school both academically and socially. Take as much time as you can after disclosing to your children to reassure them of your love and your family’s stability as well as your good health.
Seek counseling for as long as you need it to be able to deal with the shock and pain of finding out your status. Then you can share it with your loved ones.

People who are dating especially women are often at loss for when they should disclose their HIV status. You may be conflicted on whether to disclose on the first date or only if the relationship is getting serious. For fear of losing their partner people often hold off on telling about their status. This may work for you for a short period of time as the relationship may progress too fast into sex and you end up not protecting your partner. The best time to disclose is when you are ready but if you aren’t then please ensure you have safer sexual relations with your partners.
Disclosing to sexual partners should be encouraged as it is rewarding. It frees you from anxiety and enables the both of you to take control of your safety and make informed choices.

What to disclose
What you say to the various people you are disclosing to is very important. Some people like to be very open about their HIV status. That way they really don’t have to worry about people finding out later. This strategy does not suit everyone so if you are in a situation where not everybody will understand then this may not be the way for you. Even for those people who are public about their status, you may want to consider how much of your story you want to share for sometimes too much information could be misconstrued to mean some thing else.

In one of ‘Parent-children’ support groups organized by one of our partners, a woman told of how she disclosed to her children.
“I have AIDS and I’m dying soon” she told her children who had confronted her after they had been told mean things by their playmate.
The emotional trauma that followed later has affected her children to date over a decade later.

You need to have enough information about HIV and AIDS and whatever issues that are connected to it to enable you give the correct information to your partner, children, friend, colleagues or whoever you are disclosing to.
How you say what it is you are disclosing is also important. You could get books that have information on HIV&AIDS to share with your loved ones, or print out information online or even get help from your counselor, a friend from the support group or health professionals if there is need to explain things further to the people you are disclosing to.
If you are ashamed of your status, then the people you are telling to will feel the same way so try to have a positive attitude towards your condition.

A long time ago when HIV progression to AIDS was much faster due to stigma, lack of awareness and treatment, there was probably some rationale for telling your friends and family as soon as one found out their HIV positive status.
Most people were diagnosed with HIV because they were sick with one condition or another and therefore family involvement for care and support was very fundamental in recovery.
Today, the medicine for HIV management is so good that one can live their normal productive lives for years.
The decision to tell your family or your parents is ultimately your own.

There is a lot to gain from telling other people about your diagnosis. You may find that the support and understanding gained from confiding in close friends really helps reduce the stress or worries that you may have.
There is a possibility of greater access to good care and management by speaking to people or organizations that are there to support people living with HIV. It’s important to let your doctor know your HIV status so that you get the appropriate care. Disclosing could also help you get help from people with the same HIV status as you for example in a support group.

You may feel the need to tell is other for your own benefit and peace of mind. That is also good.However, as you seek to disclose your HIV status, please note that not everyone will be strong enough or supportive enough in their responses. Be prepared for this and remember that you have done nothing wrong. You need to be patient. The people you love and who love you also need the space to deal with your revelation.

As hard as disclosure of ones HIV is, its encouraged that one discloses to at least one close family member to enable them access the support they need either medically or emotionally in dealing with being HIV positive.