Alexandra Arrhén awarded the 2020 Peos Scholarship

Alexandra 2020 vinnare av Peos Stipendium

Positiva Gruppen Syd awards the Peo Scholarship for the year 2020 to Alexandra Arrhén.

“We are happy and proud to award this year’s scholarship to Alexandra. Peo’s Scholarship is about drawing attention to efforts, both everyday and exceptional, for people living with HIV, by people living with HIV. The year 2020 has tested us both as individuals and as a collective, therefore positive, uplifting initiatives and examples are needed, and this year’s scholarship recipient contributes with that, “says Emanuel Karlström at Positiva Gruppen Syd.

During the year Alexandra was nominated by her mother with the following nomination:

“Our daughter Alexandra was born in 1995, the same year that Peo died and is a fantastically happy and positive girl who received her HIV diagnosis in the autumn of 2018. She had traveled for a long period and in bliss and love became infected. After an initial shock, Alexandra took the message with great composure and has since become involved and disseminated information as well as worked hard to reduce the stigma surrounding HIV. Alexandra is training to be a nurse and has a vision to continue to spread information and to help and inform in places in the world where knowledge about hiv is less widespread. Alexandra is well worth all the scholarships in the world! We love her! ”

We called up Alexandra for a chat a few days after we announced that she will be awarded the scholarship.

Hi Alexandra, how does it feel to have won the Peos Scholarship 2020?

Hey! I was both happy and surprised at the same time! I read about Peo after I got the news and it feels so fun to be noticed, even though I do not think I have done so much. Overall I feel very grateful.

You were 23 when you were diagnosed with HIV in 2018 and it was your mother who nominated you for the scholarship. What have your parents meant to you in dealing with the diagnosis and in continuing to be yourself after the diagnosis?

A lot, mom was at the youth clinic were it all started and when we booked a visit to Huddinge hospital, dad was also there. So from day 1, they have been with me. It has been very important. I trust them and look up to them when I have questions and such. I had my own fears in the beginning, but my parents got educated themselves and pushed me to go to conferences for young people with HIV. So it has been super important to have them with me, you could say that what concerns me also affects them.

When did you first come in contact with others with HIV after your diagnosis? And what did that mean for you?

It was about three weeks after my diagnosis that I got to go to the HIV conference for young people, we were probably about 30 people. I made friends with a guy from there and we have bonded. I think it’s a lot because he got his diagnosis just a year before me and that we both share other interests, such as traveling.

Then it was obviously nice to meet all the others in the beginning who were in the same situation. I felt a bit ashamed in the beginning, that I brought this on myself, but people who had been born with HIV said that neither you nor we who were born with HIV have asked for this. Sure you got it after unprotected sex, but people have unprotected sex all the time. So it was nice to feel that we were still in the same boat so to speak, and not there because we specifically chose it ourselves.

What did it mean to, as in your case, quickly get in touch with peer contacts and others living with HIV?

Now I got in touch with other peers relatively quickly, but it would probably have been good to get a contact directly. For example, my mentor that I got later, if she could have been there a little earlier and maybe prepared me for the conference and welcomed me into different groups. Even though I got in the loop in three weeks, a lot happened, the infection tracing and the whole bit, so yes a contact early is very important.

But I also know others who have had to wait for over a year, and my friend I mentioned earlier had to wait for over a year. Then he did research himself and found others who lived with HIV.

You are studying to become a nurse, how do you see your future, what do you want to do?

Right now I’m in the gynecological ward and it’s very exciting, and it’s probably mainly women I would like to work with or young people. So I see myself working either as a midwife or maybe at a youth clinic. Then I also think it’s very exciting this with people’s own experiences of being sick, and for me, of course then, HIV hits home.

For example, I was in Ethiopia at the beginning of the year and met an organization that worked with HIV to teach me how it works there, how to think about HIV, sex and so on. They thought a little differently, both people who live with HIV and the organizations that work with HIV, I thought that was very interesting. So in the future maybe interview people and dive deeper into these issues, that would be fun!

