The Impact of Stigma on the Self-care Behaviors of HIV-positive Gay Men : Striving for Normalcy

Since the beginning of the AIDS epidemic in 1981, persons diagnosed with human immunodeficiency virus (HIV) have been the targets of stigma. This is particularly significant for HIV-positive gay men who are additionally stigmatized because of negative societal views of homosexuality. While a few studies have examined the impact of stigma on the lives of persons living with HIV and AIDS (PWHA), very little of this research specifically examines how the complex forces of stigma influence the self-care behaviors of HIV-positive gay men. The purpose of this grounded theory study was to investigate how HIV-positive gay men manage the consequences of stigma, and more specifically to examine the impact of stigma on their self-care decisions and behaviors. A theoretical sample of 20 HIV-positive gay men participated in this study. Individual semi-structured interviews were conducted with 15 HIV-positive gay men. The oral interviews were audio-recorded and transcribed verbatim. A focus group consisting of five additional HIV-positive gay men also generated data on the topic. Participants were asked to talk about their experiences of dealing with gay stigma and HIV/AIDS stigma, and to describe how stigma affected their self-care. Men responded to HIV/AIDS stigma and gay-related stigma by engaging in a number of strategies along a stigma management continuum in order to protect themselves from being negatively labeled, shamed, or rejected by others. Striving for normalcy emerged as the central category across the entire set of interviews and focus group discussion. Participants sought to maintain normal lives by seeking affirming social support networks. Most men saw status disclosure as the main route to an affirming social support system and ultimately as a way to resolve any incongruence between self-view and reflected appraisals. A number of implications for clinical practice are drawn from the findings. The study’s limitations, and suggestions for future research are also discussed