Abstract:Social research with people living with HIV (PLHIV) rarely distinguishes between gay men and bisexual men. However, bisexual men may have unique experiences of HIV-related stigma and distinct support needs. In this paper, findings are presented from a cross-sectional survey of Australian PLHIV, which included the Berger (HIV) stigma scale. A total of 872 PLHIV completed the survey, of which 48 (6.0%) were bisexual men. Bisexual men reported higher levels of internalised HIV-related stigma, greater negative sel… Show more
“…Our analysis highlights the important role of peer support for re- family and romantic/sexual partners (Hollingdrake et al, 2017;Power et al, 2021). Social connection plays an important role in adjusting to a positive HIV diagnosis and is associated with improved mental health, well-being and quality of life (Brener et al, 2020;Kendall & Rogers, 2007;Lyons & Heywood, 2016;Power et al, 2019).…”
Section: Discussionmentioning
confidence: 83%
“…
What is known about this topic
People living with HIV (PLHIV) continue to experience stigma and social isolation. Lack of social connection among PLHIV is associated with poorer mental health outcomes (Power et al, 2019 ). Peer‐based programs assist recently diagnosed PLHIV in adjusting to the medical and psychosocial challenges associated with an HIV diagnosis.…”
mentioning
confidence: 99%
“…Lack of social connection among PLHIV is associated with poorer mental health outcomes (Power et al, 2019 ).…”
Effective HIV treatments have transformed the medical needs of people living with HIV (PLHIV) to a chronic condition. However, stigma, poorer mental health outcomes and social isolation remain significant challenges for many PLHIV. HIV peer support programs have assisted PLHIV in navigating the clinical, emotional and social aspects of living with HIV. We draw on semi-structured interviews with 26 recently diagnosed PLHIV in Australia to explore experiences of HIV peer support services. Our thematic analysis identified three overarching themes. First, participants commonly reported that peer support programs offered a sense of belonging and connection to a broader HIV community. This established a network, sometimes separate to their existing social networks, of other PLHIV with whom to share experiences of HIV. Second, peer-based programs provided an opportunity for participants to hear firsthand, nonclinical perspectives on living with HIV. While participants valued the clinical care they received, the perspectives of peers gave participants insights into how others had managed aspects of living with HIV such as disclosure, sex and relationships. Finally, participants highlighted important considerations around ensuring referrals were made to socially and culturally appropriate support programs. Peer support programs fill an important gap in HIV care, working alongside and extending the work of the clinical management of HIV. Incorporating formal referrals to peer support services as part of the HIV diagnosis process could assist recently diagnosed PLHIV in adjusting to a positive diagnosis.
“…Our analysis highlights the important role of peer support for re- family and romantic/sexual partners (Hollingdrake et al, 2017;Power et al, 2021). Social connection plays an important role in adjusting to a positive HIV diagnosis and is associated with improved mental health, well-being and quality of life (Brener et al, 2020;Kendall & Rogers, 2007;Lyons & Heywood, 2016;Power et al, 2019).…”
Section: Discussionmentioning
confidence: 83%
“…
What is known about this topic
People living with HIV (PLHIV) continue to experience stigma and social isolation. Lack of social connection among PLHIV is associated with poorer mental health outcomes (Power et al, 2019 ). Peer‐based programs assist recently diagnosed PLHIV in adjusting to the medical and psychosocial challenges associated with an HIV diagnosis.…”
mentioning
confidence: 99%
“…Lack of social connection among PLHIV is associated with poorer mental health outcomes (Power et al, 2019 ).…”
Effective HIV treatments have transformed the medical needs of people living with HIV (PLHIV) to a chronic condition. However, stigma, poorer mental health outcomes and social isolation remain significant challenges for many PLHIV. HIV peer support programs have assisted PLHIV in navigating the clinical, emotional and social aspects of living with HIV. We draw on semi-structured interviews with 26 recently diagnosed PLHIV in Australia to explore experiences of HIV peer support services. Our thematic analysis identified three overarching themes. First, participants commonly reported that peer support programs offered a sense of belonging and connection to a broader HIV community. This established a network, sometimes separate to their existing social networks, of other PLHIV with whom to share experiences of HIV. Second, peer-based programs provided an opportunity for participants to hear firsthand, nonclinical perspectives on living with HIV. While participants valued the clinical care they received, the perspectives of peers gave participants insights into how others had managed aspects of living with HIV such as disclosure, sex and relationships. Finally, participants highlighted important considerations around ensuring referrals were made to socially and culturally appropriate support programs. Peer support programs fill an important gap in HIV care, working alongside and extending the work of the clinical management of HIV. Incorporating formal referrals to peer support services as part of the HIV diagnosis process could assist recently diagnosed PLHIV in adjusting to a positive diagnosis.
“…Others have noted a lack of research about younger GBM living with HIV in Australia and the challenges they may face initiating or sustaining treatment [ 50 , 51 ], particularly if they do not have access to Medicare [ 15 ], and we recommend this be investigated further. Other Australian research has not found a difference in HIV treatment use between bisexual and gay men, but showed that bisexual men living with HIV may experience more stigma and lack social support compared with gay men living with HIV [ 52 ].…”
COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants’ HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017–June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020–June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP.
“…Drawing parallels with the minority stress paradigm (Meyer, 1995 , 2003 ), many gay men living with HIV face rejection, internalized stigma, or concealment motivations related to their HIV status (Power et al, 2021 ). Research has shown that concealment of HIV status reduces access to social support, which can negatively affect both mental and physical health (Walker, 2019 ; Ziersch et al, 2021 ).…”
Introduction
HIV-positive gay men continue to experience stigma related to sexual orientation and HIV status. Although resilience toward such stressors can be achieved, limited Australian research exists that examines how resilience is strengthened toward these dual stigmas.
Methods
A total of 20 men from Melbourne, Australia, participated in semi-structured interviews between March and October 2019 to explore ways in which they manage such stigmas.
Results
Reflexive thematic analysis identified two primary themes: (1) “intrapersonal control,” which relates to individual mind set and lifestyle changes that participants utilized to strengthen resilience; (2) “systemic change,” which includes participants’ needs for better public health messaging. Findings show resilience was enhanced when proactive approaches to sexual orientation, HIV health appraisal, lifestyle changes, and social support were made. Further, outdated HIV awareness campaigns and a lack of current messaging regarding HIV transmission in the wider community were identified as inhibiting resilience development and promoting stigma among gay men.
Conclusion
The results from this study show ways that Australian gay men strengthen their resilience through both intrapersonal (e.g., self-awareness, reappraisal, and self-efficacy) and external resources (e.g., education and public awareness) and how health care providers and social policy makers could better support the men to achieve this.
Social-Policy Implications
Findings suggest that targeted public health responses are required to compliment the advances made in biomedicine and viral suppression.
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