We thank Alexandra for the chat!

What is the Peos Scholarship? – Per-Olof ”Peo” Persson was 1989-1993 chairman of Positiva Gruppen Syd and a pioneer in drawing attention to HIV and AIDS. He did this both in southern Sweden as well as nationally, as vice chairman of RFHP (National Association for Hiv-positive people, current Hiv- Sweden) during 1991-1993. Peo died in 1995 and since 1996 a memorial scholarship has been awarded in his name. Read more about Peo and the scholarship here: https://www.pgsyd.se/en/peos-stipendium/

Member stories: Michaels story “When My Life Changed”

Michael became a member in november, here he tells his story, a reflection of  change, living with hiv since 1985 and how he ended up in Malmö.

It was 1985, AIDS had only just begun to be discussed and I remember sitting around with friends and talking about how horrible it would be to contract this disease. A few months later, after weeks of diarrhoea, I was diagnosed with AIDS at the age of 25 – wasn’t called HIV back then, it was AIDS – the killing disease, the Gay killing disease.

My world ended. I expected to die the next week. We knew nothing about Aids except that it always killed you. I remember sitting in a clinic waiting room with other newly diagnosed guys – no one spoke, we’d all seen each other out and about but, in that room, that ‘death’ room, we were all silent and wallowing in our own grief.

It took me months to realise that I wasn’t going to die right away. I had so much trouble sleeping, working and even socialising. I thought it wasn’t fair, why am I going to die and all these people around me are so carefree, no troubles in the world and enjoying themselves so much. I couldn’t enjoy anything. I became bitter and angry. I started smoking weed, daily and this was the only thing that could help me forget what was going to happen to me one day.

Weeks turned into months, turned into years, and the longer I survived the more I realised that nothing was going to happen to me straight away. After 12 months I started to live my life again, started to enjoy doing things and not expecting death at any minute. 

Fast forward to 1999, I was still HIV positive, on no treatment with good T cells and low viral load. I almost forgot about living with HIV. I was asked to join a peer support program at the Melbourne Positive Living Centre. I resisted at first, I didn’t want to be reminded that I was sick and could still die from it one day. However, I went along to that first peer Support group and it changed me. Here were other guys who had all gone through the same experience as me. Some were long termers like me but many were newly diagnosed. I felt good about myself for the first time in years, and I was overwhelmed by the feelings of support and encouragement I received from other poz guys in the group. Plus, my story helped many newbies come to understand that it’s not all useless and doomsday these days and we can still manage to live a relatively normal life. 

In 2004, I stared anti-viral meds and have been perfectly healthy since then. I consider myself lucky, many friends died back in the darks times of the late 1980’s but nowadays there is a much more optimistic feel, it’s not the end of the world. Sure, it’s still an adjustment but there is so much support and care available now that it really helps the newly diagnosed avoid the feelings of isolation and utter fear that was the 1980’s. I always used to wish that I could just grow old like everyone else and not have to worry about AIDS. Well, with good healthcare, meds and support, I no longer worry about AIDS, just getting older —LOL! I have control of my life again and have done some amazing things in my life since then such as, jumped out of an airplane and saw the Berlin Wall before it was dismantled.

Being HIV hasn’t stopped me having relationships either. Once I got to know a guy well enough, I would tell him that I was HIV. By this stage I knew them pretty well and felt trust between us and in all cases, they were accepting and wanted to continue our relationship. One for 12 years (OMG, a lifetime in the gay world!) and another for 5 years, both with HIV negative guys who accepted and understood my condition. HIV was never an issue between us.

In 2012, I made a life changing decision. I’d always remembered how I used to think I was going to die any day, I wanted to continue to enjoy my life, not just live it. I made some changes to my life that would only snowball a few years later. 

I sold my business of 30 years and bought a caravan and travelled around Australia for 2 years just with my dogs, working in different cities for up to a month at a time. How awesome was this! I could go anywhere in my country and receive the same good health care, access to my medications etc. It was the beginning of even more changes ahead.

