HIV positive men as fathers: Accounts of displacement, ir/responsibility and paternal emergence

Abstract

It is now apparent that socio-cultural constructions of masculinity variously impact men's experiences of their HIV positive status, yet how being a father can feature in this mix remains under-researched. This study employed in-depth semi-structured interviews and Foucauldian-informed discourse analysis to explore the accounts of six self-identifying heterosexual fathers (four black African migrants, two white European) who had been living with HIV from five to 24 years. While the HIV-related literature calls for the need to subvert 'traditional' expressions of masculinity as a means of promoting HIV prevention and HIV health, we argue that the lived experience for HIV positive men as fathers is more socially, discursively and thus more psychologically nuanced. We illustrate this by highlighting ways in which HIV positive men as fathers are not simply making sense of themselves as a HIV positive man for whom the modern (new) man and father positions are useful strategies for adapting to HIV and combating associated stigma. Discourses of modern and patriarchal fatherhoods, a gender-specific discourse of irresponsibility, and the neoliberal conflation of heath and self-responsibility are also at work in the sense making frames that HIV positive men, who are also fathers, can variously deploy. Our analysis shows how this discursive mix can underpin possibilities of often conflicted meaning and identity when living as a man and father with HIV in the UK, and specifically how discourses of fatherhood and HIV 'positive' health can complicate these men's expressions and inhabitations of masculinity.

Masculinity, resources, and retention in care: South African men's behaviors and experiences while engaged in TB care and treatment

“…Finally, fatherhood was a highly valued identity resource. Specifically, responsibilities associated with fatherhood were key motivators for some men to actively engage in care and complete their treatment; the positive mental resource associated with fatherhood identification has been described in the HIV literature (Sherr, 2010;Highton and Finn, 2015). Men expressed a desire to become healthy again in order to provide and care for their children, as well as a desire to not transmit TB to their children.…”

“…Thus, when illness befalls men, their standing within their family and community is compromised commensurate with their loss of work and material gain. Moreover, studies suggest that men fear and experience isolation and abandonment while ill, which can compromise their role as biological and social fathers (Kumwenda et al, 2011;Skovdal et al, 2011;Mavungu, 2013;Chikovore et al, 2014Chikovore et al, , 2017Highton and Finn, 2015;Okoror et al, 2016).…”

A Systematic Review and Narrative Synthesis of Interventions for Parental Human Immunodeficiency Virus Disclosure

“…Research indicates that notions of male identity, family, and community influence disclosure among HIV-positive men ( 19 ). However, little research has examined how fatherhood affects men’s experiences with their HIV status, especially in the context of parental disclosure ( 47 ). Future studies should include HIV-positive fathers or both parents, if available, in order to understand their approach to parental disclosure and address their needs.…”