"You get a job and, if your employers learn about your status, you can just get chucked out... They just won't let you work." "Nobody goes around asking doctors about your test results, but information in a small town spreads very easily. I used to work at a market, but because someone heard something I lost my job. People believe gossip. " "Several years ago I was forced to participate in a TV programme on HIV, for one of the Central Russia Channels. At the time I was in prison and my case was studied and reported on. Before the interview, the reporter promised to not show my face and to use an alias. But he broke his word and my whole home town learnt about my illness." "I was the first infected woman sent to prison. On my release, they held me in the basement to wait for the bus. I had to wait separately on my own, but when the bus came they put me on it with the others. " "Six years ago, my brother was sentenced to nine years' imprisonment. He's HIV positive and is now really ill. He has written to the warden asking for medical attention, but hasn't had a reply. I also wrote to the Deputy Head of Administration of Verkhnaya Salda region myself, requesting medical help for my brother." "Some of our neighbours still don't return our greetings. They've a negative attitude about sick people. They probably consider us unworthy of their friendship." "People who don't know us assume the worst. One of the weirdest things I've overheard about HIV is "How can you drink tea together? It's infectious, it transmits via the air!"" "Five years ago a girl I knew died. The local newspaper reported that she died of AIDS. They called her an 'AIDS carrier'. The expression was really abusive and negative. After that, many people who knew the girl's mother stopped being friendly with her and snubbed her. After a while this stopped, but her mother still can't forgive those people who rejected her." "Scary things went on in the maternity ward. I was put in a separate room and the doctors and nurses used special instruments, gloves etc. Of course this is right and it should be this way, but the way they treated me... This is what the midwife said to me: "Why do you want a child, are you mad? You will die soon, you won't have time to bring up the baby!" A lot of people observed at the delivery - midwives and nurses - showing indecent curiosity. After the birth, I wasn't allowed to stay in the hospital and I was sent home immediately, even though it was minus 30 degrees celsius outside. Nobody offered to help me carry my baby to the car." "Only a few doctors treat my baby with respect and understanding. Some of them are afraid to touch the child. The real diagnosis is not written in the medical files, a different one is mentioned, "Contact hepatitis B". The paediatrician doesn't know the real diagnosis but even so, he is afraid of touching the child. He washes his hands immediately after touching the baby." "We think the problem is that people are not informed. Our own parents are not afraid of anything. They are not afraid of being around us, their children and grandchildren." "Both my wife and I are registered with 'second level disability', meaning we are unfit for work. My wife gets an allowance of 1100 Roubles (approximately USD 37) and I receive 600 Roubles (approximately USD 20). To keep our disability status it is necessary to pass a medical examination every year. We have to pay for the analysis ourselves. If someone is missing a leg they are unlikely to sprout a new one...and so far there is no drug that cures HIV. The process requires a lot of time, visiting a lot of doctors, analyses etc. The only thing we don't have to handle is the documentation since the Oblast, AIDS Prevention Centre, helps with that; they prepare the documents for us and we just pick them up from the Centre." "In the autumn of 2002, 13 people from our county went to Ekaterinburg for medical examinations. We were given a car for the journey. After the car was returned it was washed for a week, scrubbed with bleach and so on. They probably thought that we had bled over all the seats." "People come from many regions to see the work at the "Chance" centre. Reports about it are very positive. They really appreciate the work undertaken by the centre. However, it's vital more young people come to the centre." "There is either no money or not enough for quality services, examination and treatment. For people with 2nd group disability the medical treatment and the medicines should be free. This doesn't happen in practice. " "People should get more information, so they're not so fearful. I don't know what's so frightening about HIV. Even doctors are afraid, although they treat us. People should be more enlightened. That's how it was with the plague and other epidemics - after some time everything calmed down, a medicine was found ... Now people are not afraid of the plague, they are afraid of AIDS. " "Many things are needed, like: free drugs; specialised and even free dentists; free medical examinations; more information about HIV/AIDS so that people are not afraid anymore and support groups where doctors can refer patients." "During my pregnancy, I found out that I was HIV positive. I was invited to a meeting with the medical team, about the question of terminating the pregnancy. The team was split: for and against the birth of my child. No one was interested in my own opinion and no one asked me what I was thinking. This put a lot of pressure on me, and it affected my decision." "Even though I live with my parents, they don't know about my diagnosis. Once I shouted at my mum when she wanted to help bandage the cut on my hand. " "Possible approaches to diagnosis disclosure include: telling only those you trust or saying nothing at all; using support groups or a hot-line; chatting online with people in the same position. If you do decide to tell someone, it's better to first sound them out about their attitude towards this issue." "There may be various resons why there is too little funding for services for HIV positive people: not enough people representing them; there are other priority areas for the money; weak economy; weak civil society; poor protection of rights and lack of relevant laws. Anyway, decision makers just don't have a clue about what life is really like for HIV positive people." "Using condoms is a problem for many people. A condom is a symbol of a restriction of freedom. Many who have found out their status decide not to have intimate relations at all. " "Thinking about medical problems, I remembered this situation: a pregnant girl came out of the consulting room before me. When I went in the doctors were still talking about her: "What therapy shall we apply? Why bother, it's pretty clear it would be pointless?" " "Negative attitudes from medical staff towards people who were infected by needles, and towards those who come seeking help on their behalf, are very common. Only 80 people a year can access treatment in Saint Petersburg. It's harder for former drug-users to become one of those 80." "Most participants don't have the opportunity to talk about their status with people who are close to them. As a result, during group meetings strong emotions can come out. I think the young people will be able to understand and support each other." "Our advice about sex to other young people who have learnt they are HIV positive: 'keep your head, don’t be anxious because everything will be OK. Not much has changed, but be careful and use protection!' " "It's better to tell your former partners about the possibility of infection. We prefer anonymously, for example a letter. Concealing your HIV status is an option only if you take all necessary precautions for not infecting your partener. However, it is better to tell! You should definitely tell, sooner or later it will all come out anyway." "I took my girlfriend to have a test, having told her that I had hepatitis. I introduced her to the situation, I didn't have sex with her (I told her that it was good for former drug users to have 'periods of sexual purity'). I introduced her to couples living with HIV... " "It was awful to be given my diagnosis over the phone without any preparation or counseling. The district polyclinic phoned up and, without asking who was on the line, announced the results of my test. My mother could have answered the phone and they would have broken my confidentiality... " "There are people who take revenge for having been infected. You can understand them, but it is not worth doing this. With each negative act, we waste our energy." "In principle nothing has changed. Take care not to infect others and to avoid becoming infected with other sexual transmitted infections. Get to know other HIV positive people and everything will be fine. " "No affairs with healthy people, you can infect them even if you take precautions. " "We haven't felt any pressure from doctors or social workers directly about our sexual relations, but we have heard from friends who are also living with HIV/AIDS that it exists. Some specialists think that HIV positive people should live only with HIV positive partners." "I don't think I would stay in the relationship if I found out that my partner was HIV positive. " "Even if you took all the right precautions, but still infected your partner, you would blame yourself. It's only natural. " "If your partner has already accepted your HIV positive diagnosis, he won't blame you if he becomes infected by accident. A non-infected person makes his own choice whether to live with an HIV positive partner or not. " "People fear disclosure of their status because society is badly informed and unprepared to deal with this issue. This is the main problem, all the others derive from it." "Yes, there is fear of losing your partner if you are open about your HIV status. This is a personal problem for any individual, whether to disclose your status or not. " "In many cases, family relationships suffer. This is because parents and society as a whole are poorly informed. Often, when someone tells their family that they're HIV positive, it puts a wall between themselves and their parents. I know of cases where people were given separate crockery. These day to day household problems result from a lack of information." "I don't want to be the cause of pain and suffering for my loved ones. Personally, I don't want to tell my mother about my status because I don't want to be the cause of yet more hardship. As it is, I've been the cause of so much pain, I don't want to make it worse." "If you tell someone about your HIV status and they react badly, you can end up cutting yourself off from everyone." "Dentists at the district polyclinic refuse to see me, even though they are not allowed to deny me treatment. " "When you go to the hospital, you have to sign a document agreeing to all tests. Legally, they are obliged to ask if you agree to having an HIV test. " "In the civilised world, which I'm not sure we're part of, when someone takes an HIV test a psychologist should work with them - even if the test proves to be negative. Moreover, the psychological consultation should take place both before and after the test results. Every psychological consultation should last for at least one hour. In this way everyone who has to go through this process will be better acquainted with the problems associated with HIV/AIDS, and they will hopefully be better informed." "The doctor called me in, held out a piece of paper and said, "Read this". This is how I was told about my diagnosis. " "I was told that I was infected on the telephone. Imagine how I felt? " "I was told at a consultation, "Girl, you've got AIDS". Can they be taught not to do this?" "I know that medical students come to the hospital independently. They are interested in HIV and ask the seropositive patients to tell them about themselves. " "I overheard a doctor saying "I don't like working in this hospital, with all these prostitutes coming here I'm afraid of being infected."" "I now understand that my rights have been infringed on several occasions. When I first visited my doctor at the AIDS centre, I went in with my mother. The doctor told my mother to "get out of here!". I told him I wanted her there, but he refused to see me if my Mother wouldn't leave. Later, I read that you can have any person you wish with you when seeing your doctor. " "When my boyfriend went to fill out the forms, to give blood for the HIV test, they asked him if, "Maybe she was joking when she said she was seropositive? Maybe she decided to test you!" " "For example, recently I was stopped by the police and they saw my HIV booklets. I believe they had a negative attitude towards me simply because I was preoccupied with this problem. If I