Health Meet the HIV-positive gay men who are depressed and suicidal By Ian Howley @ianhowleyPhoto © www.flickr.com/partymonstrrrr If you just read about effective HIV treatment and life expectancy you’d be forgiven for thinking that HIV is no big deal these days. Sure your life might change but once you are diagnosed all you have to do is remind yourself to take your medication once a day, and eventually you will become undetectable and your life will go back to normal. However for many of the gay men who filled in our ‘Gay men and mental health’ survey, living with HIV is a big factor in their mental health difficulties. Many of the gay men living with HIV told us that their diagnosis threw their life into chaos, with many becoming depressed and suicidal. James is 20 and from Hull. He said: “I knew very little about HIV and STIs. I was having unprotected sex with men around my age. I thought that HIV was something only old gay men had and was naive enough to think it would never happen to me. About a year ago I got sick and had to get a check-up. My results came back as positive and my world crashed. I was given leaflets but nothing about the impact this diagnosis would have on me. I thought my life was over. Who wants to be with someone with HIV? “Since my diagnosis my mental health has plummeted. I feel very low these days and I can’t see it getting better.” Simon, 36 from Oxford, has similar feelings. He says: “I was diagnosed with HIV in January 2012. I was having lots of risky sex and I knew eventually it would happen but didn’t really care. It wasn’t until I was diagnosed that reality set in. I wasn’t ready for it and became depressed. It affected my job. It affected my social life and I became a recluse.” Neno is from Brazil and moved to London in 2013. He was new to the gay scene and within a few short months was diagnosed with HIV. He told us: “Being in a new country can be hard enough. When I was diagnosed with HIV I had no-one to turn to. I ended up not going to college, calling in sick to work, not going out. I wasn’t ready for HIV to be part of my life. Nobody knows I am HIV-positive and I’m not sure I can ever tell anyone.” Here are some other comments we received via our survey: “I was diagnosed with HIV five years ago and I felt my life was over.” “I was diagnosed HIV-positive. Disclosing to my mam was extremely difficult. I felt dirty and ashamed and like I’d let her down.” “I was diagnosed with HIV after a sexual assault. I struggled for a year with depression and anxiety.” “Since I was diagnosed with HIV my life changed from stable and well-employed (executive level) to poverty and struggle!” “I struggled literally getting out of bed in the mornings and finding a reason to go on with life after my diagnosis. It had a knock-on effect on other aspects of my life and I was slowly digging a deep hole that I was scared I wouldn’t get out of.” “I don’t want to get out of bed most mornings. I have little desire or energy to do my work or daily routine. I end up eating crap as comfort food which then feeds my issues about looking like crap.” “I’ve always suffered with low self-esteem, but after my HIV diagnosis (probably through chasing validation) I moved to Brazil with a partner and when our relationship broke up I came back to London alone and struggled to find work.” “I broke down and cracked six weeks after my HIV diagnosis and went into a downward spiral of anger, resentment and fear. It took hold of me and I let it control me until I eventually took measures to help regain control again.” “When I was 25 I was taken into hospital seriously ill, and they couldn’t find anything wrong. Eventually I got better and was allowed home and attended as an outpatient. It was then I found I had HIV. I felt my life was over.” “My mother got pricked with my needle whilst assisting a doctor in hospital and therefore contracted HIV. It had a huge impact on my mental health.” “The fear of HIV – drummed into me by prevention campaigns – as I was growing up left me feeling scared to test for HIV. Around the time of my HIV diagnosis, I was taking more and more risks sexually. It’s hard to know which came first – the depression or the risk-taking.” Is it all about HIV? Are there any other issues these men face? After ‘Living with HIV’ here are the other most popular reasons for depression: Low self-esteem – 66% Finances (money worries) – 56% Isolation – 54% Relationships – 49% Sexuality – 42% Not feeling attractive – 36% Employment – 31% For many living with HIV with a mixture of the above was the main issue for their feelings of depression and suicidal thoughts. Matthew Hodson of GMFA says: “Just as gay men often identified reasons for depression that are also common for heterosexual men, with the addition of some gay specific concerns, men with HIV had additions stresses to other gay men.” HIV AND SUICIDE Many of the gay men living with HIV talked about suicide or had suicidal thoughts. Many also tried to die by suicide. Anthony is 26 and from London. He told us that after his