The shock phase is quickly replaced by the reality phase. In this phase, the person starts to realize what their HIV status implies. Suddenly he realizes that he is infected with a life threatening disease; is HIV positive will fall ill at some stage but nobody can tell him when. To make things worse, it is not cancer or any other "normal" illness. It is HIV and AIDS, feared by many, seen by others as God's punishment for a promiscuous lifestyle - a disease associated with stigma and discrimination. He is confronted with the implications for his life: What about my family? What about my wife? Should I tell anybody that I am HIV positive, and if I do tell - who? What about medication? Can I afford it? Should I go on a trial? When do I start to look for medication? All these questions and realities lead to a severe experience of loss.
This brings on another set of emotions which could again range between anger and becoming very emotional. As the shock phase fades, and the person starts to realize the implications of his HIV positive status, they become very open to help from the outside. There is a desperate need for information and to talk to people with similar experiences or people who would be able to provide good advice. This could be a doctor, nurse or counselor. But very often a person needs to talk to someone outside the medical profession. All HIV positive people wish they could tell the people closest to them; their family and friends. But very often they are so afraid that they will lose these valuable pillars of support, that they do not have the nerve to tell them.
But at the same time, while open for help, the person is also hypersensitive in two ways: On the one hand the person might trust some people with the fact that he is HIV positive, but now he fears that those people will suddenly start to treat him differently than before. But it goes beyond people knowing your HIV status. One HIV positive person said: "It feels as if my HIV status is written on my forehead, as if everybody knows!"
On the other hand, you know that you are HIV positive. You know you will become ill at some stage but you do not know when. This suddenly causes the HIV positive person to be hypersensitive about his health. Any small illness or symptom becomes a major concern.
Confidentiality is a major concern for any HIV positive and his family. Nobody has the right to share any information about your HIV status. This becomes a major issue for any HIV positive person. They always wonder: Who knows and what do they know? Where did they find out? It is very easy to say that people should be open about their status. Remember, each person's situation is very different from the next person's situation. For some people it can be very dangerous to talk about their HIV status. We must respect a person's right to confidentiality.
Source: "Channels of Hope" workshop manual.