had disclosed my status, their attitude would have been much worse. I know of instances when the judge, having learnt the HIV status of the person he was sentencing, has given a longer sentence as he believes that only drug addicts, prostitutes and homosexuals have HIV." "If you bring together all these factors you get discrimination as a result of lack of information. This is one of the main reasons why it is not worth disclosing your status! Society doesn't want to learn more. It doesn't concern them as long as their families are unaffected." "If I believed that my mother would accept my diagnosis I would definitely tell her. However, I am sure that she will only be anxious and worry about me." "I'm simply too ashamed to tell my mother about my HIV status. " "When you go to a medical centre; tattoo salon, beauty centre, dentist, it is best to disclose your HIV status. This is for the safety of yourself and the HIV negative clients. " "In medical institutions, you should be open and honest in order to make it safe for other people and to hopefully engender more consideration. However, this is not the case in our country! The doctor will write HIV in big letters on your file! It's better to say you have hepatitis. HIV can frighten them." "If you end up in a medical institution with a simple illness, for example a cold, it is worth disclosing your seropositive status as all illnesses behave differently if you are HIV positive. If you are going to the beautician, dentist or tattoo salon it is easier to say that you have hepatitis C, since the sterilisation issues are the same, but their attitude will be much better. " "It is better to tell them at the tattoo salon, as they are very careful about sterilising the equipment. There have been many cases of people from Chechnya being infected via tattoos. " "Let's do our own television programme! Journalists, even if they come with good intentions about getting to the truth, end up giving out false information. We need our own people in the media." "The band SPLIN, Zemfira, Magic Johnson, all of them are HIV positive. This information can influence society. However, they don't do anything about HIV. But the singer Mumiitrol does always wear an HIV ribbon, and he was at the international HIV/AIDS conference in Barcelona." "At Anichkov Palace, there was a 'Social Programmes' exhibition. All the materials that Panchenko had about AIDS were taken straight away and materials of other organisations were just left. People are actually very interested in HIV. Young people are particularly interested as almost every one of them has a friend or acquaintance that is directly affected by this problem. " "I am in touch online with a person who has been living with AIDS for over 3 years. He is taking treatment, but he is very worried about this as he can't drink. He has been given free treatment in Moscow. He takes a handful of pills at certain times and with certain foods. He can't eat too much of certain things. He is preparing me in this way." "There are loads of interesting people on the e-forum. One woman sends me journals, and the website helped me a lot. When I had only just found out about my diagnosis I was difficult to communicate with. I thought about HIV all the time, I dreamed about HIV and it made me irritable. www.aids.ru helped me a great deal!" "Workshops should be organised in schools and other academic institutions to inform young people about HIV/AIDS. The more people know, the less they'll fear HIV. It's easier to do this in academic institutions, as young people have to pay attention during lessons. It is also easier to work with young people." "A compulsory surveys could be conducted, in factories for example, for adults to find out their attitudes to the problem of HIV/AIDS. People often don't have any understanding of HIV. They find out about HIV and give you up for dead." "I spoke to the head doctor at the Clinic for Sexually Transmitted Infections, and he thinks that HIV is the same as AIDS. He doesn't see any point in treating it, as the patient will die anyway. You can't change the mind of a doctor with opinions like that." "People are frightened of what they don't know or understand. Also, if they've heard something, they often don't believe the information. The information they get about HIV/AIDS on television is always to do with prostitution and drug addiction." "In the whole national AIDS budget, there's 1 rouble per infected person per year for treatment." "I don't want to disclose my HIV status, as I'll always be worrying that it is the cause of people's changing attitudes towards me. If someone is in a bad mood I will automatically think it is because of my diagnosis. You limit yourself by trying to be safe for others. I know that HIV can't be passed on through day-to-day activities, but I still take extra care." "If I lived with my parents, I would tell them about my HIV status. But as we rarely see each other I don't see any point in telling them. " "I don't want pity. I'm not poor or unhappy. One needs understanding and sympathy, but not pity. " "Anyone seropositive and wanting to conceive a healthy child should get information - from doctors, psychologists, AIDS centres, friends, training events, brochures... I found out that HIV positive girls should conceive at a specific time, and get treatment throughout the pregnancy. This gives a high chance of giving birth to a healthy child. For men there is a way of cleaning the sperm. If I decided to have a child, I would have to look into it in depth and go to places where they have a good and informed attitude about my decision." "There is a treatment that is widely available in the West, for partners who become infected during child conception. If there is a threat of infection then a medicine has to be taken for 72 hours. It is effective, but it strongly undermines the immune system. It is not known how it affects the child if the future mother takes this treatment. Treatment is not advertised for people to continue using normal safety precautions. You can request a vaccination at Botkinskii Hospital, but they might not give it in time." "I don't want my child to have the same problems as I have. The way the child is brought up is the main thing. You have to treat your child as if they were healthy. A parent can suggest to the child that he/she is ill and the child will in fact become ill. In Holland they have even thought up 'empty' medicines. They rely on the power of suggestion. In an interview with the director of Ust-Izhor, about such children they said, "They are happy, full-living children who will outlive us." Science is taking what they call, 'seven-league steps'. I heard about a child who was born HIV positive and was already healthy by his 6th year." "When and how should we talk to children about their HIV status? We can see that a child can understand and take in this information between 10-14 years of age. It may be the case that the child has learned about their illness at the hospital, or read about it somewhere. The child should be told everything in detail, about the fact that there is such an illness and that there are people who don't understand because they don't know about HIV. Gradually, if you communicate with your child, they will understand. In any case the child will need to talk to a psychologist. It is necessary to create a comfortable environment for communication. During pregnancy and birth, HIV positive parents need to get to know other HIV positive parents. They can help each other and hopefully their children will become friends and get to know each other. For example, when my mother got to know other mothers of drug addicts, she began to understand the problems they faced. She started to ask questions and she was helped, given literature and now she knows as much about drug addiction as I do." "You have to be ready for your child to one day ask, "Mama, why did you give birth to me?" The child may scream at you, go mad and storm out. You need a psychologist, and it would be an advantage if he were HIV positive himself. Feelings of guilt appear when the child starts to have problems. You need to explain to the child. Say, for example, "Your father also has HIV". Perhaps you can embellish a little bit, "You are a special child", "It is not a punishment", perhaps. Maybe tell them that, "God gives trials and God gives strength." These phrases help to look at the situation from a different perspective. There is no room for guilt here." "Everyone understands higher forces in their own way. Many young people I've spoken to at meetings say their strength comes from being in a group. If others can live without drugs, then it means I can. I became a believer because I saw a vision of God." "I'll start feeling guilty when I have to restrict my child, for example in his choice of sport. I will feel guilty that thanks to me he won't become a good sportsman and travel the world like my brother can. I have an affinity for feeling guilty." "It's more like anxiety and disappointment, rather than a feeling of guilt over giving birth to your child, when you are seropositive. It's not possible to live with a feeling of guilt. With anxiety you can manage, you can find a justification. There are many children with disabilities on this earth, at least your child has two legs and two arms." "I will feel guilty if all three of you have children. However, even if they are HIV positive, I know everything will be alright. I don't want children because I am frightened at the thought they will also have to live with HIV." "I don't believe a cure for HIV will be invented, as it won't be profitable. We can only hope for a "mad professor", as it won't happen through the government. When HIV/AIDS starts to affect their own children, then they'll solve it." "We found it difficult to use the words 'discrimination' and 'social exclusion' in Russia. There are complex ideas behind these words that have become common currency in Western Europe, but these ideas are new territory for us. For the most part of the SEYPA project, during the preparatory phase of the project, youth coordinators, workers from NGOs/municipal services and the young people themselves, say that discrimination doesn't exist because people don't disclose their status and therefore aren't discriminated against. The mapping meetings, however, do reveal discrimination and the various forms that it takes in Russia." "One issue that emerged from the youth group formation phase was that over 95% of 'people living with HIV/AIDS' in Russia are in fact living with HIV, as the epidemic here began about 10 years later than in western Europe. A number of organisations drew our attention to this and pointed out that the issues for people living with HIV and people living with AIDS are very different. Russia is not yet dealing with the second category and certainly all the members of our groups are living with HIV rather than AIDS. At the moment this is still an open question for us in terms of the SEYPA project, and what we want to deal with this issue in the consultation phase. Perhaps we can have a discussion about this at the coordination meeting and/or at the youth conference. I think we will benefit greatly from talking to our Western European partners about this." "Medical staff are rude and abrupt when giving HIV test results. They tend not to respect confidentiality despite Russian laws protecting this. Doctors tend to be better informed and more sensitive about confidentiality issues than auxiliary or nursing staff." "Not all doctors are bad and the participants from Ekaterinburg, and St Petersburg, quoted some doctors by name that they thought were particularly good. Both groups commented on the lack of training/information that medical personnel have access to, whether they were doctors or auxiliary staff. They think it would be important to change the way that medical personnel are selected and trained. 