Fear pushes patients to keep HIV status a secret
People with virus worry about backlash amid lack of awareness
Thailand celebrated the International Day Against Homophobia, Biphobia, Intersexism and Transphobia (IDAHOBIT) on Monday, to help raise awareness against gender-based discrimination.
Yet, not every LGBT individual in Thailand could mark the occasion with joy, especially individuals living with the human immunodeficiency virus (HIV) -- many of whom still choose to remain silent due to stigma over their health status, despite the relatively normal lives they lead which were made possible by advances in medical science.
The Bangkok Post spoke to a trans-woman, 32, who tested positive for HIV in December 2019. She said she didn't know where or how she contracted the virus.
"I was informed by my plastic surgeon that my blood test result came back reactive for HIV antibodies. The surgeon told me to recheck and it was later confirmed that I have to live with [HIV] for the rest of my life," she said.
Physically, she said, she did not show any signs of illness.
"However, my brain went blank once I was informed of my blood test result," she said. "I even wanted to commit suicide, as I didn't know how I was supposed to continue living."
She was immediately told to seek HIV treatment as her CD4 -- a type of white blood cell -- count had dropped to 285. In an average healthy person, the count would be over 500.
Since then, she has lived her life as a healthy person would, with the aid of medicines prescribed by her doctors. In fact, she said, she has been much healthier and stronger.
That said, she said her HIV status remains a secret, except to two of her friends who have stood by her since she was diagnosed with HIV. She hasn't told her parents and intends to keep it a secret until she dies.
"I told my friends not to tell my parents when I die, and I'm planning to ask my doctor not to reveal [my HIV status] to them because I think it will be embarrassing to those who are still living [when I die]," she said.
"I don't want them to feel ashamed of having me, and be criticised by others."
She believes there is no way of predicting how her colleagues, friends and family would react if her HIV status were to be made public.
She said she feared losing her job and getting bullied, especially since many Thais still view LGBT individuals as promiscuous and hedonistic people whose lifestyle brings them closer to HIV.
"I risk losing my job if my boss knows. Luckily, I caught [HIV] after I have worked here for three years and I am now a permanent employee," she said.
Since her diagnosis, she said she made friends with other HIV positive individuals and created a small community online which provides emotional support to those who have recently contracted the virus.
"To be honest, I feel very comfortable living with those who are the same as me as we share the same lifestyle. I'd even prefer to find a life partner with HIV," she added.
Another person who spoke to the Bangkok Post, a 45-year-old businessman, said he has been living with HIV for 11 years after contracting it from unprotected sex and drug use.
When he was diagnosed, his CD4 count had dropped to around 90 and symptoms had begun to show. He lost weight and had a mild fever every evening.
"My four HIV positive friends told me to go and get checked, and I began treatment as soon as the result was confirmed," he said. "I was so shocked I was speechless when I found out about it."
Aside from his four friends who told him to get checked, his partner of almost 30 years -- who is HIV negative -- is the only person who knows of his HIV status.
"We have been in relationship since before it happened, and we've been through so much worse. So we decided to keep it simple and live our lives like normal," he said. "All we have to do is take better care of each other."
However, not everything has gone smoothly, as he said he still faced discrimination from some medical staff when they found out his HIV status.
"Once, when I went to have my blood checked, the nurse who attended me dropped the needle she used to draw my blood. Instead of picking it up, she kicked it with her foot," he said. "I decided to ignore it so as not to ruin my mood."
"In the end, it is unfair to have a negative mindset and think that HIV is our lesson for being promiscuous. One can contract the virus by accident, such as tainted needles and blood donations, or rape," he said.
A 32-year-old businesswoman said while she has been living with the virus for seven years, she has never quite figured out how she contracted the virus.
She said she only found out about her HIV status right when she was about to donate blood.
"I went to a clinic to recheck and they confirmed the result. At that time, I was so surprised. I knew nothing about HIV," she said. "As Thai media often portray Aids as something disgusting and scary, I was scared I might disgust those around me."
She continues to live with her boyfriend, who remains HIV negative. She said that during sex, protection is vital and her boyfriend gets his blood checked every three to six months.
"This disease is not scary as long as you keep taking the medications. Frankly speaking, as our health is very vulnerable, we must take very good care of ourselves," she added.
Just like the others the Bangkok Post spoke to, she keeps the matter a secret, even from her own parents.
"I don't think my parents would be able to accept it. Last time I went back home, the neighbours were gossiping about a neighbour who was infected with HIV. I don't want my family to be talked about," said she.
Better education needed
Phawath Borisuthi, HIV Foundation General Manager and Bangkok Rainbow HIV and STIs Campaign Manager, said that LGBT individuals face double discrimination when it comes to HIV.
"In Thai society, people often view [LGBT people] as sexual risk-takers and promiscuous, fun-loving people, so the virus is often seen as their 'lesson'," he said.
He said that anyone could contract HIV through unsafe sexual activities, and the disease risks spreading further if sex education isn't ramped up.
To end the stigmatisation of HIV positive individuals, which is pervasive in Thailand and has been reinforced over a long time, proper education is needed, Mr Phawath said, adding this will also help end their marginalisation in society.
"Many of them prefer not to tell their parents because they are afraid of rejection or even physical harm," he said. "Through better education, we could save many more lives."