The role of stigma in the acceptance and disclosure of HIV among recently diagnosed men who have sex with men in Australia: A qualitative study
Autoři:
Jade E. Bilardi aff001; Alana Hulme-Chambers aff004; Marcus Y. Chen aff001; Christopher K. Fairley aff001; Sarah E. Huffam aff001; Jane E. Tomnay aff004
Působiště autorů:
Central Clinical School, Monash University, Victoria, Australia
aff001; Melbourne Sexual Health Centre, Alfred Health, Victoria, Australia
aff002; Department of General Practice, University of Melbourne, Victoria, Australia
aff003; Centre for Excellence in Rural Sexual Health, University of Melbourne, Victoria, Australia
aff004
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0224616
Souhrn
Background
Our primary study aimed to explore the experiences of men who have sex with men (MSM) recently diagnosed with HIV and their partner notification practices. Themes relating to acceptance, and disclosure of, their HIV status strongly emerged during analysis in our larger study and are reported separately here.
Method
Fifteen MSM participated in semi-structured interviews by phone or face to face about their experience of a recent HIV diagnosis. In this paper we report on how they received and accepted the diagnosis, who they disclosed their diagnosis to and what is needed to improve support for MSM recently diagnosed with HIV.
Results
MSM’s reactions to their HIV diagnosis ranged from shock, devastation and anger to a calm acceptance and feeling HIV would not have a significant impact on their lives. MSM who reported strong social support networks, or knew others with HIV, seemed better able to cope with and accept their diagnosis than those with fewer support networks. Due to prevailing stigma around HIV, most MSM were very selective about who they disclosed their status to, often only telling partners perceived to be at risk but no, or only few, close friends. Regardless of how well men accepted their diagnosis, most did not disclose their status to family members for fear of rejection or causing distress due to ideologies based on outdated information about HIV.
Conclusion
The prevailing stigma around HIV can have a significant impact on MSM’s acceptance of, and willingness to disclose their HIV serostatus to others, and consequently the levels of professional and social support they receive. HIV-related stigma needs to be addressed through community campaigns which better educate the wider population about the current state of HIV prognosis and treatment.
Klíčová slova:
Australia – HIV clinical manifestations – HIV diagnosis and management – HIV prevention – Human sexual behavior – Men who have sex with men – Social networks
Zdroje
1. Holt M. Progress and Challenges in Ending HIV and AIDS in Australia. AIDS Behav. 2017;21(2):331–4. doi: 10.1007/s10461-016-1642-0 28004219
2. Abler L, Sikkema KJ, Watt MH, Hansen NB, Wilson PA, Kochman A. Depression and HIV serostatus disclosure to sexual partners among newly HIV-diagnosed men who have sex with men. AIDS Patient Care STDS. 2015;29(10):550–8. doi: 10.1089/apc.2015.0122 26430721
3. Turan B, Hatcher AM, Weiser SD, Johnson MO, Rice WS, Turan JM. Framing mechanisms linking HIV-related stigma, adherence to treatment, and health outcomes. Am J Public Health. 2017;107(6):863–9. doi: 10.2105/AJPH.2017.303744 28426316
4. Bell S, Aggleton P, Slavin S. Negotiating trust and struggling for control: everyday narratives of unwanted disclosure of HIV status among people with HIV in Australia. Health Sociol Rev. 2018;27(1):1–14.
5. Mey A, Plummer D, Dukie S, Rogers GD, O’Sullivan M, Domberelli A. Motivations and barriers to treatment uptake and adherence among people living with HIV in Australia: A mixed-methods systematic review. AIDS Behav. 2017;21(2):352–85. doi: 10.1007/s10461-016-1598-0 27826734
6. Swendeman D, Ingram BL, Rotheram-Borus MJ. Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care. 2009;21(10):1321–34. doi: 10.1080/09540120902803158 20024709
7. Tomnay JE, Hulme-Chambers A, Bilardi J, Fairley CK, Huffam S, Chen MY. A qualitative study of means to improve partner notification after an HIV diagnosis among men who have sex with men in Australia. AIDS Patient Care STDS. 2017;31(6):269–74. doi: 10.1089/apc.2017.0080 28605227
8. Li H, Li X, Zhang L, Chow E. Effects of multiple types of stigma on the probability of HIV disclosure to sex partners: a systematic review. Sex Health. 2016;13(6):516–29. doi: 10.1071/SH16089 27491829
9. Sayles JN, Ryan GW, Silver JS, Sarkisian CA, Cunningham WE. Experiences of social stigma and implications for healthcare among a diverse population of HIV positive adults. J Urban Health. 2007;84(6):814. doi: 10.1007/s11524-007-9220-4 17786561
10. Skinta MD, Brandrett BD, Schenk WC, Wells G, Dilley JW. Shame, self-acceptance and disclosure in the lives of gay men living with HIV: An interpretative phenomenological analysis approach. Psychol Health. 2014;29(5):583–97. doi: 10.1080/08870446.2013.871283 24303867
11. Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one's HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75. doi: 10.1080/09540120801926977 18608080
12. Mahajan AP, Sayles JN, Patel VA, Remien RH, Ortiz D, Szekeres G, et al. Stigma in the HIV/AIDS epidemic: a review of the literature and recommendations for the way forward. AIDS (London, England). 2008;22(Suppl 2):S67.