'Casting is necessary for the medical staff' (i.e. there should be a careful and rigorous selection process that ensures medical staff exhibit all the necessary qualities for practising medicine)." "There's a gap between what the law says and the reality on the ground for things like: free medicines and treatment, confidentiality and other important issues in terms of health care. Medicines and services for HIV/AIDS infected people are chronically under-funded." "Support from family could significantly improve the lives of the young people. However, because of the ignorance of parents and the lack of help for those parents from NGOs, many young people conceal their status from them. Often, when they do disclose their status their family relationships are destroyed." "There is a lot of experience of working with parents of children who are drug users, particularly in St Petersburg. But this has not been translated into working with the parents of HIV positive young people." "Attitudes towards HIV positive people in Russian society are very cruel and there is an enormous lack of information and understanding, which has a very destructive impact on social, as well as family relationships. Even though the young people found many reasons for being open about their status, they think that in our country, society will not accept them and therefore it is foolish to disclose their status." "The young people understand that it is important to inform society and are ready to share information about their lives with journalists. But they will only do this if confidentiality can be guaranteed." "The consensus among most participants seems to be that concealing status is essential if HIV positive people are to secure jobs. If necessary, test results should be faked in order to ensure that employers and work colleagues don't learn about their HIV status. There are laws governing testing in work situations, but most participants have little faith in their effectiveness. It is easier to conceal your status from your employer in a large city. There is a law that restricts the spheres where people living with HIV/AIDS might work (medicine, education, etc). To apply for these positions one has to have all tests on infectious diseases and the results of these tests are written in a special certificate. People living with HIV/AIDS simply won't apply to such positions to prevent themselves from the necessity of presenting the certificate. They are afraid that the range of jobs where HIV positive people are not allowed to work will increase and thus, restrict the amount of places where they are allowed to work." "Most social/community based services for HIV positive people are linked to drug use. This means that many HIV positive young people who could use these services don't. They perceive these services to be for drug addicts. Many community services are based in medical hospitals, and although we see the advantages of this, there are disadvantages as well." "There was some discussion about schools, and the need to carry out prevention campaigns for children and young people to learn more about HIV was discussed. As with employment, the consensus seemed to be that a person's HIV status should be kept secret in further education establishments, in order to prevent discrimination and social exclusion." "When they talk about HIV, they should consider that someone infected may be in the class, and they may suffer because of the subject matter. When the day of a talk arrives, I feel scared and think 'let's see what they are going to say this time'." "Most brochures for HIV positive women, recommend they do not give birth to babies. Having a baby is a personal decision and it should not be influenced in this way. We need to be informed and given the whole picture with reasons for and against giving birth to a child. Another issue is that not all the 'official' information on HIV/AIDS is correct." "Doctors have no respect for HIV positive people; they don’t respect our rights. We don’t have therapy (only in Moscow patients receive therapy), good consultations and good doctors. We don't feel free to talk to the medical personnel." "If you are calling a health help line, their first question is "are you a drug user?". If you've got HIV, they assume you're a user. " "Changing attitudes in our communities take time. We have to work together to grow and nurture positive attitudes towards HIV: to change the hearts and minds of our families, schools, health services and communities." "Young people with HIV live with SECRETS and LABELS. Privacy is often abused. We need accurate information to get rid of the fears surrounding HIV. And we need the media to be on our side, to change hearts and minds and present positive images of young people's futures. Young people have an important role as peer educators and supporters, advocates and leaders, they can do something about the stereotypes and stigma." "Friends and families can experience discrimination too. We need to use young people as trainers and educators for health, education, social services, and their communities. We need young people to be involved in training for doctors and nurses to teach them to respect confidentiality, to be honest and positive about the future, and to support other services such as education. Young people could work with their local health services to agree the best way of giving practical and positive information about a future with HIV." "We must end discrimination in education. All young people go to school, but many schools are badly informed about HIV. Other students can bully and exclude young people living with HIV. Some schools exclude students with HIV... but they could educate their communities if they had access to better information." "Sometimes we decide against revealing our HIV status to friends because they might turn their back on us. Or they might pity us, and we'll be a burden to them. " "Why do we exist as a group? We have a common problem and we aim to make society understand that we are also people. We want to change the existing stereotypes of HIV infected people." "During my children's holidays, I had to pay babysitters, as the family couldn't always be present. There is a general lack of support. I don't want people to maintain me, but I need to have the means that allow me to have the most normal life possible." "People are different. I'm a 26 year old HIV positive person and I'm treated in the same way as a 45 year old man. " "Initially I'd only told my classmates of my diagnosis, and they had reacted very well. I felt some shame, showing explanations for my HIV status, stuff stamped by the infection clinic services. They protected me by advising me that it would be better not to say anything to my colleagues. When I decided to proceed with my studies, I talked with all my professors first. They reacted to my situation very well, as did some of my colleagues." "When I found out about my HIV status, I was at university. I had a good reaction from the few people who knew. A friend of mine accompanied me to take the test. She gave me support and we've always had a good relationship." "I can only express my happiness, realising that I've been able to achieve what seems to be a sustainable and enthusiastic core group. Maybe because I've realised that it's still possible to find "mature people" who believe in youth initiatives and also that these young people can lead, process and promote change." "We would like our parents to stop telling their friends and relatives about our medical status. All of us were surprised to find that some people already know about our HIV status. The parents' spread the news among their friends and now, their friends' children know and talk to everybody about this problem. Parents should be taught not to tell anyone before discussing the issue with their child. If the child is too young, their parents should keep the secret." "My mother never talked to me about my father's situation. She just told me to be careful with the blood and repeated several times not to tell anyone. She told a friend about my father's situation and it spread everywhere. I'm amazed people of my age still have this kind of attitude. The fact that I've had to live with this secret for so long makes it hard for me to tell anyone. My mother was especially afraid because eventually I would ask her 'how'?" "At the moment, there is some information about the conditions of infected patients, to be found in discriminatory envelopes. These envelopes contain signs, different colour markers or folds, which make its content known." "Despite the possible existence of a professional code of ethics from the doctors, the processes go from hand to hand (auxiliaries, administrative people, etc). " "I was sitting down, waiting for the admitting documents, and I see two nurses. They get a piece of paper and ask about the "HIV patient". The nurse who was beside me was talking in a loud voice about an infected woman who was, "possibly contaminating everybody". She added that she, "didn't know where she would put her", as she didn't want her to be near other patients." "They revealed my HIV status in front of everybody. I was... well, I normally react... I have now learned how to react... but, on that day, I was in a lot of pain. I had been losing blood all night. I was absolutely alone at the hospital, and emotionally I was really down. Everybody was staring at me." "Safety precautions, in terms of surgery and other medical procedures, are no excuse for failing to respect our confidentiality." "The doctor told me to go into her office and told me that I had to be admitted to hospital for some time. She then told me to sit in the corridor. Meanwhile, another patient arrived to be x-rayed and when she was called, the doctor began shouting: "Only come in here if you want to catch some very bad disease, this room is contaminated. We cannot use it until we take care of it!"" "123 " "If it is complicated to tell a friend about our HIV status, it's even worse doing it with somebody we hope to have a relationship with." "If the relationship is serious, we don't even think about telling or not telling. Truthfulness underlies the relationship. We only need to know when is the best moment to do it...? " "My family doesn't know about my HIV status, I don't think it's the right time to tell. When there were cases on TV or in newspapers, they did not show themselves to be prejudiced. But if it were in their home it could be very different! When I think it is the right time, I will do it... I would prefer them to find out from me." "My mother did not speak to me directly about my father's situation. She would only tell me to be careful with the blood and asked me not to tell anyone. " "Sometimes, I have had to stop my mother from talking in front of the hospital staff about my treatment and symptoms as other HIV infected teenagers, who don't know their diagnosis, have been around. " "The increase in the number of infected women may be a potential indicator of their husband's infidelity. People don't share their (HIV) status. Most of them fear losing the one they care about. Usually, that moment is viewed as the moment of truth. The person either accepts (the HIV positive status of their partner) or disappears." "Our parents make important financial and personal sacrifices to provide us with appropriate living conditions. Our mothers have left their jobs in order to take care of us. This seriously affects the family's financial situation and has consequences for the other family members. But nobody complains about it. It wouldn't be a problem if both our parents had jobs. It's moral support we need." "There is better quality of life compared with past years. But many medicines do not give us quality of life! " "A patient was taking medication and not eating, no-one told him otherwise. The same patient didn't get any information about the common side effects of the medication, and the best way to cope with these. He stopped taking his drugs because he was scared of these side effects (cold sweats, for example). He only went back onto his treatement when he got a proper explanation from someone who had been through the same thing and could explain how to deal with it." "The physicians don't discuss our illness with us. Most of them ask us to wait outside and while they discuss it with our parents. This is not fair, we know our diagnosis and we accept it. " "The doctors don't have time, don't explain and don't ease our doubts about medication and so on. Most of the time if the patient doesn't ask, the doctor won't say anything. These failings seriously undermine adherence and can result in drug resistance." "We are doing what we are supposed to do: informing those who can do something about it. But it seems like no one respects our rights. It is not only the doctors: it is the whole hospital (nurses and administrative staff) that get to know information about our lives." "The nurses don't respect our confidentiality. They talk about AIDS in front of children and teenagers who don't yet know their diagnosis. They give out information on their patients to any curious mother or neighbour." "Many physicians blame the parents for the medical condition of their children. They shout and treat them like they were criminals. They keep the parents waiting at the surgery door for hours and are always in a hurry. These negative attitudes are a very strong form of discrimination. If our diagnosis were different, the physicians would have adopted a different attitude towards our parents. It