Marseille 2007
Marseille 2007
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Abstract #366  -  Gay mens perceived proximity to HIV: a qualitative analysis
Session:
  18.6: Risk Perception (Parallel) on Monday @ 14.00-16.00 in CP Chaired by Elizabeth Brown, Yusef Azad
Authors:
  Presenting Author:   Dr Peter Keogh - Sigma Research, United Kingdom
 
  Additional Authors:   
Aim:
Analyses of data on men who know or believe themselves to be HIV negative from the UK Gay Mens Sex Survey 2004 (GMSS) showed that men with greater perceived proximity to the epidemic (for example, men who had ever tested for HIV or had an HIV positive partner) had less unmet HIV prevention need than other groups. Conversely, men with less perceived proximity to the epidemic had greater unmet need and may therefore be vulnerable if they do come into contact with HIV positive sexual partners. This qualitative study explored how proximity to the epidemic influences negative mens perceptions and management of HIV-related sexual risk.
 
Method / Issue:
38 men filling our GMSS 2005 online who lived in London or Birmingham, had 13 or more male partners in the previous year and believed themselves to be HIV negative were given in-depth face-to-face semi-structured interviews. These men were divided into two groups. The high proximity group (20 men) personally knew someone with HIV and had a positive sexual partner in the year prior to interview. The low proximity group (18 men) had never personally known anyone with HIV and had never had a sexual partner who they knew or believed to have HIV. Interviews were audio-tape recorded and fully transcribed. Transcripts were subjected to a case-by-case and thematic content analysis by two researchers.
 
Results / Comments:
Men in low proximity groups used moral discourses to articulate beliefs and social norms around the disclosure of HIV which might act as a deterrent to any positive sexual partner disclosing. Moreover, the majority of the men in this group expected positive sexual partners to disclose for a range of practical and moral reasons. However, low proximity men had difficulty in articulating how they would respond to disclosure should it ever occur in a sexual context and how they would manage any consequent sexual activities. For the men in the high proximity group, living around HIV constituted a part of everyday life. Disclosure and discussion of HIV did not violate their social norms. The majority did not expect positive sexual partners to disclose to them and knew how they would respond to such disclosure if it occurred. Most were aware that a partner may be positive despite not disclosing. Men in this group did not use moral discourses about disclosure but rather talked practically about better and worse ways of managing HIV disclosure.
 
Discussion:
Proximity to HIV is mediated by strong social norms and self-perpetuating moral discourses which effectively create a social divide between men who perceive themselves to be in low proximity to HIV and HIV positive men. Men with perceived low proximity to HIV would expect an HIV positive partner to disclose their infection prior to sex though many were unclear how they might react if this occurred. Their naivity about disclosure and lack of preparedness to actively manage risk when HIV was known to be present in a sexual encounter make the group an appropriate target group for HIV prevention activities.
 
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