{'fraction_non_alphanumeric': 0.019065776930409915, 'fraction_numerical': 0.002859866539561487, 'mean_word_length': 4.863128491620111, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 2, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Commentary: Public health counselling following an HIV diagnosis among men who have sex with men: tensions between individual needs and health protection mandates

I have worked in and around human immunodeficiency virus (HIV) care since 1991 and as a community HIV specialist nurse for the last 17 years. I found this research study extremely interesting and although it is only a small pilot, it reflects what I regularly see in practice, particularly in men who have sex with men who may struggle to come to terms with their HIV diagnosis and their ability to negotiate life after HIV, with some feeling guilty and others angry or embarrassed that they took risks. Some have talked about feeling chastised, even rejected, by friends rather than supported, with a sense of ‘you should know better’. However, a few have talked about feeling welcomed into the ‘HIV club’ after their diagnosis, having been the only HIV negative one in their friendship group. All of these experiences and feelings are reflected in this research and have left their mark for many years, even decades, after diagnosis. My main role is to case manage people living with HIV and other complexities such as comorbidities, ageing, alcohol, recreational drug use and/or mental health issues, which is made more complex by a lack of motivation and isolation that partly stems from the initial diagnosis. There are those who years later still have not shared their status with anyone other than their HIV service. As a nurse and advocate it saddened me to read in this research study that some participants felt the counselling and support they initially received had a negative effect ‘adding to their burden’ and they feared judgement or mistreatment, which therefore led to disengagement with the HIV service. In the United Kingdom we have a range of services to support the newly diagnosed such as peer support or peer-led ‘recently diagnosed courses’, which have helped some to feel more in control of their HIV, nurses and health advisers encourage sharing of HIV status but this may be discussed over months or years,