Barcelona 2013
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| Abstract #165 - Stigma and Discrimination | ||||
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Session: 46.5: Stigma and Discrimination (Parallel) on Wednesday @ 09.00-11.00 in Teatre Chaired by Piedad Arazo, Joseph Lau Authors: Presenting Author: Mr. Pahl Samson - LIVE CONSORTIUM, United States |
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| Additional Authors: Dr M Paz Berm Dr Gualberto Buela-Casal, | ||||
| Aim: Stigma connected with HIV/AIDS has decreased considerably since the early epidemic, yet affects those living with HIV in many ways. Little research, particularly qualitative research, concerning HIV stigma from the perspective of gay men has emerged. The present qualitative study aimed to fill the aforementioned evidence gap by examining how HIV stigma is perceived, experienced and responded to by gay men who have become HIV infected. | ||||
| Method / Issue: A purposive sample of MSM in a large U.S. city was recruited by network referral. Eight in-depth interviews and three focus group discussions including a total of 19 men were conducted in spring 2012. Participants? ages ranged from 32 to 66 years, the average years of living with an HIV diagnosis was 13, most self-described as White, and all identified as gay. | ||||
| Results / Comments: In analyzing these men?s narratives using thematic analysis, it became clear that there were six main themes. A first theme of HIV stigma was stigmata ? visible marks and signs that designated individuals as HIV-positive. The disease manifested through three stigmata: HIV medications, lipodystrophy, and male homosexuality. Secondly, the men reported encountering HIV stigmatization, which ranged from subtle to blatant discriminatory behaviors due to their HIV-positive status, including gossip behind people?s back, rejection, verbal harassment, and loss of employment. Overwhelmingly, the participants found stigmatization to be most intensely felt within their own gay communities. The stigma attached to HIV was perceived as dividing gay men into separate, HIV-negative versus HIV-positive, cohorts. Fourth, one of the most profound themes that we identified was internalized HIV stigma, referring to the HIV-positive person?s internalized negative attitudes and feelings about their own HIV status. They described having feelings of shame, guilt, lack of self-worth, and feeling damaged because of being HIV infected. A fifth, and related theme was the closeted nature of HIV. Many participants described how they and people they knew, for fear of ramifications, devised strategies of concealing their seropositivity, such as hiding pill bottles and using clinics outside of their neighborhood. Lastly, regarding how the men dealt with receiving an HIV diagnosis and experiences of HIV stigma, a theme of adaptation became clear. For most, it seemed the adjustment approximated a grief process, characterized in particular by the emotions of denial, anger, depression, and for a few, eventual acceptance which typically took years. | ||||
| Discussion: Our results firmly support a scaling up of stigma-reduction initiatives to increase awareness of- and counter stigmatization of HIV-positive gay men. Although exploratory, the results can serve as a beginning framework for understanding and assisting seropositive gay men who experience HIV stigma. The findings are important because it is realistic to expect that, in a climate in which HIV has become increasingly invisible and closeted, and in which infections are on the raise, gay and bisexual men will be increasingly affected and infected by HIV. | ||||
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