diagnosis he couldn’t handle it. He said: “About three months after I was told I was HIV-positive I tried to overdose. I didn’t cope at all with being told I had the virus. I thought my life was over and suicide was the best option. Luckily my attempt failed.” Liam is 30 and from Dublin. He said: “Here in Ireland nobody talks about HIV. It’s like it doesn’t exist. I’ve had unprotected sex several times but never really worried about it, as I thought it was only a problem in major cities like London. I went for my check-up and was told my test came back as positive. I didn’t know enough about just how advanced the medication is these days. My first question was “when will I die” and thought it would be better to kill myself rather than die with AIDS. It wasn’t until I was educated about how the medication works and talked to other HIV-positive guys that I became OK with it. I still struggle and haven’t told my family. Some days I think it would be best to end it all but those days don’t last long.” Ravi is 29 and lives in Bradford. He told us that being from a Muslim background being diagnosed with HIV brought ‘great shame’ on him. He said: “When I was told I had HIV I had to deal with what my family would think. I come from a Muslim family and they are just about OK with me being gay. Telling them I have HIV is not possible. It would bring great shame on them. I think about killing myself every day because of this.” Some other anonymous comments we received were: “My life changed as I was diagnosed with HIV and afterwards suffered discrimination at work. I lost my job and source of income. I had post traumatic stress disorder and depression, and am still fighting unemployment and depression with a constant desire to put my life to an end.” “I had a breakdown after losing my grandmother five years ago, and then moved to Barcelona where my long-term partner passed HIV on to me. It had a huge impact on me as the reality kicked in I had this disease and that the person I had loved and been loyal to had passed it on to me. In February this year I took an overdose.” Is this all down to being HIV-positive? Off all of the men who ticked ‘living with HIV’ when we asked them what reasons were the main factors in feeling suicidal or attempting suicide? We asked: What were the main reasons for feeling suicidal or attempting suicide? Living with HIV – 66%Low self-esteem – 60%Relationships – 39%Isolation – 33%Homophobic bullying – 29%Sexuality – 27%Finances – 22% Living with HIV remained the main reason for HIV-positive men’s suicidal thoughts or why they have attempted it. Though just like the gay men who didn’t tick ‘living with HIV’ other issues like relationships, and low self-esteem were high factors for feeling this way. How are they coping now? “I am coping better than I was. I see my psychologist every week.” “I am well supported. I have invested time into my well-being.” “I’m working hard in my job and concentrating on health and fitness. So I feel good about myself externally – which helps.” “I am no longer suicidal. I have never since tried to end my life. Once I got some support and talked to others about living with HIV my life changed for the better.” “I’m feeling much stronger now. I took the power by opening up publicly about my HIV status.” WHAT HAVE WE LEARNT? To say that HIV is no big deal these days is completely wrong. Obviously not all gay men living with HIV experience depression or suicidal thoughts but from the stories we received via our survey being diagnosed with HIV still has a big impact on gay men. We can also see from the results that it’s not just HIV. Many gay men living with HIV become isolated, suffer low self-esteem, have employment problems and have to deal with financial issues they may not have had before their diagnosis. “HIV remains one of the most stigmatised of all health conditions,” says GMFA’s Matthew Hodson. “Rates of depression among gay men with HIV are twice as high as they are among other gay men, affecting about one in every four men. And depression in men with HIV can lead to poor adherence, which can have a major impact on their physical health as well. “Depression also has an impact on someone’s likelihood of becoming HIV-positive,” adds Matthew. “A recent study showed that men with depressive symptoms were more likely to have unprotected sex, and to have unprotected sex with several partners. Tackling the mental health challenges faced by gay men is crucial if we are going to reduce the high levels of sexual risk-taking and high incidence of HIV in our community.” Support For details about counselling services that may be available, call THT Direct on 0808 802 1221. GMFA has a section of its website dedicated to gay men living with HIV. Visit www.gmfa.org.uk/living-with-hiv. Whether you are HIV-positive or negative, gay or bisexual, experiencing issues with addiction or just need someone to talk to about your sexuality, the organisations listed on GMFA’s website may be able to help you. Visit www.gmfa.org.uk/prevention-support-services.