GMFA Self-esteem and HIV Self-esteem (or self-worth) is basically the opinion you have about yourself. It is about how valuable you think you are, and whether you feel you have a purpose. It is also about being confident, knowing your strengths and weaknesses and being able to be self-critical without feeling de-valued. Having high self-esteem doesn’t mean you are better than everyone else, it just means that you know that you are as worthy as everyone else, and that you like yourself. Living with HIV can affect you in many different ways, and it can have an effect on self-esteem. Other factors, such as feelings of rejection, can lower your self-esteem. Rejection doesn’t just mean being turned down for sex however. If you have had to deal with rejection when you came out as gay, possibly by your family, or when you told people you have HIV, then these can build up and over time have a negative effect on how you see yourself. People with low self-esteem tend to lack confidence in themselves and feel less worthy than people around them. They can feel overwhelmed by the pace of life and have trouble asserting themselves. This can lead to them withdrawing from the outside world and from people close to them. Low self-esteem can cause people to lack the confidence to succeed, meaning they often underachieve. This in turn can cause people to have an even lower opinion of themselves, and even less confidence in their ability. This lack of self-confidence can be a major cause of anxiety and stress, and at its most severe can lead to longer-term health problems such as depression. On the other hand, low self-esteem can actually be a symptom of depression. We talk more about this in the section on Depression. It’s not uncommon for men with low self-esteem to take more risks with their lives, and to put themselves into situations where they feel pressured into doing something they don’t really want to do. If you are using sex as a form of escapism, and to try to make you feel better about yourself, then quite often it can have the opposite effect. You could also find yourself in situations where you are not as safe as you would like to be when having sex, but don’t feel confident enough to say something or do something about it. "I’d had problems with stress and self-confidence for quite a while. To be honest I didn’t like myself at all. I felt paranoid in public, and unable to fit in with all the other gay boys around me when I did go out. I started fucking around, thinking that this would make me feel more like everyone else, and that I would be accepted. I had sex with whomever and whenever I could, and to be honest I couldn’t care less about condoms when I did. I did some pretty stupid things, but I just wanted to feel good about myself. However, fucking around like this made me feel even more worthless and I didn’t really enjoy the sex I was having anyway. Eventually I was diagnosed with depression and since I started to get that sorted I feel like a cloud has been lifted. I also exercise regularly now – I found that swimming made me feel great, and improved my body image. The old paranoid me has gone now, and I’m getting my life back on track again." (Joe, 31)If you feel you are having problems with your self-esteem then it may really help if you talk to someone about it. You could speak to your doctor or a health adviser at your clinic about it and they’ll be able to tell you if there are any services available through the clinic that could be of use. Alternatively, call THT Direct on 0808 802 1221 for help finding counselling that is right for you.If you are interested in seeing a life coach, the Lifecoach website provides more information on how you could access more help.