13. Stutterheim SE, Bos AE, Pryor JB, Brands R, Liebregts M, Schaalma HP. Psychological and social correlates of HIV status disclosure: The significance of stigma visibility. AIDS Educ Prev. 2011;23(4):382–92. doi: 10.1521/aeap.2011.23.4.382 21861610
14. Institute Kirby. HIV, viral hepatitis and sexually transmissible infections in Australia:annual surveillance report 2017. Sydney: Kirby Institute, UNSW Sydney; 2017 2017.
15. Rueda S, Mitra S, Chen S, Gogolishvili D, Globerman J, Chambers L, et al. Examining the associations between HIV-related stigma and health outcomes in people living with HIV/AIDS: a series of meta-analyses. BMJ Open. 2016;6(7):e011453. doi: 10.1136/bmjopen-2016-011453 27412106
16. Earnshaw VA, Chaudoir SR. From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav. 2009;13(6):1160. doi: 10.1007/s10461-009-9593-3 19636699
17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57. doi: 10.1093/intqhc/mzm042 17872937
18. Darletson-Jones D. Making connections: The relationship between epistemology and research methods. Aust Community Psychol. 2007;19:19–27.
19. Conrad P, Barker K. The social construction of illness: Key insights and policy implications. J Health Soc Behav. 2010;51(S):S67–S79. doi: 10.1177/0022146510383495 20943584
20. Reidpath DD, Chan KY. A method for the quantitative analysis of the layering of HIV-related stigma. AIDS Care. 2005;17(4):425–32. doi: 10.1080/09540120412331319769 16036227
21. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative research in psychology. 2006;3(2):77–101. doi: 10.1191/1478088706qp063oa
22. Gribch C. Qualitative data analysis: An introduction Second ed. London: Sage Publications Ltd; 2013.
23. Barbour RS. Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? BMJ. 2001;322(7294):1115. doi: 10.1136/bmj.322.7294.1115 11337448
24. Thomas DR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval. 2006;27(2):237–46.
25. Flowers P, Davis MM, Larkin M, Church S, Marriott C. Understanding the impact of HIV diagnosis amongst gay men in Scotland: An interpretative phenomenological analysis. Psych Health. 2011;26(10):1378–91.
26. Martinez O, Carballo-Diéguez A, Ibitoye M, Frasca T, Brown W, Balan I. Anticipated and actual reactions to receiving HIV positive results through self-testing among gay and bisexual men. AIDS Behav. 2014;18(12):2485–95. doi: 10.1007/s10461-014-0790-3 24858480
27. Kalichman SC, DiMarco M, Austin J, Luke W, DiFonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32. doi: 10.1023/a:1024252926930 12921006
28. Hult JR, Maurer SA, Moskowitz JT. “I'm sorry, you're positive”: a qualitative study of individual experiences of testing positive for HIV. AIDS Care. 2009;21(2):185–8. doi: 10.1080/09540120802017602 19229687
29. Newman C, Persson A. Fear, complacency and the spectacle of risk: the making of HIV as a public concern in Australia. Health. 2009;13(1):7–23. doi: 10.1177/1363459308097358 19103713
30. Bray F, Chapman S. Community knowledge, attitudes and media recall about AIDS, Sydney 1988 and 1989. Aust N Z J Public Health. 1991;15(2):107–13.
31. Power J. Movement, knowledge, emotion: Gay activism and HIV/AIDS in Australia: ANU E Press; 2011.
32. The Lancet HIV. U = U taking off in 2017. The Lancet HIV. 2017;4(11):e475. doi: 10.1016/S2352-3018(17)30183-2 29096785
33. Grubb IR, Beckham SW, Kazatchkine M, Thomas RM, Albers ER, Cabral M, et al. Maximizing the benefits of antiretroviral therapy for key affected populations. J Int AIDS Soc. 2014;17(1):19320.
34. Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, et al. HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med. 2008;67(8):1225–35. doi: 10.1016/j.socscimed.2008.05.032 18599171
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