is the same as our parents losing their jobs because their child is HIV positive." "Older medical professionals don't appear to know too much about HIV/AIDS. There should be a law to force the older medical professionals to attend courses on HIV/AIDS. " "My ex-boyfriend did not want to protect himself, but I always made him. He used to say it was for love, but whenever he got worried he used to blame me. He got convinced that I had contaminated him, until he took the test." "The local clinics do not communicate with the centre in Bucharest and they don't agree when changing the therapy (of patients). There were many situations when we received a new therapy when coming to the hospital in Bucharest and the medical staff from the local clinic reverted to the old therapy." "The poverty in all our hospitals is terrible. Everywhere we are faced with a lack of medical supplies as well as delays in medical tests." "In all our specialized clinics and departments the word 'AIDS' is written on everything (the towels, the blankets, the plates, the beds). " "The medical staff don't wear gloves and masks with everyone. They are really worried and show so much prejudice towards us. They shouldn't only protect themselves against HIV positive patients. People will only know my seropositive status if I tell them. By just looking at me they wouldn't know. They are waiting for some "seropositive look" and they are, in reality, waiting for a patient with a series of secondary signs. Doctors should be as careful when they operate on a seropositive person as when it's any other patient. If they are worried, they should start protecting themselves against everything, behaving the same way in relation to everybody." "We're treated really badly by auxiliary staff. They've never got a blanket for an HIV infected person. They expect a bigger tip than from other patients, and HIV patients are always the last one to get food or something they need. What's more, auxiliary staff barely talk to HIV patients, yet they find time to tell everyone else about their diagnosis." "When we go into hospital, we notice that the doctors don't wear gloves or masks. " "A short time ago, I was in a situation that contributed to me losing my self-esteem. I was taken to hospital suffering from a uterus infection, and I was losing blood. A doctor saw me and the first thing I told him was what was and wasn't going on with me...my HIV status. He treated me very well. I had a medical, to check what was happening with me. Then there was a shift in attitude. I had an x-ray and when I was leaving the room the doctor said 'close that door immediately because this room is contaminated!' in front of everybody." "In Bucharest, we enter the day clinic through the room where all the files are kept. It is scary to look at those shelves full of huge files with covers that read "Deaths 2002" "HIV August 2003" and "AIDS 2002". We feel very uncomfortable seeing the archives of people who have died of AIDS. We realise that all those files contain thousands of names of people suffering from HIV/AIDS. We suggest simply hiding the shelves: to move them into a room where the patients have no access, to buy special shelves that can be closed so that nobody can see what is written on the files, or to change the labels by using a specific code or colour so as not to be so obvious to the young people." "In our day clinics, they only have posters about HIV/AIDS on the walls. This makes it impossible for a child (who does not know their diagnosis) not to start thinking about AIDS. These posters should be combined with posters referring to other diseases too. Another suggestion is to post more HIV/AIDS posters in other areas of the hospital, for more people to see the information and warnings. At the specialized day clinics, the patients either know their diagnosis and are well informed about HIV/AIDS, in which case the posters only remind them about their illness, or the patients don't know their diagnosis and wonder why the posters are only put there and not in other parts of the hospital." "The auxiliary staff are hysterical. When they see us walking around the hospital, they act like we're hungry monsters." "So, I thought that it wasn't there that I wanted to be (with that group of medical professionals). I left the hospital, stayed home and my condition got worse. My actions had huge negative consequences." "The resistance is poorly commented on or explained. It is possible for the seropositive patient themselves to be an information source for the doctors. They can help them to understand better the problems faced by seropositive people and to see the other side, which, for different reasons, seems not to be reached." "I've never seen a project like this. A lot of things have already been done; studies research, etc. but nothing like this. " "A lot of taboos still exist. I wasn't able to talk about it when I lived with an infected person. I've lived through a very complicated phase. " "This project is very important. At the moment, nothing like this exists in this area. From these project recommendations it will be possible to spread new ideas and promote growth in different fields. " "I’m happy because I’ve been able to achieve what seems to be a sustainable and enthusiastic core group. Maybe this is because it’s still possible to find adults that believe in youth initiatives and believe that these initiatives can lead, process and promote change." "My mother still doesn't accept my HIV status. The separation of cutlery and clothes has stopped, but there is still some resistance." "I think young people have a lot of fear and a lack of respect. But when they go out at night, it's risky of them to choose a sexual partner based on physical appearance alone." "Today, most young people use condoms to prevent pregnancy rather than an STD. There is still the idea that condoms take away pleasure." "I try to pass on everything I have learnt to my brothers. They have learnt from my mistakes." "What I pay to rent a house, could easily buy one. " "We know that no mother wants to get pregnant (and to have a baby) when she's in a terminal state of her life. What happens is that although there are technicians and doctors available who are experts in high-risk consultations and therapy, these doctors make access to an abortion very difficult (even when this is the mother's choice). The option to abort is a result of doctor's decisions instead of the mothers. This situation leads to clandestine searches for abortion places, which are increasing and putting the lives of these mothers at risk. This is also generating a global concern about the future of children who are born not knowing how long they will be able to live with their mothers. Who will be there to take care of these children when their mother's health no longer allows her to provide the care and treatment they need?" "The age at which diagnosis takes place is an important factor affecting your employment. " "Some enterprises strongly discriminate through compulsory HIV/AIDS tests for all employees. This is clearly discriminatory behaviour because of the irrelevance of a person's HIV/AIDS status for most jobs. There is no control over this situation as tests are made before the person gets the job or without the person's knowledge." "The protection of an HIV positive patient's privacy is the responsibility of everyone working within the health services. " "The impact that diagnosis disclosure has on each person depends on the life phase in which it occurs. It is completely different when diagnosed occurs during childhood, compared with during adolescence or adult life." "A lot of secrecy and fear [of reavealing the diagnosis] still exists within the workplace. " "People insist on primary prevention. This help could be published for seropositive people as well. Help centres are located only in big cities and even then, they are poorly advertised. Medicines are not given and patients have to pay for them." "There is no specific information service about HIV/AIDS treatment. There should be someone who has good communication skills available to simplify, explain and quash false beliefs and perceptions. " "A seropositive patient's state of health, can often lead to an increase in absenteeism from work, which can in turn bring financial instability. " "There are services, like the ones at the anonymous HIV testing centres, where the services offered are quality ones. There is psychological counselling available both pre and post HIV test and everything is done anonymously, confidentially and free of charge. These and other similar services (such as the CAD's) should be publicised more widely." "A Resources Guide could be really useful. Such a guide should contain information about social answers and the necessary steps to help solve social problems. In many cases, the person [affected by HIV/AIDS] doesn't even know where to go or how to reach places." "Telephone Help Lines (in relation to HIV/AIDS) could be more effective and/or give information about other questions in this area. " "There's a need for a structure that provides training on HIV/AIDS for teachers. Real training in this area doesn't exist. Most teachers do not know how to deal with issues surrounding HIV/AIDS, and this results in a lack of answers. This situation might be improved by training teachers in public health topics, not only in HIV/AIDS." "After a bad experience with an association, infected people tend to withdraw and give up looking for help from other non-governmental organizations. " "Portuguese people have a less positive attitude towards diversity; even the younger population. However, in Germany, for example, there is a different mentality. In Germany there is work being developed that is only starting now in Portugal." "The level of communication of values and concepts seems to have become lower." "The national culture may be a factor that explains the existence of discriminating behaviour in different fields, not only in the field of HIV/AIDS. " "Young people still discriminate against their infected peers. They know what HIV/AIDS is and they know the main ways of transmission, but they still have a stereotype of what it means to be HIV positive. They discriminate because they are afraid." "A person who has to retire because of HIV gets approximately €175. Instead of this, a seropositive person should be encouraged to work. " "In the case of death (of a person with HIV/AIDS who has taken out a loan), the bank would have to repossess the family home. They try to prevent this situation by refusing to give loans to seropositive people. " "It's a vicious circle: Banks do not authorize loans to seropositive people and the insurance companies refuse to do business with someone who knows he's going to die. " "Nobody will grant a loan over € 65 000 to a seropositive person. This is because, up to this amount, it's not necessary to have medicals. " "There could be a fund to which everyone would contribute. This fund would pay for possible losses incurred by the insurance companies. It could be maintained by the State, or we could appeal to companies´ sense of social responsibility. " "I was discriminated against within my own family: mother, sister and brother, they all stopped talking to me. My mother still does not accept my (seropositive) status. Initially, I hid my diagnosis; my family only got to know of it later due to hospitalisations." "I told my two brothers about my diagnosis. They were 14 and 16 at the time. I needed support, and someone to help my grandmother. When I told my grandmother, I thought she would not understand what it was, but I was mistaken! I started to live with my mother. She still does not accept my diagnosis, she doesn't participate and won't visit me in hospital. Nowadays, my sister is my best friend. My brothers keep themselves informed about the disease, but one of them did take 3 years to accept it!" "When we face social exclusion, our thoughts and feelings are: fear, (of abuse, of not being free, of being discriminated against), denial, anxiety, and sadness. " "We feel discriminated against inside the family when we encounter: over protection within the family, isolation, a lack of relationship opportunities with our peers, fear of HIV transmission and a general lack of knowledge about HIV (inside and outside the family)." "Social exclusion could be reduced in schools if teachers were to organise training sessions about HIV. Small groups could be addressed inside classrooms by professional experts and experienced people invited by the school." "We need to share our HIV experiences, with friends who have similar experiences and difficulties. " "It is important to build relationships apart from telling friends about