I then lived for 2 years in subtropical North Queensland next to a beach with the Great Barrier Reef at my doorstep. Met a guy from Brazil, a lot younger than me but hey, what the heck! We lived together for 2 years and then moved to Brazil where we lived for 18 months. No problem with health care there, I was able to access medications for free as a resident of Brazil. Next came Italy for two and a half years and now finally, I’m in Malmö which brought me to contact the Positiva Gruppen Syd to find out about any support groups here that I can access or maybe even help out with in the future. 

Of course, we have new challenges around today. Living through the pandemic reminds me a little of living with HIV in the beginning, although I don’t think the stigma of COVID really compares to the stigma of AIDS – AIDS was always the worst! Now we are suddenly being careful not to shake hands with people or even to meet them at all let alone kiss them…or more. I think COVID, however, has an end in sight, perhaps next year, a vaccine that may allow us to return to our normal ways whereas Aids medications took some time to develop and I remember thinking back in the 1980’s, “What? 10 years before we have a cure? I’ll be dead by then!” Now, of course, we have some outstanding treatments that can keep us alive indefinitely.

I now control my HIV, it no longer controls me.

A podcast POSITIVT miniseries: Diana – My journey with hiv

Diana - journey with hiv

A couple of weeks ago, we recorded two episodes where Linda interviews Diana. We are now releasing episode 1 of 2 of this miniseries in English.

Diana is originally from Peru but moved to Sweden and Malmö after living and working several years in Spain. In this first episode, we hear Diana talk about, among other things, the time when she suddenly started to fall asleep just about everywhere, which became the first sign that something might not be right. The conversation also revolves around telling others about your HIV status and how to live well with HIV, even in times of adversity.

Episode two of this miniseries will be published ahead of World Aids Day, as part of our World Aids Week. You can listen to the podcast on our podcast page here: https://www.pgsyd.se/podcasten-positivt/ or directly on Youtube: https://youtu.be/xf7ldNReM5o

Report from the wellness weekend in Tylösand

View over Tylosand

It is Thursday 15 October at the time of writing this and a few days have passed since we came home after the wellness weekend in Tylösand. Conversations, laughter and discussions have been mixed with good food and time in Hotel Tylösand’s spa. Here follows a summary of impressions from myself, input from participants and the weekend as a whole.

We left Malmö by car around 16:00 on Friday afternoon for the trip to Halmstad and Tylösand. Some of the 15 registered participants came from elsewhere and went to the destination on their own. We chose to go by car and avoid public transport as in September corona in Skåne had increased and as organizers we tried to ensure that the event was as safe as possible.

Once at the hotel we checked into our rooms and could spend an hour to get acquainted with the hotel and the new surroundings. The dinner took place in the hotel restaurant at 7 pm and before the meal a short welcome speech was given together with some practical advice and tips for the stay. Many had not met before and the dinner was, in addition to the food, an event of informal introductions between the nearest table neighbors.

Lectures and workshops start!

After breakfast, Saturday started with a lecture at 10 o’clock on the theme “Peer Support – What is it, why does it matter and how do we ensure all people living with HIV gets it”. You can see and download the presentation here, although without animations:

During the hour-long presentation, an introduction was given to peer support and why it is important in relation to living with HIV. We also had the opportunity to discuss HIV status and openness in groups of 3 people. Who might you tell? What are the benefits of telling? What are the disadvantages? And are there any downsides to not telling? The origins of focusing on openness are based on the research and the notion that many people living with HIV would like to be more open. The questions gave everyone the chance to listen to someone else’s thoughts and experiences and think about their own. We also went through practical tips on how we can act around telling, to help we had the five Ws taken from Positively UK, a leading organization in peer support for people living with HIV. All participants also had the opportunity to introduce themselves and tell about their HIV status openly to everyone else.

Emanuel presenting

Next up was from Arielle from Lund University. Arielle started working with us last year, then as a student writing a masters thesis, today she is employed at Lund University and works with a study in peer support for people living with HIV. The results are not ready for publication yet, but we got an insight into the work and what themes Arielle found and built her study around, which for example included where peer support is given and by whom. The study is ongoing and more interviews with people living with HIV will be conducted. If you want to participate, you can contact us directly.

