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Men who have sex with men (MSM) are a key population in the HIV epidemic in Western industrialised societies. Significant strides have been made in preventing HIV infection in MSM—indeed, a 60% decrease in HIV incidence was observed in London at the end of 2016.1 This can be attributed to the combined effect of treatment as prevention and pre-exposure prophylaxis (PrEP) in high-risk MSM. However, sexual risk-taking, inconsistent condom use and low uptake of PrEP remain obstacles to eradicating new HIV transmissions. Advances have also been made in enhancing HIV care. In England, 87% of MSM living with HIV have been diagnosed and over 90% are now on effective antiretroviral therapy (ART).2 Yet, some patients struggle to accept and adjust to their HIV diagnosis. Some decide not to initiate ART. Some are lost to follow-up. Often, the underlying causes are psychosocial in nature. We believe that social psychology has a role to play in developing steps to improve HIV prevention efforts and patient engagement with HIV care.
Psychosocial constructs, such as identity, culture and psychological well-being, are central to effective prevention and care. Identity process theory3 postulates that individuals regulate their sense of identity by attempting to deflect threats to important ‘principles’ of identity, such as self-esteem and sense of continuity. It is easy to see how diagnosis with HIV could challenge one’s sense of continuity over time, or how exposure to HIV stigma could threaten self-esteem. Our culture, in part, shapes the meanings we attach to events and situations, …
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