HIV. " "HIV disclosure to a partner is confidential and always takes place after a trusting relationship has evolved. " "HIV disclosure to a partner implies a serious relationship. It's important that the partner is aware and has the right information. It's also crucial to carefully plan the right time and place to tell your partner." "When someone decides to disclose his or her HIV status, there is always the fear of being abandoned. " "Our HIV status is very often kept secret from our local community. This is because of a lack of knowledge and understanding (about HIV). " "A persons HIV status is often kept secret because of the lack of information within society about HIV and AIDS. People need to know our legal rights. " "We need to receive more attention from the medical staff and time needs to be taken to talk and listen to HIV infected people. We should receive better explanations regarding the reasons behind why we need to take pills. " "Health services should give more consideration to our need for privacy. " "Leisure activities are often missing from our lives because of our HIV 'secret'. This is because of our need to take pills to a scheduled timetable, visit medical services, miss school because of frequent sickness, etc." "It is hard to keep our HIV status secret, as we have to take pills, attend medical appointments and have a high absence from school because of frequent sickness." "Although sport is important, not all sports are OK for us. We tend to skip sports classes because of possible accidents and because of other people's fears about transmission." "Keeping a job's not easy for us and can be harder when nobody from work knows our HIV status. Sometimes, we fear losing our jobs because of frequent sick leave and medical appointments - we also need to take pills regularly while not being observed. Everything would be easier if employers knew our legal rights." "Social services should create conditions where young people living with HIV can know and understand their situation better. They need access to information about specific topics (for instance sexual relationships) and they should be able to share their experiences with other young people to increase their self-esteem. They should feel strong and secure and understand their illness better. Here are some examples: to increase meetings with other young people to share experience and feelings like the ones done in the mapping process; to promote group meetings with other young people living with HIV. Inviting some experts to explain specific topics." "[In the emergency room] I do not know if they will understand the fact of I'm HIV infected, then I do not I say it. They ask me if I take some medication, why, for what, and they insist. Once it happened to me that I said that I am HIV infected and they answered me "Wait a moment, I'll seek a physician who understands about HIV"." "When I think of HIV, I ask myself 'why me?'. " "Being HIV positive means I have to struggle against society. " "I would like to be healthy because I'm tired of taking drugs. " "I fear being discriminated against and being isolated by others. " "For me, the colour red means death, but it can also mean strength, to go on. " "Feeling bad because we always have to pay attention to the others. " "I hope they will discover new things about the virus. " "HIV makes me think of the death of loved ones and also my own death. " "Actually, those people who don't know about HIV are the ones who are prejudiced. " "There is a bond between infected people: they have things in common that others cannot understand. " "We underline the important role of the family regarding the social exclusion (of HIV positive people) because it is the first environment of development. Often, over-protection increases the feeling of being different from others, even if this behaviour is comprehensible considering the risks related to HIV 15-20 years ago." "Many parents are over protective because they are scared about HIV. " "There was more risk of death in the past. " "Because of over-protectiveness in the family, we put off having relationships with our peers. " "Because of our HIV, we feel there's a gap between our childhood and adolescence, like we missed something. " "Over-protectiveness from our parents only reduces our chances of forming relationships with others when we are children. " "Social exclusion may increase as children grow up. A lack of contact with their peers in childhood makes it more difficult to initiate new relationships later. Also, families can feel more fearful as more occasions for establishing relationships occur and their possibility of control diminishes." "Diagnosis disclosure is an important moment, as knowing what we have from childhood helps us manage our disease in a responsible way. This can also help parents to trust us more." "There are things we can do to help the parents of HIV infected people overcome the barriers of diagnosis disclosure: we can help parents be more confident in their role, ask for confidence in our ability to manage our disease, testify to our experiences of disclosure (and what follows) to make parents think about the diagnosis disclosure process, give support to the parents at the moment of disclosure and improve the dialog between parents and children to make sure that the children are listened to." "By talking with us like this about our illness, the parents could see that they can worry about HIV more than we do ourselves, which was a relief to them." "We feel many emotions when talking about our experiences of HIV and it's implications for our lives. During the discussions with the parents we felt secure and hopeful, but also embarrassed, angry and hurt. Knowing all this, we want to help other parents to communicate with their children and to talk to them about disclosing their HIV positive status." "We want to show and tell people that our lives are the same as any other young persons life. " "I want to be seen as normal instead of an ill person. " "We must understand young people’s fears and prejudices and their misconceptions about HIV positive young people. " "In order to be accepted and understood, we have to give specific and scientific information on the HIV infection and what is risk/not risk behaviour. " "We, as HIV positive young people, have the same relationships as everybody else because we are just like them. " "It is important to be seen as we are, in order to be accepted. " "The meetings with the families enriched communication within those families. It stimulated the "thinking" towards the needs of their HIV infected children by promoting more empathy and constant listening." "The education in the community (the peer education model) shows other young people that HIV young people are different to what they expect. " "My experience with my family regarding HIV has always been very good; they have always been on my side, I have never felt any kind of rejection and everybody has always been there for me." "While my family knows everything, I don't think my distant relatives know much. They have guessed something is wrong because they can see I'm on a lot of medication, and they know my mother was not very well. However, it's better for me that only close relatives, who love and care for me, know everything." "I've spoken with my father a lot on this topic and since I changed my hospital, we go together to the doctor. We help each other to manage the treatment and we support each other. As we do not live together, we phone each other and ask whether we have taken the pills. When we go to the hospital, we are in the same doctor's office and this is very beneficial." "As for me, there were two parties. One of my grandmothers has always been in agreement with the medication I am prescribed and the other not. One of my grandmothers is a naturalist and when I was younger and living with her, she disagreed with the medication. Anyway, they have both cared for me very well." "For me, now it's O.K. But some time ago I was having problems taking my medication and my grandmother helped me. There was a certain medicine that every time I took it I was vomiting and when nobody was looking I threw it away. My grandmother thought that I was taking it, when she found out I wasn't, she sat with me and made me try to take it with different things, lemon juice, etc. One day, I went to Port Aventura, but I had no medication. There, I was given the same treatment but in pill form; now I only take pills. My physician had never given me pills because he thought that I wasn't able to swallow them. Now I take the treatment without any problems. I have no other problems with my medication." "With my family, everything is normal; they have always helped me with everything. I'm the only HIV infected person in my family. My father and my aunt are not (seropositive)." "I can't understand why people believe that it just involves taking a couple of pills and that's all. I can't blame them because I understand they think it is really easy; but they don't have to do it. I would like to see if they would be able to swallow so many pills every twelve hours, along with going to the medical office and everything else. It is much more than just taking pills. I have to go to the medical office and see people that are worse that me. You end up asking yourself; will I end up like that?" "I am very content with my situation. I have two physicians who visit me and I love them both. What I find appalling in my hospital is the pharmacy service: you have to wait so long. When they do serve you, they pass your medication over the table in a transparent bag. That seems disrespectful to me because HIV medication is recognisable from being on TV all the time." "I dislike the fact that some members of the specialist medical press demand too much of us. " "The problem was that my hospital was 40km from home. I would waste the whole day getting there. Everything's quicker now because my new hospital is nearer home. Also, it's an adults' hospital so I get treated with them, and it specialises in HIV." "When I am given my medication in front of nurses who don't know me, they look at me as if they could get infected despite being aware. " "As the pharmacy gives me my medication in a transparent bag, I take my backpack with me and pop it straight in there." "Previously I would see a general paediatrician, but now I go to paediatrician specialising in HIV. With him, things are O.K. He insists I take my medication and I tell him when I have taken it. However, sometimes I'm not very well and this can make him suspect that I'm not taking it." "I know that when my doctor gives me a hard time about my medication, it's for my own good. But there are ways and there are ways...It's the same with the food, I do actually realise that I don't have a balanced diet." "My physician spoke to me nastily about my medication, the drugs and the alcohol... So, I decided not to talk to him about this stuff at all. " "My family found out about both my infection and my mother's togther, when we were taken to the hospital. " "I can feel the discrimination in the public waiting room at the hospital, as when people realise that I am there to see my HIV physician, they look at me strangely. " "They don't even let me eat with the other children. " "The professionals that come to talk give out incorrect information. They inaccurately explain transmission, and also say that it causes death - as if there were no other options." "In a public swimming pool I saw a sign saying, 'No Entry For People with AIDS'. " "I had access to employment. I don't think I was discriminated against because I didn't tell anyone about my being HIV positive." "Teachers and those who lecture must inform themselves before talking about this subject; they must have accurate and correct information. Often those who come to talk are not prepared and this does not help us. " "They should not say 'AIDS' when they mean 'HIV', and they should never say 'you will die'. Many of us hear these assertions about the direct association between HIV and death!" "Sexual health education in schools is fundamental. The work done at the moment in Portugal needs to be improved. We want sexual education without moral issues" "Society needs much more information. " "You do not have access to certain types of teaching if you have HIV. " "There is no psychological help specific to HIV at the hospitals, or at the Primary Attention Health Centres. " "There are no sex advisory services specifically for HIV. I would like to be advised about what sexual relations I can have. " "We need more colour in our hospitals. " "We need medical specialists who can understand the problems faced by adolescents. Paediatricians do not always understand what is