After lunch at the hotel we returned to the conference room Gessle, it was time for Tobias and the workshop “Succeeding with HIV prevention”. The name and workshop are based on a publication from the Swedish Public Health Agency. The publication functions as a manual and can be helpful for planning, carrying out and following up initiatives. For this workshop, we had adapted the content and started with questions such as “Why is it important that the Positive Group South exists?” and “What is the main problem the Positive Group South wants to counter?”. The questions had the participants first think for themselves and then share their answers. Some of the answers were: “Counteract stigma”, “be a contact hub for peers” and “educate”.

In the next part, the focus was on goals – “What is the goal of Positiva Gruppen Syd, what would the situation look like when the goal is met?” and “Do your main problems fit within the overall goal?”. The answers varied and everything from that HIV would be a smaller part of one’s life to that no more work with HIV would be needed was included in the answers. The common thread was however related to reduced stigma and a better understanding from others of what HIV is. Finally, various target groups were discussed and what Positiva Gruppen Syd does today and how well the participants think that the organization worked with the problems that the participants wanted to be solved. There were both wishes to try to reach, for example, the lonely and vulnerable better with outreach activities, such as launching education packages and contacting healthcare, schools and other institutions in society to reach out widely with information about living with HIV.

After the workshop, coffee was served and the conversations continued before people started heading back to their rooms for some well-deserved rest.

Dinner in Halmstad and evening hang out in the hotel’s spa

At 6 pm, a table was booked at Fridolfs Krog. The food was pre-ordered and among the favorites was butter-fried char which was enjoyed by five people in the party. The cod was not as popular as only one person chose this alternative, but it is said to have tasted fantastic. The restaurant was relatively full and although the serving took a while, everyone was happy and satisfied when we after two and a half hours went back to Tylösand and the hotel. At this point it was noticeable that people had started to get to know each other and compared to the dinner the night before, there was no lack of conversation points and both this and that was discussed 🙂

Back at the hotel, most people were looking forward to the hotel’s spa with several pools and saunas. Since it was a weekend, the spa did not close until 12 o’clock and there were surprisingly few people in the spa, which was good both considering the corona and the opportunity to use the amenities. It felt like a perfect environment to talk and get to know each other further. A constellation was created in the pool, someone left and someone new was added and so on. The spa was used until the last minute and hopefully everyone fell asleep satisfied, happy and relaxed.

Closing and summary of the weekend

At the check-out at 11 the next day we gathered briefly to thank each other before going back home again. In summary, the weekend was very appreciated. The stay could easily have been extended by one more day, but maybe it’s not so bad to end with a feeling of wanting more?

A group of 15 participants, 17 together with the lecturers was appropriate considering the layout and how much time we had to spend together. Given the corona the risks would have also increased with a larger group and how we interacted might also have been restricited. With this groupsize we could easily apply a number of fairly straight forward measurements; private transport, no participants with symptoms and also preferably new town for corona, well-scattered seats in the conference room and generous supply of hand sanitizer and individual rooms in the hotel.

It was also extra fun to see so many new participants, with the mix of those who have been members for a long time and newcomers, the dynamics were perfect. The weekend also provided ideas for themes for new activities, something we have already woven into the next activity on 7 November. We look forward to meeting again and hope the weekend gave encoragement as well as tools in living well with hiv.

Weekly meet-ups cancelled – to be replaced by other activities

Drop in PG Syd hiv Malmö

Due to an increase in the corona virus during the month of September we have decided to cancel our weekly meet-ups (Drop-in) and replace the meet-ups with other activities. By making this adjustment we want to contribute to a decreased risk of further spread of the Corona virus among staff and among our key population.

The cancelled weekly meet-ups are replaced by one larger activity. We will also adjust and make ourselves more accessible for one to one meetings. The new monthly activities will be presented on our website pgsyd.se, in social media and other various channels we currently use or are seen in.

