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Living and Thriving

No one gets HIV alone. No one should be alone with HIV.

In December of 2013, UNAIDS proposed a bold new goal for ending the HIV epidemic. By 2020 they wanted 90% of all people living with HIV to know their HIV status. Of those 90% who knew their status, they wanted 90% of them on antiretroviral therapy. Of those receiving antiretroviral therapy they wanted 90% of them to have an undetectable viral load. It was projected that by meeting these goals, AIDS as a public health threat would be over by 2030! As numerous cities around the world began pledging to the 90-90-90 goal, talk turned to establishing a fourth 90: improving the overall health, longevity, and quality of life for people living with HIV.

How to measure it is still up for consideration but groups like Toronto to Zero are tackling the question by first challenging HIV stigma and discrimination and helping to build a health and wellness centre named HQ. HQ will provide services in support of gay men’s physical, mental, and emotional health needs and is slated to open Fall 2021 in downtown Toronto. 

Others are embracing the concept of ‘HIV neutral’, which explores the roles both HIV-positive and HIV-negative folks play in preventing new HIV infections, removing the onus solely from those living with HIV. Similarly, the concept of an HIV Doula has begun to garner prominence within HIV-positive communities. Doulas have begun to be embraced as a support option that helps folks navigate an HIV diagnoses and walks with them through the trails and tribulations the disease can bring with it.

Together these new ways of thinking and supporting folks are challenging the current limitations of HIV care in Toronto and asking our health care practitioners for greater autonomy. It is not enough anymore to just be living and surviving with HIV. HIV-positive folks want to THRIVE!

Studies by social scientists that explore the quality of life among folks living with HIV however still show markedly poorer outcomes then their HIV-negative counterparts. Feelings of anxiety and/or depression, mobility issues, difficulties with performing everyday activities, medication side effects, relationship challenges, lack of social supports, fear of prejudice and discrimination, and more are not uncommon among those living with HIV, especially long-term survivors.

So how do we get to the point where we are thriving with HIV and what are the challenges we will face when trying to reach the goal of a fourth 90? How do we make sure having HIV is not holding us back from achieving our goals and aspirations?

We’d love to hear your feedback and questions!

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Our mental health is just as important as our physical health. Disorders such as depression for instance (a not uncommon condition among folks living with HIV) can impact our physical health in a myriad of ways. It can cause us to miss doses of our HIV medications for example or cause physical symptoms in the body like aches and pains. At ACT, we provide free and confidential mental health services to people living with HIV in Toronto for this reason. Our services include counselling and group programing that strives to meet the mental health needs of gay men as they navigate challenges like homophobia, body image issues, HIV-stigma, disclosure, interpersonal relationships, intra-minority stressors, and more. To thrive, it is vitally important we do the work of self reflection and check in with ourselves about how we are thinking and feeling. Especially now as we struggle with the negative impacts of COVID-19 and the effect that multiple lockdowns has had on our persons. To access ACT’s free counselling services call 416-340-2437 or email us at info@actoronto.org

If you are in distress or experiencing a mental health crisis, you can get support over the phone by calling any of the following queer friendly Canadian service providers:

For additional crisis support services in Toronto visit the Centre for Addiction and Mental Health Hospital’s website here

The 519, located in the heart of Toronto’s Queer Village, is a queer advocacy organization committed to the health, happiness and full participation of the LGBTQ2S community. Formed in 1975, the 519 offers free trauma-informed counselling services, community leadership opportunities, and a safe space where queer people can meet, organize and grow. To learn more about their counselling programs visit the below links.

Additional 519 Resources:

HIV treatment has changed a lot since 1987 when AZT was first approved to help Canadians fight AIDS. In the years since, developments in drug therapies have allowed those of us diagnosed with HIV to live longer, healthier, and less stigmatized lives. Today, there are over 60 different HIV medications available as treatment options for the newly diagnosed, with most folks only needing one pill a day to control their HIV infection.

With advances in treatment resulting in poz folks living life spans comparable to those of our HIV-negative counterparts, with less HIV medication side affects, our attentions have now turned to comorbidities and growing older with HIV, family planning, and emotional health and wellness among other concerns. How do we enhance the years we have left with good health and ensure we are able to get the best out of our lives and our bodies?

We can start by getting a good night’s sleep. Adults need about 7-9 hours of sleep each night according to Health Canada. Too little or too much and it could be a sign of a different health issue. Sleeping helps our bodies heal, regulates our emotions and thoughts, and helps our nervous system to work properly.

Exercise is also vitally important. It produces a chemical called endorphins in our brains which is a natural painkiller, stress reliever, and can generate feelings of general well-being. People living with HIV can do the same types of physical activity and exercise as individuals who do not have HIV. Brisk walking, running, biking, dancing, jumping rope, swimming and weightlifting are just a few examples of exercise that benefit our bodies. 