going on with us. We can't talk about drugs and alcohol with them; they just scold us and that is not what we need." "We need coloured rooms that are fun, decorated by people of our own age. " "HIV must not be an impediment to having sexual relationships. " "We need more information than other (non seropositive) people, because sometimes we may not be sure whether we are at risk of transmitting the virus or not. " "You shouldn't be educated differently just because you have HIV. " " My family has never told me anything about HIV. Surely, if you talk about it, you will be able to control it a little bit more. " "They should inform people about relationships and risks relating to HIV. " "Do not explain HIV to everybody in the same way. Use a different approach when you explain it to your grandmother, your cousins, your uncles, etc. The age of the person is very important. " "You must speak to somebody you believe to be reliable and trustworthy; you shouldn't keep it locked up inside. " "Now I have turned 18, I have moved to an adult hospital that has a specific HIV clinic. This means I can go to the same clinic as my father (as we are both adults)." "At home I need a regular timetable run by adults. This enables me to follow my medication timetable. " "I think it is right that they respect my decision about when and to whom I want to disclose my HIV status. " "I don't think it's right, but sometimes I feel like I don't belong to my family; like I'm an outsider because of my HIV status. " "They press me to talk about my HIV with someone I don't want to, like my father's partner. " "Professionals should not treat us badly just because we are young. " "They shouldn't keep track of time so strictly; they should give more time to the patient. " "I need more warmth from health professionals when they are dealing with me. " "I need more solidarity when it comes to the problems I may face, as not all the professionals understand the issue. " "I think it is right that we should have free access to medication." "We would like our age to be closer to that of our specialists, so then they might treat us with more familiarity. " "It is wrong that we have to wait so long for attention in our hospitals. " "Pharmacy bags are not discreet. They're transparent, so you can see the medication inside. People around me can find out about my HIV status. " "Outside HIV professionals treat us unfairly. They are untimely, stroppy and they lack warmth. " "It is not right that they talk to children as if they were adults. " "I don't like it when professionals ignore me; they talk about me with other adults when I am there. " "I need accurate information about HIV. " "I need the teachers and the school directors to know my situation and to take it into account in case of any emergency. " "I need respect for my privacy." "In difficult times we need somebody to count on. " "It's when we grow up that we will need more support. " "It's right to talk about sexuality and sexually transmitted diseases in elementary schools. " "I think it's wrong there's a difference between teachers in primary schools and the ones in secondary schools. I have more confidence in the teachers in primary education. " "I think it's right they consider my opinion and don't plan social actions without consulting me. " "I think it is wrong that they sometimes use a prize/punishment method to ensure that you take care of yourself. " "I think it helps to give clear and accurate information in the media. " "I think that sharing my experiences with other young people affected by HIV helps me. " "The work of the HIV associations and the conferences help the people affected by HIV and AIDS. " "It doesn't help at all when people affected by HIV and AIDS are labelled as being junkies, prostitutes or homosexuals. " "Ignoring the fact that the groups at risk actually include everyone is a dangerous attitude. " "I don't like it when adults, either parents or teachers, propagate the idea that HIV makes someone different and separates people rather than uniting them. " "I think the media makes a big deal about HIV and AIDS and portrays it in a very negative way. " "Being HIV positive doesn't mean that I don't need serious relationships, a family and children. " "I think it is very difficult to make people understand how a seropositive person feels and what it is like for them being seropositive. " "I have met individuals who, even though they are well informed about HIV, don't care about HIV positive people. " "Working, when you are HIV positive is definitely an option in our country, as long as secrecy about our HIV status is maintained. " "We need community and social carers to support us more often than once a year. If they don't, we will resolve nothing. " "We take the risk of speaking about our HIV status, because by doing so we can help thousands of other infected young people." "Parents exaggerate our situation a lot. They cry or don't want to speak about HIV and AIDS. They are over-protective, dishonest and they lie about our diagnosis. " "The neighbours shout "you've got AIDS", as if we should be ashamed or feel guilty about our HIV status. " "My classmates don't know anything about HIV and AIDS. But they pretend to know everything and refuse to talk seriously about it. They don't make the distinction between HIV and AIDS and never think about the possibility of discussing it with an infected person. They say they could never be friends with, or even touch such a person." "Most of our teachers ignore the subject of HIV and AIDS completely. " "Most medical professionals do not know about HIV and AIDS and they don't bother to learn about it. " "When you enter an infectious diseases hospital, there is "AIDS" posted on every wall. They should take off all those stupid AIDS labels that are on everything: towels, cloths, plates and furniture. " "We don't want to be so brutally reminded about our diagnosis. " "When I was in hospital, I had to eat from a plate with a label saying AIDS stuck on it. I felt like that plate was shouting at me, just like the neighbours on the street. " "We should protect the other young people living with AIDS, as our talking too much might impact badly upon them. " "We are aware that not all of the young people know their diagnosis and not all of them want to talk about it. " "My daughter has no plans for the holiday, as she has never been to Bucharest before. She is very excited about meeting the other children. " "Our teenage children want to have babies, and they want to discuss it as they hope that a cure or vaccination will be found. " "My daughter used to talk about babies: how many she wanted and what she wanted to call them. After she found out about her diagnosis she suddenly stopped. Now, she has heard about the MTCT program and she has started to make plans again." "My boy came back (from the camp) completely changed. He is now more open, more relaxed and he has made a friend who lives in Constanta. They talk on the phone and they plan to visit each other. " "No child will be exposed in any way during the project unless he/she so chooses. " "There is a need for information within schools and the community, as young people are not yet prepared to openly speak up (about their HIV status). " "The previous meeting changed me a lot. It made me think seriously about my situation and myself and helped me to understand my friends' points of view. Since our last meeting, I have discussed my diagnosis with four of my friends." "We are like a very dark cloud with a pink surface. We have to pretend that we are happy all the time and that the HIV infection doesn't influence our everyday lives." "We have to pretend that we are always happy and well, as a small headache can make our families think the worst. " "We have to keep our diagnosis confidential, which can involve telling lots of lies about our frequent visits to the hospital. " "The dark cloud with the pink surface is our perspective on the HIV infection: it is inside our body, but it allows us to look like any other happy teenager. " "We believe that the SEYPA project must lead to the reducing of the dark part of the cloud and provide more space for the pink part, which should not only be on the surface. " "We want to be consulted on the intermediary version of the toolkits for families, children and educators. We are not particularly interested in the courses for medical professionals." "I want my friends to spend time with me, not because I am HIV positive, but because they like me as a person. " "We filter most of our friends' attitudes and behaviours through the belief that everything can be justified by our HIV status. We always think that our friends' acts and words have something to do with our HIV status. We believe that if someone offers us a piece of chocolate it will be because of our HIV status. In many cases, the social exclusion and the discriminatory behaviour, is actually in our own minds." "I feel very embarrassed when my friends are overprotective. " "We don't want people asking us how are we feeling, if we are cold, if we need something more than the rest of the group and so on." "The friends I told about my diagnosis reacted surprisingly well. None of them ran away and none of them did anything bad to me. " "We received a lot of support from our friends because we were able to explain clearly to them what it means to be HIV positive and how transmission can be prevented. " "I was almost fainting from nervousness when I told her what was wrong with me; but she just kept asking me to pass her a sandwich. " "We've seen how the news can shock our friends. However, their natural reactions were better than we had expected, and we felt very good about having had the courage to speak up. " "I tested my best friend for two years before telling her about my diagnosis. " "All our friends should be tested before any honest discussion about our diagnosis. Most of the tests refer to the general attitude towards the HIV/AIDS infection, the level of knowledge and the openness towards discussing the subject." "I will only talk about my diagnosis with my best, long-term friends. " "I see no point in discussing the diagnosis with my friends. It is very possible that after time they will no longer be my friends and the trust I put in them will be turned against me." "I have a girlfriend who is also HIV positive and I think that we support each other very well without involving other friends. " "I think that in general, our medical status is something very private and should not be discussed with anyone outside the family, apart from the medical professionals. " "I really don't feel the need to tell my friends anything. " "We feel like screaming out loud that we are HIV positive. It is very difficult for us to lie repeatedly about our frequent visits to hospital, or to think three times before saying something for fear of disclosing our HIV status." "I don't have any good friends, so I don't trust anyone of my age. " "I really feel the need to discuss my HIV with someone of my own age who is not infected, but I don't trust anyone. I am so afraid that people may find out about my HIV status that I keep a "safe" distance from my friends. I am afraid that, after some time, even my best friends could let anyone in the neighbourhood know about my HIV status." "Sometimes, I feel like I want to stand up in front of all my friends and shout out loud that I am HIV positive. " "For us, doing our best to hide our medical status and telling lies to our friends is a form of social exclusion. " "We prefer not to talk about this subject with our friends. We believe there is no point in giving up our confidentiality since it doesn't improve our medical condition. " "It is better if our friends find out about our HIV status from ourselves rather than from other people. However, we think that people who know about our HIV status should be limited to close friends and family. " "The friend I could trust would be very open-minded, understanding and patient. They would also be capable of "keeping their mouth shut". They shouldn't know too much about HIV/AIDS, but must be patient and willing to let the HIV infected friend inform them." "We are aware that other people are both scared and curious about (what it is like) living with HIV and AIDS. We are also aware that they can understand the feelings of their friends when they talk about HIV and AIDS. " "The "trusted friend" could be a long-time friend, boy or girl, of a similar age. " "Before telling someone about our HIV status, we test and prepare our friends for the big news. " "Before I consider telling someone about my HIV status, I try to figure out their likely reaction. I usually start a general discussion about AIDS, asking questions and making