Experience of sexual self-esteem among men living with HIV

Much of the focus on sexual health for people living with HIV has been on promoting safe sex behaviours. However, also important for sexual health is a positive sexual self-esteem. This article reports on an interpretative phenomenological analysis of interviews with seven men about the impact that having HIV has had on their sense of sexual self. Five overarching themes were identified: the ‘destruction’ of a sexual self; feeling sexually hazardous; sexual inhibition; reclaiming a sexual self and finding a place through sero-sorting. With HIV now being a chronic illness, interventions are required to support people to lead sexually satisfying lives.

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Riding a rollercoaster in a hurricane – researching my own chronic illness

Qualitative Research Journal ◽

10.1108/qrj-09-2021-0092 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Rachel Murphy ◽

Belinda Harris ◽

Katharine Wakelin

Keyword(s):

Chronic Illness ◽

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Medical Condition ◽

Psychological Impact ◽

Phenomenological Analysis ◽

Complex Nature ◽

Content Type ◽

Incurable Condition ◽

The Impact

PurposeThis article outlines the experience of conducting Interpretative Phenomenological Analysis research into the chronic illness of Inflammatory Bowel Disease, an incurable condition of the gastro-intestinal tract which results in numerous physically and psychologically symptoms that are difficult to live with, by a researcher who shares the same condition. It considers the complex nature of researcher positioning from a nuanced, relational rather than binary insider/outsider position (Berger, 2015; Hayfield and Huxley, 2015). Additionally, the importance of reflexivity when conducting such personal, reciprocal qualitative research is brought to life, illustrating how such reflexivity deepens the relationship to the research, increases understanding of the interpretations and in turn its validity adds to the trustworthiness of both the endeavour and the written account (Etherington, 2007; Oakley, 2016).Design/methodology/approachConducting research into a medical condition that the researcher also experiences brings its own particular challenges (Hofmann and Barker, 2017). When the chosen methodology is Interpretative Phenomenological Analysis, with its in-depth, relational nature, those challenges intensify (Smith, 2009).FindingsUsing researcher journal extracts, the lived experience of researching whilst experiencing a chronic illness is explored. This includes the psychological impact of experiencing deep empathy for others living with IBD, managing the impact of increased disease knowledge, researching through fatigue and experiencing the claustrophobia of living with and researching one's own condition.Originality/valueFinally, tactics for surviving such research are provided in a bid to enable researchers and supervisors embarking on similar projects, to successfully manage the research rollercoaster ride even when it's in the middle of a Hurricane.

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The changing self: The impact of dementia on the personal and social identity of women (findings from the Improving the Experience of Dementia and Enhancing Active Life programme)

Dementia ◽

10.1177/14713012211047351 ◽

2021 ◽

pp. 147130122110473

Author(s):

Hannah Scott

Keyword(s):

Interpretative Phenomenological Analysis ◽

Psychological Impact ◽

Self Esteem ◽

Phenomenological Analysis ◽

Dementia Diagnosis ◽

Self Presentation ◽

Loss Of Self ◽

Active Life ◽

Self Enforcement ◽

The Impact

This paper explores the impact of dementia on the selfhood of women, specifically the ways in which changes occur as a result of such a diagnosis. Interviews were conducted with 12 women (recruited from the Improving the Experience of Dementia and Enhancing Active Life programme dataset), and analysed using interpretative phenomenological analysis. Emergent themes concerned the process of receiving and adjusting to a dementia diagnosis, the emotional and psychological impact of dementia, self-presentation and stigma and the self-enforcement of new boundaries. The analysis showed that dementia had a wide-ranging impact on the selfhood and identity of women, with newfound characteristics associated with the disease leading to a loss of self-esteem, sadness and anger. The women subsequently engaged in the modification of their behaviour, as a means of coming to terms with the losses experienced.