The decision is valid until further notice.

Hiv and physical activity – How and why to get get started

Hiv och fysisk aktivitet - vad gäller och hur kommer jag igång

The development of treatment for hiv has been fantastic. But despite that, people living with hiv still face worse health outcomes compared to the general population. What can we do to counter this and improve our health and well being? Turns out, quite a lot, and it starts with movement!

In our 30´s our bodies begin to age. The biological aging process makes the cells in our bodies slower and less fit. From the reproductive system to our skin, muscles and senses, most of our bodily functions become affected. The aging process also affects cognitive abilities which can result in changes in mental health. How fast and in which way we age hinges on genetics, our environment as well as way of living.

Today we know that almost any physical activity has a positive impact on our health and slows the aging process, even when physical activity is initiated at an older age. In other words, there is no best before date to get started with some exercise.

Living with hiv and general health

The ability and function of the heart, lungs and muscles is often referred to as cardiorespiratory health. In people living with hiv, cardiorespiratory health is in general worse compared to people not living with hiv (1). The exact reason behind this is not fully known, but there are signs of a faster aging process, commencing earlier, in people living with hiv (2). A number of studies has shown that the aging process starts 5-10 years earlier in people living with hiv, resulting in an earlier onset of common aging disease such as diabetes, cardiorespiratory disease and certain cancers.

The good news is that we do have ways to both slow down the aging process and decrease the risk of early onset of aging diseases.,Whether it’s in a gym or just in everyday life, physical activity is something that most can do and fit into their lives.

What impact does physical activity have on the health of people living with hiv?

Just like with anyone else, physical activity improves the health in people living with hiv. Increased lung capacity, ability to absorb oxygen and mobility are some of the effects that have been proved when people living with hiv start with some form of physical activity. Both aerobic activity (for example brisk walking and bicycling) and resistance training (for example weight training and swimming) has shown to have similar effects(3). Other benefits of physical activity is more of the healthy cholesterol and less of the bad cholesterol. Since certain hiv medications can increase lipids and fat in the blood physical activity works as a great counter measure (4).

Physical activity has also shown positive impact on overall well being and quality of life in people living with hiv. In one study, a group of people living with hiv that currently did not exercise started on a three times a week training regimen. Compared to a group that did not start exercising the group that did exercise showed improved quality of life as well as less anxiety and depression (5).

Even the sleep can be improved by physical activity. Bad, interrupted or too little sleep are often one of the causes of fatigue, which in turn can lead to decreased or no physical activity. However,pPhysical activity should not thou be thought of the holy grail to insomnia. Stress, socio-economic status, mental health, hiv in itself or medications can all impact your sleep (6).

What type of training should I aim for?

All types of physical activities are beneficial, but there are some differences in how and in what way certain types of physical activity improves our health. The best effect however, is a combination between aerobic activity and resistance training and in general, the higher the intensity, the better effect (7). One should of course be cautious to not sustain injuries and gradually increase the intensity.

How do I get started?

Being shameful of our bodies, our health and ourselves can be barriers preventing to get started. But with support, cheers and a sense of everyone started out as at some point, can help.

Studies have also shown that a training buddy, or someone who checks in on the progress, increases the chances to continue sticking to the training. Could a friend with hiv, a neighbor, relative or maybe someone at the gym be your go to person to talk to? Another method is to get a prescription for physical activity from your doctor and let a health professional follow your progress.

Three final advice

  • Find a type of physical activity that feels good for you. Test and try, be brave and experiment to find out.
  • Get together – train, cycle, walk or just talk about your own ambitions and progress with someone to share your experiences and be proud of every small step forward!
  • It’s never too late – if you haven’t started yet you have the most to gain!

If you are having a hard time getting started, or maybe the motivation isnt really there? Get in touch and let’s talk how to get going!For further reading, check this article which summarizes many of the most important points in this article:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124952/

References:

  1. https://journals.lww.com/aidsonline/Abstract/2019/05010/Cardiorespiratory_fitness_is_associated_with.10.aspx
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413877/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997336/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6124952/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323156/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266344/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5997336/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318073/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089845/

Free training at Friskis & Svettis for members!