the friend express their opinions on people living with HIV and AIDS. I avoid questions like, "What would you do if you find out that one of your best friends is HIV positive?" for fear of arousing suspicion. More often, I talk about cases that have been in the newspapers - like "a few days ago I read in the newspaper about a teenager who had AIDS" or "I heard some people talking about an HIV positive person"." "We try to be honest with our friends. We understand that people are curious and scared about HIV and must be informed. We don't mind about our friends' lack of information. The ignorance and the self-sufficiency bother a lot. " "After testing our friends, we start to inform them on how it is to live with the HIV infection. We spend a lot of time explaining transmission and common prevention methods. The information is delivered in phrases such as, "I read in a brochure, or on a flyer that you can contract HIV through..., In the biology manual it says that you can't get HIV infected if...". We never argue if the friends continue to believe in stereotypes. We just inform. We choose those friends who are receptive to the information to be told about our HIV status." "When I decide to talk to my friends about my HIV status, I make sure that I have time for a long discussion. I must be alone and there must be no possibility of being interrupted by anybody. It is important to create the conditions for the friend to run away if he/she feels like doing so. Usually, the discussion goes like this: "I have to tell you something very important and I don't know what your reaction will be, so please don't ask anything, just sit down as you will need to be. Don't try to guess, because you never will! Well, I am HIV positive!" I don't use any other introduction. Then, I will have to answer thousands of questions. " "I was telling her that I was HIV positive and she was asking me to give her a pancake. I told her that I was not joking and she said: "so what? Am I in danger somehow? Shouldn't I eat the pancake?" After that, thousands of questions came out, but the most difficult moment had been overcome." "I was telling her that I was HIV positive and I was crying, but she was laughing like she has just heard the best joke in months. She wouldn't believe me. She said that I didn't look like someone living with AIDS and that she wouldn't believe it. She saw I was crying and stopped laughing. Than she asked me how she could prevent herself from becoming infected too. From that point on, the discussion went well and the thousands of questions were answered one by one." "We could have friends without telling them about the HIV infection. Our social life would continue. Only it is important to say the same thing to everybody. When people are curious about the repeated visits to hospital, or about the pills that must be taken at a certain time, we must have a good explanation and must be consistent in offering the same explanations because people may confer." "We are not going to avoid loving relationships because of our HIV status. We are aware of the risks and the responsibilities we have in such a relationship. The best solution is to have a boyfriend or girlfriend who is also HIV positive. This would avoid lots of trouble and uncomfortable discussions. This is the only situation where nobody will make a big issue out of our medical status." "Having a boyfriend or girlfriend who is not HIV positive, is really difficult. By hiding my HIV status from my girlfriend I feel I'm not putting trust in her. But it's very difficult to talk to her about it in the first place." "I think I should tell my boyfriend about my HIV status, but not on our first date. " " I would talk about it (my HIV) only if it comes to discussing marriage. I would be taking a lot of risks speaking about my HIV status. When it comes to misunderstandings the girlfriend could blackmail me and I would be afraid to end the relationship for fear of her no longer keeping it secret. " "Our families' are very supportive. " "Our foster parents have always known we're HIV positive. They were informed and they accepted the situation. Our biggest problem is the total lack of freedom. We're not allowed out of the house without our parents, we don't go to normal school, and we have no social life. " "Parents are more scarred than we are about the evolution of the infection. " "We have learned to live with the HIV infection, but our parents don't take it as well. While the mothers are more positive, in their thinking and their acceptance of the facts in spite of their obvious suffering, the fathers are completely scared. In most cases they refuse to even say the words HIV and AIDS. " "For every single spot on the skin, the parents panic and start running through the house calling for the medical professionals. They read all sorts of magazines for paranoids and make a disaster out of nothing. In most cases, the spot disappears before the alarmed mother can find an appropriate treatment. This attitude makes us feel very uncomfortable and scares us as well. " "Parents, especially mothers, develop strange habits. Most of them collect medicines. Each of us has in his or her room, a shelf full of medicines we have never needed. Some of them expired a long time ago, but they are still there. Apart from collecting of medicines, the parents take notes on everything that happens to us. They have huge notebooks with daily notes on everything. They describe all the events in our lives: the medication, the nutrition, the hours of sleep, the friends we meet, everything." "The parents don't behave normally towards us and we make this difference in behaviour very easy, especially if we have brothers or sisters who are not HIV infected. " "We have hardly any freedom and our parents are over-protective. " "We want to talk with our parents like the normal teenagers. We feel like the HIV infection is always present in our parents' minds when talking to us. We don't want the medical status to affect all our relationships with our family." "The best scenario is my little brother not knowing about my problems, so he'll behave normally. " "We believe parents should talk about the HIV infection with their children. It's not fair, and makes no sense, to keep it a secret. It affects both the family and the teenager in two ways. First, communication in the family is a disaster. When the parents have something to hide they suffer and the child feels that something isn't O.K. and starts to mistrust their parents. Then, it comes to the point when the child suspects his actual diagnosis and the family acts like they don't know that the child knows. Discussing this with their parents is a big relief for everybody." "We would like our parents to stop talking to their friends and relatives about our medical status. All of us were surprised to find out that some people already knew about our HIV status. The parents' spread the news among their friends and now, their friends children know and talk to everybody about it. The parents should be taught not to tell anyone before discussing it with the child. If the child is too young, the parents should keep the secret." "Hospital auxiliary staff stigmatise us and keep finding reasons to limit our rights. In hospital, the only way to avoid the shouting and the insults is to stay motionless in your bed and not ask for anything." ""You're the kid with AIDS, aren't you?" It is very difficult for us to keep hearing this phrase from the physicians we see. It usually happens when we have minor problems like changing our glasses. In most cases we are honest and tell the physicians that we are HIV positive. We tell them in order to convince them to use gloves and to sterilize the equipment after the consultation. The problem is that in most cases the medical professionals make unnecessary remarks about our HIV status. We are not comfortable hearing doctors or nurses inviting you into the clinic with the phrase, "The kid with AIDS, come in!" This is a problem of mentality and it is not easy to solve. The physicians don't want to hurt our feelings; the medical professionals simply don't care about our feelings. Is like they think that one person cannot have both feelings and the HIV infection." " None of us knew for sure the age limit for the day clinics. Medical professionals from the day clinics send us to the adults' clinics and the physicians from the adults' clinics send us back to the children's day clinics. We don't know if the age limit is 14, 16 or 18, or if there are any regulations about this subject. " "Our medication is 10 years behind the U.S. and Western Europe. " "The general perception that all neighbours snub HIV affected people is wrong. We have nice neighbours who help us, or ask us for information. Some neighbours stop us on the street to ask questions about HIV and AIDS. Some take our side when others harass us about our condition." "Bad neighbours keep looking for excuses to swear at us. Most neighbours exaggerate their reactions towards the families and the orphanages for HIV infected people. If the music is too loud, they call the police, but this doesn't happen when the music is heard from another house, or they start shouting bad words about HIV." "Most people are very uncomfortable with an orphanage for HIV infected children being in their neighbourhood. They see it as a threat to their children's health and don't listen if someone tries to explain that there is no danger. They lack information and refuse to learn anything about HIV and AIDS. All they know is that people die from HIV and AIDS and that there's no cure if you're infected. " "The neighbours don't know anything about HIV and AIDS. We are convinced that our neighbours know absolutely nothing about HIV and AIDS and don't even consider learning anything. They are ignorant and believe all the gossip they hear." "The neighbours don't allow their children to play with us for fear of their children becoming infected. They never allow their children to play with, or even to speak to an HIV infected person. There are situations where an HIV infected teenager has disclosed his/her diagnostic to his/her best friend and the friend's parents are totally against their friendship. In one situation, the best friend kept the secret and receives visits from the HIV infected teenager without telling the parents about the HIV problem. In most cases the friends discuss the issue with their parents and avoid meeting with the HIV infected friend. Most of the children simply imitate their parents' behaviour and start ignoring all the information if the parents say that they can get HIV infected simply by touching "such a personâ" " "Our neighbours envy our family for getting money, food or medical consumables from the government or NGOs. We've often been asked things like "I heard you're going on a camp for free. Could my child come too?". It's difficult to understand how such parents instantly forget the supposed huge risk of contracting HIV when it comes to obtaining something for free!" "Our neighbours like to gossip a lot and HIV and AIDS is a good subject for gossip. If it weren't for the small talk, nobody would have cared about the family affected by HIV. This is why the neighbours are extremely curious and keep asking around and even violate the family's mail. " "People obtain information on the HIV status of their neighbours from friends working at City Hall or other administrative institutions dealing with official documents. The people working in the administrative structures don't respect our confidentiality. We must provide confidential information in order to obtain special social aid and the people who work in the institutions involved read our files and start spreading gossip within the community. This happens especially in small communities where people know each other. " "I was at the hospital and some journalists were looking for HIV infected children to interview. My mother took me and we left the hospital in 2 seconds." "We're used to journalists. They used to come to the foster home all the time to do interviews. Even now, we still give interviews. Anyway, everybody knows about us being HIV infected so we have nothing to hide." "This summer, I promised myself I would avoid any further contact with the media. At a 10 year birthday party for the Day Clinic in Bucharest, some journalists insisted on an interview and promised to respect my confidentiality. But when they put my picture in the newspaper and the next day, one of the few friends I still have didn't want to see me anymore, even though he had known about my problem for a long time." "I run away every time the journalists show up at the hospital. There's no point giving up my confidentiality to help them produce