Living With HIV Confidently: Positive Attitudes and Judgment-Free Care

"Sometimes our words are a kind of medicine. No drug needed, just understanding." This is a sentence my team uses to remind ourselves every day, because some of the people who come in to talk about HIV only got their result that morning, some are afraid someone will find out, and some have already been judged, laughed at or turned away elsewhere. This article is written for people living with HIV, the people around them, and healthcare workers.

HIV today is not the HIV of memory

The picture of HIV many people remember comes from an era without good medicines. The reality today is:

• HIV is a manageable long-term condition, like diabetes or high blood pressure: one tablet a day and regular follow-up.
• People who start treatment early and keep taking it have a life expectancy close to everyone else's.
• When the virus is undetectable, HIV is not passed on through sex, according to U=U.
• You can have a partner, marry and have children who do not have HIV.
• HIV is not spread by eating together, working together or living in the same house.

After a diagnosis, your mind needs care as much as your body

In the early days after a diagnosis, shock, denial, anger, sadness or guilt are normal reactions to big news. They do not mean you are weak. What helps:

1. Get into treatment early. Starting antiretroviral treatment makes many people feel they have taken back control of their lives.
2. Find at least one person to listen. It could be a doctor, nurse, counselor, or a peer group of people living with HIV.
3. You do not have to decide everything in one day. Work, relationships and telling your family can be thought through one at a time.
4. Watch for signs of depression, such as weeks of poor sleep, not wanting to do anything, feeling worthless, or thoughts of harming yourself. Ask for help straight away. You can call 1323, Thailand's free 24-hour mental-health hotline (Thai language; ask for English support).

1. 1Start treatment earlyStarting antiretrovirals helps you feel in control again
2. 2Find someone to listenAt least one: doctor, nurse, counsellor or peer group
3. 3Decide graduallyWork, relationships, telling family; one thing at a time
4. 4Watch your moodIf you feel depressed or think of self-harm, call 1323 (Thailand mental-health hotline)

Shock, anger, sadness or guilt at first are normal reactions, not weakness.

Words that change how people feel

Stigma often hides in small words we use without thinking. Try changing them like this:

Instead of saying

• AIDS patient / infected with AIDS
• Where did you catch it?
• You have to take pills for life
• Clean / clean blood result

Try saying

• Person with HIV / person living with HIV
• Let's think about how to look after your health today
• Start treatment today and you can live a normal, healthy life
• Negative / HIV-negative result

vs

Rights to know in Thailand

• Health confidentiality. Section 7 of the National Health Act B.E. 2550 (2007) states that a person's health information is private and confidential, and no one may disclose it in a way likely to cause that person harm.
• Free treatment under your scheme. For Thai nationals, antiretroviral medicine and follow-up tests are covered by the Universal Coverage (gold card) scheme, Social Security and the civil servant scheme. Foreign residents and visitors usually receive care at private hospitals or clinics, or through their insurance.
• Work and education. The rights principles followed by Thailand's AIDS agencies are that HIV testing must be voluntary, results are confidential, and blood results should not be used as a condition for hiring, admission to education or dismissal. If you face discrimination, you can complain to the National Human Rights Commission of Thailand (NHRCT) or seek help from AIDS civil society organizations.
• Relationships and family. Since 23 January 2025, the Marriage Equality Act has been in force, giving couples of every gender the rights of spouses, including making medical decisions for each other. (Read Marriage equality in Thailand.)

How to tell a partner or family

Disclosing your status is your right, and there is no single correct way for everyone. What I usually suggest:

• Sexual partners should know so they can look after their own health, for example by testing for HIV, using PrEP or understanding U=U. A doctor can help you plan the conversation, or join it in the consulting room.
• Choose a safe time and place, and prepare some basic information, for example: "I'm on treatment, my virus is undetectable, and I don't pass it on through sex."
• Assess your own safety. If you fear being harmed, talk to a doctor or a support service first. In an emergency in Thailand, call 191 (police).
• Family and friends: tell them when you are ready, and only the people you trust.

If you are the person being told, read When your partner has an STI. The best first sentence is often "Thank you for trusting me enough to tell me."

What judgment-free care looks like

At Dr. Kris Clinic, we aim to make the clinic a safe space for people living with HIV and people of every gender and sexual diversity. Our practices are:

• Listening with respect, and not asking intrusive questions that are not needed for your care
• Giving straightforward information in language that does not tear you down
• Never disclosing personal information without your permission
• Treating everyone equally, whatever their gender, occupation or behaviour, including sex workers
• Not making you feel guilty, but helping find care that fits your real life

We do not ask "Where did you catch it?" Instead we say, "From today, you don't have to face this alone."

Let me walk alongside you

I provide care from counseling after a diagnosis and planning your entry into treatment under your scheme, to long-term care of your sexual health, hormones and mental health, and counseling for couples and families, both at the clinic in Surat Thani and online anywhere in Thailand. English-speaking consultations are available. Wherever you are in life, you can always talk to us.