Positiva Gruppen Syd offers all members free training at Friskis & Svettis. Choose whatever activity you would like, for example swimming, gym och a group session, and train whenever you like!

You can access any of the 7 facilities owned by Friskis & Svettis in Malmö. If you are living elsewhere, let us know!

Get in touch with us and we will arrange the membership needed at Friskis & Svettis, after that you are good to go and can start training!

Not yet a member in Positiva Gruppen Syd?

Read here how to become a member for only 100 kr per year and get more benefits: https://www.pgsyd.se/en/become-a-member/

Update of pgsyd.se – Welcome to our new website!

After four years it was time for a change. With the new website we hope to be able to deliver knowledge and information for all people living with or affected by hiv in southern Sweden. We have created a whole new design and layout, which hopefully makes it both easy intuitive to find whatever you are looking for in terms of hiv, regardless if you are reading this from a mobile phone, tablet och desktop computer.

Compared to our old version, all the content has been either updated or replaced by new content. We also hope the themes and topics we choose to include feels relevant and provides an image to what hiv is in 2020. A major new feature is the addition of English language, all pages in Swedish are also available in English.

The coming months will be spent to tweak, update and iterate where needed. If you have feedback or just want to ask something, feel free to reach out. We hope you enjoy the site and finds answers to your questions, otherwise we are available on the chat or just send us an email info@pgsyd.se

Moving to Sweden with hiv – what you need to know

Moving to a new country can be taxing, moving countries with hiv can be even more difficult and require additional planning and knowledge. In this article we will present a broad overview of what you need to know when moving to Sweden with hiv. The article starts with a general background of hiv and healthcare in Sweden, laws related to hiv in Sweden and finally immigration to Sweden with hiv, including work and studies.

The information in this article is accurate as of 30th of April, 2020. If in doubt, always consult a legal party to gain up to date information or contact us. (Article updated july 2019 in wake of the new announcement from Folkhälsomyndigheten/Swedish public health authority)

The Swedish healthcare system and hiv

Sweden offers universal healthcare. In practice this means healthcare is available as a right to all citizens, and in many instances also for people permanently or temporary residing in Sweden (more on this later). Hiv testing, treatment and care is generally incorporated in the division of infectious diseases at hospitals and Hiv care is offered at most major hospitals in Sweden’s 21 counties.

For persons living with hiv in Sweden, check ups on eg. viral load and cd4 is usually done every 6 months for stable patients, and in some cases even less frequently. The infectious disease doctors, who normally treats persons living with hiv, can together with the patient decide the frequency of checkups. Normally lab work is done a couple weeks ahead of the appointment with the infectious disease doctor, thus every checkup round requires two visits to the hospital. Both visits are by appointment only.

All hiv medicine are prescription only in Sweden, and persons living with hiv usually receives a one year prescription and are able to refill once every 3 months. Medicines needs to be pre-ordered as they are rarely kept in stock in smaller local pharmacies, and can be either sent to a nearby postal service or to the nearest state run pharmacy (Apoteket).

Healthcare in Sweden is governed through a separate legislative county level body called ”Landsting”. In Sweden there are 20 of these and all run their own budgets. Local management, governance, doctors mandate and differences in county interpretation of laws might cause some differences in how patients experience hiv care.

Laws regarding hiv in Sweden

According to the Swedish Communicable Diseases Act, individuals who might suspect they contracted hiv are obliged to consult a doctor and test for hiv. Sweden also requires all persons living with hiv to adhere to a set of rules which in practice means that when there is a situation, even theoretically posing a risk for transmission, persons living with hiv needs to disclose they are living with a “blood borne infection”. These situations includes dental work, drawing blood, getting a tattoo, using syringes and all forms of sex, even while using a condom. (New rules as of July 2019, see further down)  The rules should be thought of in conjunction with the level of prosecution for hiv-related offences in Sweden, which historically is and has been very high compared to other western countries.