a sad story instead of informative material. It is no help for me to make people say "poor boy, thank God it's not me!" Because this dos not change the way people behave towards us." "I've had many encounters with the media; they published my opinions and interviews. It's true that they don't know too much about HIV and AIDS, never tell the whole story and always make mistakes. But if you don't play the victim and don't start crying when speaking about HIV and AIDS, they will respect you." "Journalists produce material on HIV and AIDS because they want to have exclusivity. HIV and AIDS is a good subject for gossip so people will pay attention to material on this issue. They need shocking information, images and stories to compete with other journalists. They are very interested in publishing the image of an HIV infected person, as if this were more important than the information that could be published/broadcast using the same resources. They don't actually care too much about the HIV infected people who accept collaboration and rarely respect the confidentiality agreements taken before the interview. They want to gain credibility; they don't want to help, just to shock the public." "There is little interest from journalists towards the problems faced by the young people who give interviews. We feel that the journalists use the HIV infected young people only for credibility, as the message is more appealing to the public if it comes from an HIV infected person." "The journalists follow their stereotypes about HIV and AIDS and don't give the correct information. They want us just to confirm what they think about HIV and AIDS." "Once you gave them the interview they (the journalists) forget about the confidentiality matters." "All the journalists want is to put our picture on their front page so that their readers will recognize us in the newspaper. They want to satisfy people's curiosity about us, not to inform them about HIV and AIDS." "No matter how much information you give the journalists, they always make mistakes and publish only what supports their theories about infected people. It's like they've already written it before meeting you." "We agree to talk to the journalists because we want to inform both the journalists and the general public about HIV and AIDS issues and because we get angry when we read or see so many incorrect statements about HIV infected people. This second reason is related to the solidarity with other HIV infected people who suffer discrimination by the media. Every time we read about HIV affected people being stigmatised and rejected by the community (like the case in Golesti) we feel like we should take a stand against the discrimination." "We are afraid that journalists won't respect our confidentiality, even if we have an agreement about it. We have lots of examples of HIV infected people who appeared in the media with recognisable photos and real names and addresses, even if the journalists promised the opposite." "Journalists are not actually looking for information, but for their image. We believe that if a journalist wants to be informed on HIV/AIDS, he/she could contact a specialized NGO and receive all the information he/she could possibly be interested in. The problem is that journalists are interested most in interviews and pictures with the HIV infected young people, so the image is more important than what the HIV infected people think or say. " "Another important factor that makes us avoid contact with the media is that, in most cases the decision to give an interview is not taken by ourselves. For those living in families, the parents make that decision for two reasons: first because the young people are underage and no decision is legal without the parents consent. And second because within the family they have little freedom to make decisions and parents are over protective." "The media should be an ally in the fight against stigma and discrimination, not be the actual vehicle of negative attitudes. Journalists should be helped to protect a free media without undermining HIV infected young people's right to confidentiality." "We want to become a team, so we can fight together and resolve our problems. We want solidarity between the countries, support and solutions." "Some doctors speak to the children about their treatment. " "Young people do not listen to peer educators, they listen to their parents, who usually have no information about HIV. " "Sometimes we advise other parents to tell their children about the diagnosis. " "We must stop playing the victim and stop asking for "help". We should replace "help" with "collaboration". " "The message we must get to journalists is: "collaborate with HIV infected young people". " "I have known him since September 2002. I found out about his health problems very late (may 2003) because he was behaving just like a normal teenager. He was full of questions, very sociable, intelligent, a nice person and very well developed. He participates regularly in church projects and is very devoted to these. Personally, I appreciate him very much and I recommend him as a very ambitious, perseverant and coherent young man. As a self-learner, very attracted by music, literature and IT, he manages to achieve a lot. I wish him good luck and I will always be there to help him anyway I can." "I think he (one of the boys from the SEYPA group) is such a well-developed teenager for his age, compared to other HIV infected young people, due to good specialist treatment and the excellent care of his parents. Just like most of the teenagers suffering from chronic diseases and being frequently hospitalised, he is too mature for his age. He is serious and responsible in what he does, and is highly receptive to suggestions that could help him. He is friendly and altruist. He enjoys to learn and is passionate about music and IT. " "I'm proud to be "The Dragon's" physician. Despite the fact that his family face many difficulties, including other serious health problems, I think the Dragon is very lucky to have such a great family. All of us benefited from being open to him. With his way of living, his strong will and his continuous struggle, he teaches us how to resist, to win, to lose and to recover despite great suffering." "I've known "The Dragon" for 4 years. I treated him for HIV related dermatological complications. I was so impressed with his will to live and with how his state of mind went from depression to optimism. I must mention his mother’s impressive contribution. She has had a key role in his positive psychological progress. At present, he is a normal teenager living a life absolutely similar to other teenagers." "Many people stigmatise HIV infected people and do so with the wrong information or no information at all. I overheard some people saying that HIV could be contracted by touching, hugging or kissing an infected person. Before last summer, I didn't know too much about this virus. But then, finding that someone very close to me was infected, I started to change my way of thinking. I started to really pay attention to everything related to this issue. I think that everyone should know how HIV can be contracted and understand the difference between AIDS and HIV infection. AIDS is when the virus is too advanced, but this can be prevented with special medication. We should not exclude HIV infected people because they are normal people, just like us. If people don't know about someone's HIV status, they behave normally. People are afraid of what they don't know and I think that if they were better informed they would behave properly. Why did I stand so close to the HIV infected people and why didn't I exclude them? The first HIV infected person I knew of was my best friend. When I found out, I did not react in any way. Knowing her, it seemed something normal, like everybody was HIV infected. We must not exclude HIV infected people because it could happen to anyone, even to me. Nobody chooses to be HIV infected and nobody plans it. Anything can happen. It is strange how such a small thing can change someone's life completely and I am sure that when someone finds out that they are HIV positive, they wouldn't like to be treated differently. One would like to be treated like nothing has changed. Therefore, before judging someone, we should think about how would we like to be seen by the community. Maybe this way we can see the difference and make good choices." "I am writing you this letter in thanks for all your support and love. With your help, I am learning to share my worries, my questions, and the sadness I have kept hidden from other people. Its good to have an understanding person like you around. I am doing fine now and it is a great joy for me to let you know that now I am a volunteer in a project about social exclusion (SEYPA). We are trying to help HIV infected people facing social exclusion. The aim is to help healthy people (teachers, neighbours, professionals, etc.) to understand HIV infected people. Would you like to get involved in this kind of activity? Of course, I can tell you more about the project. I hope you are as understanding as always and will give us a hand." "I've known "The Lioness" since she was very young, so knew very early on about her hardship. I had various emotions about it. I have always thought that her being HIV positive is not a danger to anyone." "I knew about it long before she herself was told the real diagnosis, but I kept the secret just like all the others. I was not afraid, not even for a single moment, because before doing anything I got informed and sought out all available answers to my questions about HIV/AIDS." "She is an extraordinary child. There is no way I could stop being close to her. Someone in her situation needs a lot of support. All HIV infected people should be offered a helping hand, instead of being discriminated against." "First of all, I want people to know that I did not reject my friend. It makes no difference to me that she is HIV infected. It makes no difference in the positive meaning of the word. I can't deny my first reaction, but she prepared me for the moment of sharing "THE BIG SECRET", as she called it. She was careful not to make it too big a shock for me. I did not reject her because she is my best friend, my confidante and my desk-mate at school. I did not reject her because she is full of life, full of fun, very communicative and because she has the most incredibly strong will that I have ever come across. In addition, as I know, and I hope that everyone knows, HIV infection cannot be contracted by touching, kissing, or being close and friendly with an infected person. No sick person, with or without HIV, should be marginalized and isolated. We are all human beings, we all have a soul and we must be accepted the way God made us: nobody is guilty for being ill. We all must accept, and be accepted, the way we are." "How can it be that it happens to the best of students? I'd been teaching her English for two years when her mother told me. Astonishing and sad, but true! I had read articles and seen TV programmes about HIV. I had even translated some leaflets about it for a friend working in a family planning clinic. But I never imagined I was so close (as her main teacher) to someone in that situation. I talked a lot with her mother. Initially I refused to believe it was true. Then I did my best to support her. The secret was kept from the others; only her mother and myself knew about it. Her classmates were asked to protect her, to help her, because I told them she was suffering from some liver disease. We came together and managed to facilitate her access to various medical clinics and to obtain sponsorship from pharmacies in order to supplement her medication and nutrition. Having an incredible will, she proved to be very brave, a fighter who showed that nothing could scare her and that she could get through by working hard. She continued to be one of the best students in the class. At present, she participates in national and international contests and wins many awards. When she found out about her real diagnosis, she couldn't believe that I knew and that I was not afraid. I was, and I will always be supportive of her with my heart, my mind and my soul. There is no other way to help her become self-confident again. Only this way can she go on fighting. I love her with all my heart." "The moment I found out about her, I felt it my duty to treat her the same as the other children. After all she is intelligent, pleasant and full of life. I supervised her in writing some poems for the Language Olympics; she won a medal. I have never been concerned about getting infected because I know very well how it can be transmitted. I do believe that all the