Unpacking Relationships

When Tricia Kayiatos-Smith was still earning her master’s degree in social work from Hunter College in New York City, she learned all she needed to know about trauma.

“Trauma is a backpack we carry around daily, not realizing how hindering its weight is,” says Smith. “I create a space where clients feel comfortable setting down the backpack and examining what’s within. My goal is to look at and honor each item inside and, ultimately, relieve some of that weight.”

It was through working with transgender women of color engaged in survival sex work — women who suffer disproportionate rates of violence and sexual assault — that Kayiatos-Smith realized that it was critical to try to recover from and heal trauma in order to live a healthy life.

Today, she’s a clinical social worker and psychotherapist in Los Angeles, who is still focused on helping and healing those within her own community — the LGBT community.   

Among the many areas that Kayiatos-Smith specializes in (anxiety, depression, relationship issues, codependency, LGBTQ issues, gender identity, HIV and other chronic illnesses, and PTSD), she is most passionate about helping trauma survivors, something there is unfortunately no shortage of among people living with HIV.

Kayiatos-Smith likes to argue that HIV is “culturally, medically, and therapeutically” a part of the LGBTQ community, and we shouldn’t ignore the great stigma perpetuated within our own community.

She uses the example of slang often used in gay dating apps like, “Are you clean?” It’s a clumsy and stigmatizing way to ask someone if they are HIV-negative. Kayiatos-Smith says that these types of terms can be emotionally harmful for those living with HIV.

So what does Kayiatos-Smith feel is missing from the conversation around HIV in 2018?

“I think PrEP is the number one thing,” she says, and adds that the prevention method is “quite revolutionary for folks who are HIV negative [and] folks who are in serodiscordant relationships.” She says PrEP also is a good thing because it “brings us to conversations around slut-shaming, and the stigma around the disease that very much still exists.”

Expert Tips on Relationships and Dating from Tricia Kayiatos-Smith

1. Disclosure:Disclosure is a personal decision. People living with HIV are often judged and sometimes even criminalized for choosing when, if, and how to disclose. For those disclosing, try bookending it between conversations with your support system or practicing with a friend or therapist. For those hearing the disclosure, work on providing a safe and accepting space for someone’s vulnerability.

2. PrEPare Yourself!: PrEP, or pre-exposure prophylaxis, is a daily medication for folks considered to be at risk for HIV contraction and stops the virus from taking hold in and spreading throughout your body. It’s a safe, effective option for people in serodiscordant relationships, with multiple partners, or who have receptive anal sex. 

3. Undetectable = Untransmittable: When a person is “undetectable,” it means that they are adherent to their HIV medications to the point that the virus is no longer detectable in their system. Studies have shown that couples who participate in both receptive and insertive sex have had no seroconversion when the HIV-positive partner is adherent to their medications, and has reduced their viral loads to the point of being undetectable. 

4. Self Care: You can’t pour from an empty cup and taking care of yourself is an act of taking care of those around you. In order to show up for our partners and our relationships, we need to be, or aim to be, our best selves. It might seem counterintuitive but taking time alone for ourselves helps us to be better company.

5. Couples Counseling: The stigma of therapy and, especially, couples therapy can often prevent people from accessing help when they need it. Couples counseling is an opportunity to speak truth in a safe, nonjudgmental environment aimed towards conflict resolution. It’s not just for couples on the verge of splitting up, but for couples looking to learn new ways of communicating effectively and lovingly.