Although these laws still are in effect, increased understanding of transmission while on treatment and the concept of TasP (Treatment as Prevention) has incurred changes. Since 2013 infectious disease doctors has the mandate to void the need to disclose when engaging in sex. This applies for individuals following treatment guidelines, meaning taking their medicines as prescribed, showing an undetectable viral load for at least six months and being free of other sexually transmitted diseases. Condom use is still required, and only the need to disclose is voided.

Moreover, a ruling by the Supreme Court in 2018, acquitting a person living with hiv on the count of “creating a danger to another”, despite having unprotected sex, in effect established that the risk of transmitting hiv while on treatment is too low to be considered a risk judicially.

As of 2019 new rules are under revision and is expected to decrease the legal burden on persons living with hiv and generate greater freedom.

Update July 2019:

Folkhälsomyndigheten (Swedish public health authority) announces  that there is no risk of transmitting hiv, when people living with hiv are undetectable and on a stable treatment regimen, when engaging in unprotected sex. The infectious disease guidelines that are given to people with hiv whom are undetectable and on a stable treatment regimen has been revised. The new guidelines does not include an obligation to disclose status, even when having unprotected sex. Hence, the use of a condom is no longer required.

For more information:

Announcement from Folkhälsomyndigheten:

https://www.folkhalsomyndigheten.se/nyheter-och-press/nyhetsarkiv/2019/juni/ingen-risk-for-hiv-via-samlag-om-behandlingen-ar-valinstalld/

Infectious disease guidelines for hiv:

https://slf.se/smittskyddslakarforeningen/app/uploads/2019/07/hiv-pat-med-valinstalld-behandling-190703-korrekt-titel.pdf

Children with hiv

Childcare is a right for all children in Sweden and they can start pre-school from the age of one. For children living with hiv, the status does not affect this right whether it is preschool or higher education. Regarding possible disclosure of hiv status eg. “blood borne infection”, it is not required by law to disclose this information prior to entering preschool. When entering preschool, healthcare journal requisition is optional and the guardians can opt out of having it transferred when entering preschool. However, it is the responsibilities of the guardians to see that your child adheres to the guidelines set by the Swedish Communicable Diseases Act, thus to prevent transmission.

Nonetheless, for children entering  preschool it is a common recommendation for guardians to inform the preschool manager about the status. If further personnel is to be informed it is in consultation with guardians and  your doctor. When starting school it is the school health team, thus the school doctor and nurse who should be informed. Regarding disclosure of status it is always you as guardian who decide who, or if to inform.

For children living with hiv there are a number of hiv related educational activities and social gatherings such as ”Barnhiv Centrum”. With the aim of providing an inclusive environment for children living with hiv where knowledge, social development and friendships can be gained. 

Immigration to Sweden and hiv

Sweden does not ban entry or stay based on hiv status, and your hiv-status will not influence your immigration process, whether you are visiting for a few weeks, moving for work, or immigrating to stay with a Swedish spouse.

For individuals seeking asylum in Sweden, a basic healthcare check will be offered, inclusive of hiv testing. The outcome of the test does not influence the immigration process or the decision by the Swedish Migration Board, irrespective of granting asylum or not.

Access to treatment and costs

For eu-citizens moving to Sweden

Hiv treatment for eu-citizens residing in Sweden is regulated by the European Union and is generally free of charge. If you misplace or lose your medication you are entitled to substitution medicine. However, all hospitals might not stock all brands of hiv medicine,so getting ahold of your hiv medicine on the spot might become an issue.

For non-related hiv issues that are deemed ”non-essential”, care might not be offered for free. If visiting a health care facility, the practitioner will assess how essential the need for care is and depending on the circumstances care might be offered free of charge. The objective with the guidelines of providing essential care is to make visitors feel safe and medically taken care of while they are staying in Sweden. Essential care should ensure that a planned stay in Sweden is not cut short because of a medical need.