Eating well is also essential. Canada’s Food Guide recommends eating a variety of healthy foods each day including whole grains and fruits and vegetables. Adding a vitamin and mineral supplement to your diet is also a good idea. The Toronto People With AIDS Foundation (PWA), in partnership with The Village Pharmacy, supplies clients with vitamin supplements for free. To become a client of PWA contact their Service Access Team at 416-506-1400 ext. 205.

Diet and exercise are also both important lifestyle habits that can help prevent bone disorders in people living with HIV. When you have HIV, your risk of early-stage bone loss and risk of bone fractures increases significantly despite weather or not you are on a successful treatment.

Diet and exercise are also important for your heart and can lower your risk of cardiovascular disease. The risk of a heart attack or a stroke increases as we age, but folks living with HIV are at an increased risk for heart disease and can develop heart disease earlier than our HIV-negative counterparts.

While healthy lifestyle choices like exercise and being on a successful HIV treatment are vitally important, let us also not forget that flu shots, and vaccinations against COVID-19, HPV, shingles, and pneumonia are also important. For more information about the effectiveness and safety of vaccines in general visit Yale Medicine.

Substances can be used to enhance sexual experiences and facilitate intimacy, but they can also be a detriment to your quality of life if you feel your recreational drug use is a problem. If you’re looking to make changes to your substance use, ACT hosts SPUNK!

If you’re not looking to make changes to your substance use but want to use safer and party more responsibly, check out our new From Dusk ‘Til Dawn resource and our Safer PnP: A Virtual Chat support group. Safer PnP is an online space for gay, bi, queer guys to connect with other queer guys, either cis or trans, about PnP (party and play), drugs, chemsex, community and harm reduction before they party. This is a great way to connect with other folk about strategies and tips without any expectations or requirement to change, with a great group of like-minded guys interested in learning how to PnP safer and with more enjoyment.

Chemsex parties are a sexual experience that is fundamentally built on drug use. For guys living with HIV, partying can be a way to be introduced to a group of men that accept your HIV status in a shame-free and sex-positive space. You may find a lot of sexual freedom in PnP scenes. Here are some important harm reduction strategies to keep in mind if you are living with HIV and partying.

  • Sometimes you can forget to take your HIV medication while having fun partying. Try setting alarms or reminders or ask a party buddy to remind you to take your meds.
  • If you throw up within an hour of taking your HIV medication because of G use or another drug, take your medications again rather than waiting for your next scheduled dose.
  • Your immune system may be vulnerable while taking drugs like T or G because your body may be lacking in sleep, nutrition or because you missed taking your HIV medication. By planning for sleep and making sure you have enough food, you can help combat feeling worn down by partying.
  • We know there is no risk of transmitting HIV when you are fucking while undetectable but sharing needles may still carry some small risk of passing on HIV. So, bring your own sharps and harm reduction tools and do not reuse or share your gear.

For more information about “party drugs”, drug interactions, and more, check out Toronto Vibe. Toronto Vibe is a project of ACTs that provides accessible information about common substances you might use or find at a party. It also includes information about how these substances may interact with your HIV medication.

HIV can make a person feel lonely, secluded and often scared. Anyone who gets a positive diagnosis needs to remember: there is help out there if you need it! We meant what we said: no one should have to deal with HIV alone. In Toronto we are lucky to have many AIDS Service Organizations dedicated to the mental, physical, and social well-being of people living with HIV. Just within ACT, there are many programs offering this sense of community. Here are just a few:

  • Newly Diagnosed – a group for people who have been recently diagnosed. This group defines “new” not in time, but in experiences you may be encountering through your diagnosis.
  • Jumpstart – a cross between a support group and an educational resource for those recently diagnosed with HIV.
  • Living with HIV – a support group for anyone living with HIV, regardless of social determinants.

We also offer programs that include HIV education in a more general vein, but with a focus more on socializing and building community. These include:

  • Totally outRIGHT – a leadership programmed designed for younger guys who want to make friends and learn to be more active community members.
  • Gay Men’s Coffee Night – for men over 40 who are living with HIV and are seeking a sense of community, support, and a safe space to chat with others seeking the same.

And these are only a few! Find more listed here on our ACT website.

If you can’t commit to joining one of our programs, you can find ACT in other queer spaces around the city. You may see us performing community outreach at bars, bathhouses – even the beach! Say hi to us if you see us at Hanlan’s, and feel free to ask us a question, and maybe take some free condoms and lube from us!

People living with HIV used to, and still sometimes do, deal with a lot of negativity – from friends, family, their communities, doctors, and others. It hasn’t always been easy to keep one’s head up in the face of adversity. We are now seeing that change. People living with HIV are not only living (longer) and thriving, but they are also being recognized as vital to our queer community. We know what it means to fight for our love, our lives, and our rights and we’re not done fighting yet!