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Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health

BMC Public Health ◽

10.1186/s12889-021-10296-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kristie C. Waterfield ◽

Gulzar H. Shah ◽

Gina D. Etheredge ◽

Osaremhen Ikhile

Keyword(s):

Public Health ◽

Health Care ◽

Clinical Care ◽

Hiv Infections ◽

People Living With Hiv ◽

Negative Consequences ◽

Persons Who Inject Drugs ◽

Persons Living With Hiv ◽

Living With Hiv ◽

The Impact

Abstract Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases. Discussion As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher risk of contracting HIV, including persons who inject drugs or men that have sex with men, the risk of COVID-19 infection increases if they have certain comorbidities, are older than 60 years of age, and are homeless, orphaned, or vulnerable children. The risk of COVID-19 is also more significant for those that live in Low- and Middle-Income Countries, rural, and/or poverty-stricken areas. An additional concern for those living the HIV is the double stigma that may arise if they also test positive for COVID-19. As public health and health care workers try to tackle the needs of the populations that they serve, they are beginning to realize the need for a change in the infrastructure that will include more efficient partnerships between public health, health care, and HIV programs. Conclusion Persons living with HIV that also have other underlying comorbidities are a great disadvantage from the negative consequences of COVID-19. For those that may test positive for both HIV and COVID-19, the increased psychosocial burdens stemming from stress and isolation, as well as, experiencing additional barriers that inhibit access to care, may cause them to become more disenfranchised. Thus, it becomes very important during the current pandemic for these challenges and barriers to be addressed so that these persons living with HIV can maintain continuity of care, as well as, their social and mental support systems.

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Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

BMC Health Services Research ◽

10.1186/s12913-021-06331-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Marwân-al-Qays Bousmah ◽

Marie Libérée Nishimwe ◽

Christopher Kuaban ◽

Sylvie Boyer

Keyword(s):

Socioeconomic Status ◽

Health Expenditure ◽

Antiretroviral Treatment ◽

Catastrophic Health Expenditure ◽

Hiv Care ◽

Free Access ◽

People Living With Hiv ◽

Art Policy ◽

Living With Hiv ◽

The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

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Vaccine responses in ageing and chronic viral infection

Oxford Open Immunology ◽

10.1093/oxfimm/iqab007 ◽

2021 ◽

Author(s):

Chloe Rees-Spear ◽

Laura E McCoy

Keyword(s):

Viral Infections ◽

The Elderly ◽

People Living With Hiv ◽

Chronic Infections ◽

Vaccine Responses ◽

Inflammatory Conditions ◽

Immunological Changes ◽

Cellular Responsiveness ◽

Living With Hiv ◽

The Impact

Abstract Lay Summary Improved life expectancy in recent years has led to a growing population of adults over the age of 60. Age is commonly associated with increased inflammatory conditions and infections. Similar immunological changes have been observed during chronic infections, in particular HIV, where this is compounded by the success of antiretroviral therapy that has increased the number of people living with HIV into their sixties and beyond. The increased susceptibility of these groups to infection makes vaccination all the more important. However, the alterations to their immune systems call into question how effective those vaccinations may be. Here we discuss vaccine efficacy within elderly and chronically infected populations and investigate the immunological changes that may impact vaccine responsiveness. Over the last few decades, changing population demographics have shown that there is a growing number of individuals living past the age of 60. With this expanding older population comes an increase in individuals that are more susceptible to chronic illness and disease. An important part of maintaining health in this population is through prophylactic vaccination, however, there is growing evidence that vaccines may be less effective in the elderly. Furthermore, with the success of anti-viral therapies, chronic infections such as HIV are becoming increasingly prevalent in older populations and present a relatively unstudied population with respect to the efficacy of vaccination. Here we will examine the evidence for age-associated reduction in antibody and cellular responsiveness to a variety of common vaccines, and investigate the underlying causes attributed to this phenomenon, such as inflammation and senescence. We will also discuss the impact of chronic viral infections on immune responses in both young and elderly patients, particularly those living with HIV, and how this affects vaccinations in these populations.

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‘This is Killing me Inside’: The Impact of Having a Parent with Young-Onset Dementia

Dementia ◽

10.1177/1471301217702977 ◽

2017 ◽

Vol 18 (3) ◽

pp. 1089-1107 ◽

Cited By ~ 3

Author(s):

Helen J Aslett ◽

Jaci C Huws ◽

Robert T Woods ◽

Joanne Kelly-Rhind

Keyword(s):

Interpretative Phenomenological Analysis ◽

Service Providers ◽

Phenomenological Analysis ◽

Parent Support ◽

Young Onset ◽

Roles And Responsibilities ◽

Affected Parent ◽

Young Onset Dementia ◽

The Impact ◽

Depth Interviews

This study explored the experience of young adults having a parent with young-onset dementia. In-depth interviews were undertaken with five participants aged between 23 and 36 years of age and these were analysed using interpretative phenomenological analysis. Participants were found to experience a number of stresses in relation to their parent’s illness, many of which were linked to loss and guilt. Five main themes were identified related to relationship changes, shifts in roles and responsibilities, support for the non-affected parent, support for self and the impact of living with their own potential risk of dementia. These findings are discussed in relation to the existing literature and suggest that individuals with a parent with young-onset dementia have needs which service providers should consider in the wider context of young-onset dementia care.

