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A positive test result for HIV can be devastating, but since the 1990s drugs have been available in the UK to enable people living with HIV to live relatively normal lives. Unfortunately some of the drugs can have one very visible side effect that can render it difficult to keep your condition a secret. This year there will be an estimated 100,000 people living with HIV in the UK; one in four do not know they are HIV positive. With cuts to HIV prevention, many are predicting we will see a sharp rise in new infections in the coming years. Thanks to a big AIDS awareness push in the ‘80s and 90s, these days the majority of us who lived through those times are aware of the risks and practise safer sex, at least when we first meet a new partner. But be honest – how many of us have demanded that said partner takes an HIV test before, six months into a relationship, we decide to leave the condoms out of the equation? With numbers on the rise, it is something to be thankful for that today’s medications mean HIV is a condition you can live with. It might not be something you would want to live with, but if the worst happens you can get the drugs that will help you to continue to live a comparatively ‘normal’ life. So far, so good. But there’s a stigma attached to HIV that just won’t go away, and even if you’ve managed to come to terms with it yourself and are getting on with your life, you probably don’t want your condition to be visible to the casual observer. And there’s the catch. Some of the drugs used to treat HIV – although brilliant in many ways – do have one unfortunate 24 Winter 2012
side effect: they block the chemical messaging system to the fat cells in the body, preventing them from absorbing fat and causing that gaunt look that can sometimes be associated with being HIV positive. This condition – known as lipoatrophy, or fat loss for the less technically minded – means that it can be very difficult to hide your illness from onlookers, and whilst no one would recommend that you try to cope with something as life-changing as an HIV diagnosis on your own, a degree of privacy is desirable. Blogger Mark King from The Bilerico Project, www.bilerico.com, has been an outspoken advocate for people living with HIV since testing positive in 1985, explains his feelings on the matter: “When I choose to disclose, privately or publicly, it’s on my terms. I choose how and when to tell you. I want you to know. Facial wasting takes that choice away. “It’s as if the disease is intruding, is taking the upper hand somehow, and worse, taking away my decision about when and to whom I disclose my status. And as much as I want to claim ‘Most Out Poz Guy Ever,’ I don’t like wearing HIV across my face.” Mr Christopher Inglefield, surgical director of The London Bridge Plastic Surgery www.lbps.co.uk has seen a sharp rise in the number of patients – particularly men – seeking treatment for lipoatrophy in the last three years. “Lipoatrophy tends to be particularly noticeable in those parts of the body where you