As a eu-citizen you should carry and be able to present your European healthcare insurance card at health care facilities and hospitals. This is to avoid having to pay any medical fees upfront. In the case you are not carrying the card you might have to pay a fee, although these fees would be reimbursed by your EU-country, nontheless you would still need to claim the cost back by yourself. A check will also be performed to make sure that the care given in Sweden is covered by your healthcare plan policy in your home country.

For non-eu-citizens moving to Sweden

In general, if you have received a permission to stay that is less than 1 year, you won’t be able to obtain a personal identification number and receive healthcare as citizens or people insured in the Swedish social security scheme. However, hiv-treatment due to its importance for sustaining life and lowering transmission will be offered once in country, there might be shorter prescriptions than 1 year, and refills might be only monthly due to the temporary nature of the stay. For non-eu citizens that has received a permission to stay longer than 1 year, a personal identification number can be obtained and healthcare is offered on the same level as citizens.

For asylum seekers and non-documented immigrants

Non-documented and non-eu immigrants with a permission to stay is entitled to hiv treatment free of charge according to the law. Some differences, such as shorter refills and pickup at hospital might occur.

It should be noted that the county level management of hospitals and interpretation of the law does influence the level of care and procedures surrounding hiv-care for immigrations, especially asylum seekers, non-documented immigrants and non-eu citizens.

Moving to Sweden for work

There is no mandatory hiv testing in Sweden to obtain a work permit but for certain professions persons living with hiv are barred from taking up employment, this relates mainly to work in the military branches. Other professions such as flight attendants, surgeons and police officers, although not explicitly excluding persons living with hiv has at least anecdotally direct or indirect discriminated against people living with hiv.

As a rule of thumb, even if employers are asking for health information, it does not relate to ones legal right to work in Sweden. Discriminating people living with hiv based on hiv-status alone is illegal.

Moving to Sweden for studies

Hiv does not pose a barrier to study or obtain a visa to stay based on studies.

In summary: Hiv does not pose a barrier moving to Sweden and hiv treatment will be offered, if its needed, to anyone, regardless of immigration status. However, obtaining a personal identification number can make the experience living with hiv in Sweden better and easier. Whether this is done through a longer permission to stay, work or other arrangements, the personal identification number grants clarity for both the health care staff in how to service you as the healthcare offered would be on par with what a Swedish citizen receive. The laws concerning hiv and people living with hiv, can be tricky, there are several rules to adhere to, and although there are signs of change, Sweden still has a history of prosecuting and criminalizing hiv. Thus, living well with hiv in Sweden requires one to stay on top of both rules, and one’s own health.

New reports of hiv and Covid-19 from New York and Barcelona

In the city of New York data has been compiled for 5 700 patients admitted to hospital with confirmed Covid-19 between March 1st and April 1st. 0,8% of the admitted where confirmed to also be living with hiv. I the city of New York approximately 1,3% lives with hiv, which suggests that people with hiv is not any more likely than the general population to contract or get severely sick from Covid-19. The outcome of the admitted patients with hiv was not reported, for the full read see: https://jamanetwork.com/journ…/jama/article-abstract/2765184

A study from Barcelona reports five people in the ages 29-49 living with hiv in a study among 543 patients admitted to hospital with confirmed Covid-19. One person was living with undiagnosed hiv (cd4 levels just north of 100) and two were living with additional underlying disease. After care, where two of the admitted were considered severe cases, four of the five were released from hospital. One person remains in hospital. The person with undiagnosed hiv, which had the lowest cd4 cell count were one of the released. Researchers underlies the need for more data and studies for older people with hiv as knowledge about older people living with hiv and Covid-19 is lacking. .
Read the full study here: https://www.thelancet.com/…/la…/PIIS2352-3018(20)30111-9.pdf

The reports confirmed what has earlier been documented by IAS and the cases with hiv and Covid-19 in China and Switzerland, hiv does not seem to be a riskfactor to contract nor develop a more severe illness due to Covid-19. However, future studies might show otherwise so take precautions and protects yourself and others. Feel free to reach out to us if you have the need to talk or want to know more.