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Stigma, gay men and biomedical prevention: the challenges and opportunities of a rapidly changing HIV prevention landscape

Sexual Health ◽

10.1071/sh16052 ◽

2017 ◽

Vol 14 (1) ◽

pp. 111 ◽

Cited By ~ 15

Author(s):

Graham Brown ◽

William Leonard ◽

Anthony Lyons ◽

Jennifer Power ◽

Dirk Sander ◽

...

Keyword(s):

Hiv Prevention ◽

Gay Men ◽

Sexual Minorities ◽

Research Policy ◽

Scale Up ◽

People Living With Hiv ◽

Structural Level ◽

Biomedical Technologies ◽

Living With Hiv ◽

The Impact

Improvements in biomedical technologies, combined with changing social attitudes to sexual minorities, provide new opportunities for HIV prevention among gay and other men who have sex with men (GMSM). The potential of these new biomedical technologies (biotechnologies) to reduce HIV transmission and the impact of HIV among GMSM will depend, in part, on the degree to which they challenge prejudicial attitudes, practices and stigma directed against gay men and people living with HIV (PLHIV). At the structural level, stigma regarding gay men and HIV can influence the scale-up of new biotechnologies and negatively affect GMSM’s access to and use of these technologies. At the personal level, stigma can affect individual gay men’s sense of value and confidence as they negotiate serodiscordant relationships or access services. This paper argues that maximising the benefits of new biomedical technologies depends on reducing stigma directed at sexual minorities and people living with HIV and promoting positive social changes towards and within GMSM communities. HIV research, policy and programs will need to invest in: (1) responding to structural and institutional stigma; (2) health promotion and health services that recognise and work to address the impact of stigma on GMSM’s incorporation of new HIV prevention biotechnologies; (3) enhanced mobilisation and participation of GMSM and PLHIV in new approaches to HIV prevention; and (4) expanded approaches to research and evaluation in stigma reduction and its relationship with HIV prevention. The HIV response must become bolder in resourcing, designing and evaluating programs that interact with and influence stigma at multiple levels, including structural-level stigma.

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Quality of Life in People Living With HIV: An Exploratory Cross-Sectional Survey in Belgium

AIDS Education and Prevention ◽

10.1521/aeap.2021.33.3.249 ◽

2021 ◽

Vol 33 (3) ◽

pp. 249-264

Author(s):

Gert Scheerder ◽

Sandra Van den Eynde ◽

Patrick Reyntiens ◽

Ria Koeck ◽

Jessika Deblonde ◽

...

Keyword(s):

Quality Of Life ◽

Negative Impact ◽

Sexual Life ◽

People Living With Hiv ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Related Stigma ◽

Living With Hiv ◽

The Impact

This cross-sectional survey explored the quality of life in 505 people living with HIV in Belgium. Several domains of quality of life were impaired: 26% had been diagnosed with depression and 43% had weak social support. HIV-related stigma is still widespread, with 49% believing most people with HIV are rejected and 65% having experienced discrimination due to HIV. The impact of HIV was limited on professional life, but 40% experienced a negative impact on life satisfaction and 41% a negative impact on sexual life. For several domains, people with a recent diagnosis of HIV and long-term survivors had significantly worse scores. This survey also uncovered strengths of people living with HIV, such as positive coping and HIV self-image. Expanding the scope of quality of life in people living with HIV may provide a more complete picture of relevant life domains that may be impacted by living with HIV, but this needs further validation.

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Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework

Journal of Aging and Health ◽

10.1177/0898264317724549 ◽

2017 ◽

Vol 31 (1) ◽

pp. 109-138 ◽

Cited By ~ 10

Author(s):

Mark J. Siedner

Keyword(s):

Quality Of Life ◽

Conceptual Framework ◽

Care Delivery ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Sub Saharan ◽

Living With Hiv ◽

The Impact

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.

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