Bridging the HIV Divide: Stigma, Stories and Serodiscordant Sexuality in the Biomedical Age

Persson, Asha; Ellard, Jeanne; Newman, Christy E.

doi:10.1007/s12119-015-9316-z

Cited by 27 publications

(20 citation statements)

References 24 publications

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“…As noted in the introduction, such a framing may be part of an identity‐based struggle aimed at affirming the regularity and general unproblematic nature of serodiscordant relationships so that participants (and their relationships) might gain social recognition and legitimacy (Persson et al . 2016, Squire 2010). Given that participants often focussed on the shared project in managing HIV, this article, though including men in non‐monogamous relationships, focuses solely on HIV within the primary relationship.…”

Section: Resultsmentioning

confidence: 99%

The ‘normality’ of living as a gay serodiscordant couple in Sydney, Australia

Philpot

Persson

Prestage

et al. 2020

Sociology Health & Illness

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Serodiscordant couples are often understood through a discourse of HIV‐risk or researched in terms of the psychological stressors they face. However, due to antiretroviral treatments people living with HIV can achieve undetectable viral loads, which not only make them non‐infectious to partners, but allow them to think of their lives and relationships as safe and viable. These realisations mean that serodiscordant couples often embrace an HIV ‘normalisation’ discourse. In this article, we argue that this discourse of HIV ‘normalisation’ can overlook the more nuanced complexity of issues still faced by couples today, which reveal how their experiences of ‘normal’ are sometimes challenged and are not necessarily ‘normal’. Utilising semi‐structured interviews with 21 gay men in serodiscordant relationships in Sydney, Australia, we draw on the concept of ‘home’ life to explore how men engage with discourses of normalisation to describe and enact their relationships. We argue that although HIV is managed well enough to be insignificant in the context of home life, experiences or anticipation of stigma in public often remind couples that they are yet to be considered ‘normal’ socially.

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Section: Resultsmentioning

confidence: 99%

The ‘normality’ of living as a gay serodiscordant couple in Sydney, Australia

Philpot

Persson

Prestage

et al. 2020

Sociology Health & Illness

Self Cite

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“…Most men were reluctant to assume a victim narrative, or frame PrEP in a negative light, noting that not only were they able to “manage” the negative issues associated with PrEP but that stigma rolled off their back so-to-speak. Our participants described how PrEP removed fear and stress related to contracting HIV, and told us that they saw PrEP as representing significant social progress for HIV-positive guys that helped to bridge the “sero-divide.” 29 , 30 However, we think it is important to reflect on the public health significance of some men on PrEP saying that they no longer discuss HIV status with sexual partners because of their PrEP use. While this reported change in behavior may be intended as a form of social progress—aimed at destigmatizing HIV positivity—there may also be potential unintended consequences of this behavior if more widespread.…”

Section: Discussionmentioning

confidence: 99%

The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users

Grace

Jollimore

MacPherson

et al. 2018

AIDS Patient Care and STDs

107

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With the emergence of daily oral tenofovir disoproxil fumarate and emtricitabine-based pre-exposure prophylaxis (PrEP) use in Canada, questions have emerged concerning the impacts of this HIV prevention tool on gay men's social and sexual lives. We conducted small focus groups and individual qualitative interviews with 16 gay men in Toronto who were part of the ‘first wave’ of Canadian PrEP users. Participants were on PrEP for at least one year as part of a demonstration project (November 2014–June 2016). These participants accessed PrEP before regulatory approval by Health Canada in February 2016. The mean age of participants was 37.6 years (SD 11.02); 94% completed secondary education, and 69% were white. Sex-stigma emerged as a complex theme in men's accounts of PrEP use across three overlapping domains: (1) PrEP-related stigma, including discussions of concealment and stigma from friends, family, and sexual partners, (2) PrEP as a perceived tool for combating HIV-related stigma, where some men said that they no longer discussed HIV status with sexual partners, and (3) PrEP as illuminating structural stigma, where it was attributed to unmasking stigma related to sex and sexuality. For some participants, PrEP has allowed for liberating sex and a self-described return to normalcy—normal, exciting, pleasurable sex that was no longer reliant on condom use. Paradoxically, some men said that PrEP use both led them to experience stigmatizing reactions within their social and sexual networks, while also helping to remove stigma, shame, and fear related to HIV, sexuality, and sex with gay men living with HIV.

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“…The determination of people living with HIV to embrace the metanarrative of HIV normalization is challenged by the ignorance of wider society about the radical transformations in HIV biomedicine, making it difficult to be open about their HIV status. In doing so, it reduces “the ‘social problem’ of HIV to an individualized concern” (p. 509).…”

Section: Discussionmentioning

confidence: 99%

From activism to secrecy: Contemporary experiences of living with HIV in London in people diagnosed from 1986 to 2014

Rai

Bruton

Day

et al. 2018

Health Expectations

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BackgroundSuccesses in biomedicine have transformed HIV from a debilitating and frequently fatal infection to a chronic, manageable condition.ObjectiveTo explore how the contemporary metanarrative of HIV as a chronic condition is understood by patients and how it varies depending on when they were diagnosed.DesignQualitative interviews with 52 people living with HIV who were diagnosed during different phases in the history of the epidemic.Setting and participantsParticipants were recruited from two HIV clinics in London to include four “HIV generations”: generation 1 were those who had been diagnosed pre‐1997 (pre‐ART), generation 2 from 1997 to 2005 (complex ART), generation 3 from 2006 to 2012 (simpler ART) and generation 4 diagnosed in the year before the study (2013‐2014).ResultsParticipants in all HIV generations took their medication as prescribed, attended clinic appointments and were well informed about their immunological biomarkers. While the pre‐treatment generation had been engaged in community endeavours such as activism, public education and use of support groups, those more recently diagnosed had little experience of collective activities and their HIV was essentially a private matter, separate from their social identity. These strategies worked for some; however, those experiencing clinical or social problems related to HIV or wider issues often relied exclusively on their HIV clinic for wider support.ConclusionThe loss of public conversation around HIV, the imperative for patients to take on greater individual responsibility for HIV management and the streamlining of HIV services alongside reductions in ancillary support services may expose some people to suboptimal health outcomes.

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Bridging the HIV Divide: Stigma, Stories and Serodiscordant Sexuality in the Biomedical Age

Cited by 27 publications

References 24 publications

The ‘normality’ of living as a gay serodiscordant couple in Sydney, Australia

The ‘normality’ of living as a gay serodiscordant couple in Sydney, Australia

The Pre-Exposure Prophylaxis-Stigma Paradox: Learning from Canada's First Wave of PrEP Users

From activism to secrecy: Contemporary experiences of living with HIV in London in people diagnosed from 1986 to 2014

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