The social construction of HIV/AIDS

Goldstein, Natalie; Pretorius, Gertie; Stuart, Anita

doi:10.4102/hsag.v8i2.122

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Women are certainly vulnerable to infection not only because of physiological differences (Goldstein, Pretorius, and Stuart 2003), but also because of power imbalances in their interactions with men and gender inequalities in society. This has contributed to the development of a theme of female oppression in discussions about HIV and AIDS, with very little critical exploration of men's subjectivities.…”

Section: Introductionmentioning

confidence: 99%

Constructions of masculinity among a group of South African men living with HIV/AIDS: reflections on resistance and change

Lynch

Brouard

Visser

2010

Culture, Health & Sexuality

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Male sexuality in Africa is often associated with harmful sexual practices, which, in the context of HIV and AIDS, often positions men as central to the spread of the epidemic. Despite this focus on men's practices, there is a lack of research exploring the subject positions of men living with HIV. This study explores how masculinity is constructed by a group of black South African men who self-identify as heterosexual and are living with HIV. Using discourse analysis, a construction of a normative masculinity is identified as being both idealised and perceived as a burden, in that men continually need to engage in actions that affirm their position as 'real' men. By depicting men as invulnerable and unemotional, this construction limits men from acknowledging health risks or accessing support. A second discourse constructs HIV and AIDS as disrupting normative masculinity, in that it restricts men's agency through illness and the need for care. A final discourse relates to a transformed masculinity, where men living with HIV reconstruct their masculinity, as conforming to normative constructions of male identity is perceived as restrictive and harmful.

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Section: Introductionmentioning

confidence: 99%

Constructions of masculinity among a group of South African men living with HIV/AIDS: reflections on resistance and change

Lynch

Brouard

Visser

2010

Culture, Health & Sexuality

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“…Our study reinforces the literature that the social complications associated with disclosure affect myriad HIV-related concerns, including, as shown in our data, delayed initiation of ART [ 30 ]. While there have been consistent efforts targeted at couples such as HIV couple counselling and testing [ 57 ], there is a need to recognise that HIV initiation is a socially constructed decision [ 58 ] with individuals weighing their social situations in decisions to initate on ART. ART programs can address patients’ social circumstances when initiating ART by using patient-centered communication strategies and tools such as differentiated service delivery (DSD) and community-engagement to facilitate more rapid initiation [ 54 , 59 , 60 ].…”

Section: Discussionmentioning

confidence: 99%

‘I need time to start antiretroviral therapy’: understanding reasons for delayed ART initiation among people diagnosed with HIV in Lusaka, Zambia’

et al. 2022

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Introduction Rapid antiretroviral therapy (ART) initiation can improve patient outcomes such as viral suppression and prevent new infections. However, not everyone who can start ART does so immediately. Methods We conducted a qualitative study to inform interventions supporting rapid initiation in the ‘Test and Start’ era. We purposively sampled 20 adult patients living with HIV and a previous gap in care from ten health facilities in Lusaka, Zambia for interviews. We inductively analysed transcripts using a thematic, narrative approach. In their narratives, seven participants discussed delaying ART initiation. Results Drawing on messages gleaned from facility-based counselling and community information, many cited greater fear of rapid sickness or death due to imperfect adherence or treatment side effects than negative health consequences due to delayed initiation. Participants described needing time to ‘prepare’ their minds for a lifetime treatment commitment. Concerns about inadvertent HIV status disclosure during drug collection discouraged immediate initiation, as did feeling healthy, and worries about the impact of ART initiation on relationship dynamics. Conclusion Findings suggest that counselling messages should accurately communicate treatment risks, without perpetuating fear-based narratives about HIV. Identifying and managing patient-specific concerns and reasons for the ‘need for time’ may be important for supporting individuals to rapidly accept lifelong treatment. Key messages Fear-based adherence messaging in health facilities about the dangers of missing a treatment dose or changing the time when ART is taken contributes to Zambian patients’ refusals of immediate ART initiation Responsive health systems that balance a stated need for time to accept one's diagnosis and prepare to embark on a lifelong treatment plan with interventions to identify and manage patient-specific treatment related fears and concerns may support more rapid ART initiation Perceived social stigma around HIV continues to be a significant challenge for treatment initiation.

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“…According to the UNAIDS Global AIDS Epidemic Report, 80 % of women aged 15 and older living with HIV are in sub-Saharan Africa, despite the declines in new infections of the disease [ 1 ]. These have been attributed to several factors such as gender roles, socio-cultural expectations, power dynamics in relationships, and physiological vulnerability that predispose women than men [ 2 – 4 ]. Most work on HIV-related stigma has focused on women’s experiences of stigma and has described such experiences as being more intense than those suffered by men [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

Okoror

Falade

Walker³

et al. 2016

BMC Public Health

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BackgroundThough research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria.MethodsUsing purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants’ experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis.ResultsParticipants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants’ experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members’ diagnosis were less likely to report experiencing HIV stigma and more likely to report “not feeling less than a man” and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers.ConclusionsSocial context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their care seeking behaviors. These findings have implications for HIV programs geared towards African heterosexual men in general and HIV positive men in particular.

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The social construction of HIV/AIDS

Cited by 5 publications

References 8 publications

Constructions of masculinity among a group of South African men living with HIV/AIDS: reflections on resistance and change

Constructions of masculinity among a group of South African men living with HIV/AIDS: reflections on resistance and change

‘I need time to start antiretroviral therapy’: understanding reasons for delayed ART initiation among people diagnosed with HIV in Lusaka, Zambia’

Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria

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