Introduction In the UK, HIV disproportionately affects men who have sex with men (MSM). In the advent of antiretroviral therapy, HIV is considered a life-altering, rather than life-limiting, condition. However, the socio-psychological aspects of HIV infection can be challenging. Moreover, the promotion of positive wellbeing, health, and behaviour change can be difficult for HIV care-providers. Two studies are presented, which explore the psychological aspects of managing HIV infection from the perspectives of HIV-positive MSM and HIV clinicians, respectively.
Methods A qualitative interview approach was employed. For study 1, 15 HIV clinicians were recruited at sexual health clinics. For study 2, 20 HIV-positive MSM were recruited at sexual health agencies. The data were analysed using thematic analysis and Identity Process Theory from psychology.
Results Results from study 1 yielded the following themes: (1) Assessing the patient’s knowledge base, (2) Exploring disclosure patterns in patients, and (3) Promoting positive methods of coping with an HIV diagnosis. Clinicians’ accounts elucidate perceived opportunities for, and challenges associated with, health and wellbeing promotion among HIV-positive MSM. Results from study 2 yielded the following themes: (1) Difficult disclosure patterns and experiences, (2) Making sense of the identity transition process, (3) Building resilience amid identity threat. MSM’s accounts highlighted the identity threat associated with the experience of living with HIV and the strategies – both effective and ineffective – for coping.
Conclusion Both studies reveal overlap in the perceived challenges of HIV infection amid social stigma. There was some divergence in the construal of HIV and the importance of HIV status disclosure. While clinicians speak from medical/public health perspectives, patients discussed their HIV infection with identity requirements in mind. Collectively, results of both studies highlight possible ways in which wellbeing and health promotion interventions for MSM living with HIV can be designed and implemented. Some recommendations are provided.
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