What you need to know

 
 

In this text we will present a broad overview of what you need to know when moving to Sweden with HIV. We start with a general background of HIV and healthcare in Sweden, laws related to HIV in Sweden, immigration to Sweden with HIV and finally information about what you can do to meet others living with HIV.

The Swedish healthcare system and HIV

You are entitled to free treatment. Visits to the doctor, tests and medicines related to your HIV infection are free. This applies to everyone who lives in Sweden, even if you are an asylum seeker or have no paperwork. For other medical and dentist visits, you will have to pay as usual.

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. Your treating physician will provide you with rules of conduct that you must follow. 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).

You have the right to be involved in all decisions regarding your treatment, in consultation with doctors and healthcare professionals. This means that you have the right to change treatment if it makes you unwell and also the right to continue any treatment that you are happy with. The focus should be on your wishes and needs. You have the right to switch treating physicians. If you feel that you are being treated badly, you have the right to report the health service.

You have the right to psychosocial support and the right to choose who you want to talk to. You also have the right to support concerning your sexuality. Not all places have a counsellor, but you still have the right to see a counsellor if you want.

Healthcare workers and interpreters are bound by professional secrecy and confidentiality, which means that no one is allowed to disclose that you are living with HIV or what is said during your visits.

Shared health records enable all health care providers you visit to see what care you have received. The purpose is to facilitate treatment and provide better care. For example, it could be important to know how different medications work together. If you do not want this, you have the right to block this information. Since your health records can then not be read by different care providers, you have a duty to provide information if there is a risk of transmission. It is important to tell your treating HIV physician if you are receiving other care. You also have the right to read your own health records.

You cannot be denied the care you need because you are living with HIV. This also applies to private healthcare providers who receive compensation from the Swedish Social Insurance Agency.

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 “bloodborne infection”. These situations include dental work, drawing blood, getting a tattoo, using syringes and all forms of sex, even while using a condom. 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.

In 2019, Folkhälsomyndigheten (the Swedish Public Health Agency) formulated an updated statement about well treated HIV, which is assumed to play a role in how the law can be interpreted in the future.

Folkhälsomyndigheten 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 do not include an obligation to disclose status, even when having unprotected sex. Hence, the use of a condom is no longer required.

The new infection control situation means that the law is applied in a new way: 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.

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.

Meet others living with HIV

PG Väst is a resource for people affected by HIV regardless of gender, nationality, sexuality or legal status. We can give you advice, support and information. If you would like to meet others with similar experiences, we provide peer-to-peer counselling and social activities.

It doesn’t matter if you are HIV positive, a partner, relative or friend. Everyone is welcome.

Read more about what we are up to here:
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You can call us at 031-14 35 30.


This text is partially based on a blog post from Positiva Gruppen Syd from 2020. Thank you for inspiration and input.