HIV Diagnosis as Both Biographical Disruption and Biographical Reinforcement: Experiences of HIV Diagnoses Among Recently Diagnosed People Living With HIV

Wells, Nathanael; Murphy, Dean; Ellard, Jeanne; Philpot, Steven; Prestage, Garrett

doi:10.1177/10497323221146467

Cited by 11 publications

(7 citation statements)

References 53 publications

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“…For participants in our study, the period of viral detectability generally coincided with the period immediately following an HIV diagnosis, a period of significant adjustment and concern for their futures. 30 A greater focus on the needs of PLHIV during the period in which their viral load is detectable may help some PLHIV adjust to an HIV diagnosis and improve psychosocial wellbeing.…”

Section: Discussionmentioning

confidence: 99%

‘It’s like I have this weird superpower’: experiences of detectable and undetectable viral load among a cohort of recently diagnosed people living with HIV

et al. 2023

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Background By reducing HIV viral load to undetectable levels, HIV treatment slows disease progression and eliminates the possibility of sexual transmission. The promotion of undetectable viral load has also been accompanied by expectations of reducing HIV-related stigma, including self-stigma. Drawing on accounts of people recently diagnosed with HIV, we explored experiences of both detectable and undetectable viral load. Methods Between January 2019 and November 2021, semi-structured interviews were conducted with 35 people living with HIV (PLHIV) who had received an HIV diagnosis in Australia from 2016 onward. Of these participants, 24 completed follow-up interviews approximately 12 months later. Interviews were transcribed verbatim, entered into NVivo (software v12), and thematically analysed. Results Reflecting on the period in which their viral load was detectable, some participants described feeling ‘dirty,’ ‘viral,’ and ‘a risk’ to sexual partners. During this period, some participants minimised or ceased having sex, sometimes despite being in ongoing romantic relationships. Reaching undetectable viral load was commonly characterised as an important goal in HIV care and signalled a marker of good health and enabled a return to sexual relationships. However, the psychosocial benefits of undetectable viral load were not universally experienced, with some participants highlighting ongoing challenges of living with HIV long term. Conclusions Increasing awareness of the benefits of undetectable viral load is an important and powerful tool for improving the health and wellbeing of PLHIV; however, the period in which one’s HIV viral load is detectable can be challenging, particularly as feelings of being ‘unclean’ and ‘a risk’ may be internalised. Ensuring PLHIV are appropriately supported during periods of viral detectability is necessary.

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Section: Discussionmentioning

confidence: 99%

‘It’s like I have this weird superpower’: experiences of detectable and undetectable viral load among a cohort of recently diagnosed people living with HIV

et al. 2023

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“…and their lives (i.e., (stressful life, dark life, painful life, etc.) [ 16 , 31 , 32 ]. However, our study highlights novel findings on the application of additive and subtractive strategies that involves an interweaving of individuals’ internal assets or traits, such as hope, optimism and resilience, and external resources, including support from families, healthcare professionals, friends and co-workers, in the participants’ biographical reinvention.…”

Section: Discussionmentioning

confidence: 99%

“…These findings provide an understanding of how an interweaving of these aspects (internal asset—hope and external resource—health provider support) enabled participants to take on new positive activities (i.e., regular ART access, daily medication intake and regular check-up (additive strategy)) and giving up health-compromising activities (i.e., cigarette smoking, alcohol drinking, and drug use (subtractive strategy)). The application of these strategies enabled them to cope with or leave behind negative experiences (mental health and social repercussions of HIV) and work on a ‘reinvented’ future [ 15 , 32 , 37 ]. The findings have significant implications for HIV interventions and healthcare providers to recognise internal assets that PLHIV have and provide appropriate support to amplify those assets and enable PLHIV to cope with HIV-related challenges and develop their futures.…”

Section: Discussionmentioning

confidence: 99%

“…The results reveal self-acceptance and finding meanings as enabling factors that led to the change in negative attitudes and behaviours (i.e., sex with sex workers) and the commitment to help other PLHIV (i.e., assisting others in accessing ART). These reflect the core aspects of both subtractive and additive resilience strategies and the participants’ self-realisation as external resources for others in need [ 15 , 32 ]. Thus, it is plausible to suggest that accepting HIV-positive status and meaning-making may assist men in overcoming challenges and improving their mental health conditions, which may also have positive impacts on the overall health and well-being of their family members.…”

Section: Discussionmentioning

confidence: 99%

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Biographical Reinvention: An Asset-Based Approach to Understanding the World of Men Living with HIV in Indonesia

Fauk,

Mwanri,

Gesesew

et al. 2023

IJERPH

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HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at individual and social levels. This disruption has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV; n = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of ‘biographical reinvention’. Study participants were recruited using the snowball sampling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a ‘reinvented’ biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a ‘reinvented’ biography.

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“…Advances in HIV treatment have led to a reframing of HIV from a likely fatal illness to a chronic, manageable condition (Moyer, 2015 ; Moyer & Hardon, 2014 ; Newman et al, 2015 ). However, receiving an HIV diagnosis remains a significant and challenging experience owing to persistent HIV-related stigma, concerns about the health impacts of HIV, and anxieties of living with a long-term health condition (Pantelic et al, 2019 ; Sangaramoorthy et al, 2018 ; Sullivan et al, 2020 ; Wells et al, 2023 ). As such, the emotional and psychosocial wellbeing of people living with HIV are crucial considerations when conveying positive HIV diagnoses (Wells et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Requesting HIV Results Be Conveyed in-Person: Perspectives of Clinicians and People Recently Diagnosed with HIV

Wells¹,

Murphy²,

Ellard³

et al. 2023

Sex Res Soc Policy

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Introduction Guidelines recommend that, where possible, clinicians convey HIV-positive test results in person in Australia. However, HIV-negative and all other STI results are routinely delivered by phone or text message. Requesting individuals to obtain positive HIV test results in person could be a deviation from the standard delivery of healthcare and be interpreted as indicating a positive HIV diagnosis. Methods This paper is based on two related, ongoing qualitative studies conducted in Australia with HIV healthcare providers and people recently diagnosed with HIV. In study one, in-depth, semi-structured interviews were conducted with people who had recently received a positive HIV diagnosis. In study two, in-depth, semi-structured interviews were conducted with HIV healthcare and peer support providers. Interviews were analyzed thematically. Results While clinicians were willing to convey HIV-positive diagnoses by phone, most preferred in-person delivery. In-person delivery enabled clinicians to assess visual cues to better respond to the psychological and emotional needs of patients. For some participants living with HIV, however, the requirement to return to the clinic was interpreted as an unofficial HIV-positive diagnosis. This led to a period in which recently diagnosed participants believed they were HIV-positive without having received an explicit diagnosis. Conclusion Protocols for delivering HIV diagnoses by phone, followed by a face-to-face appointment, may reduce the period of anxiety for some patients and assist with an early connection to HIV care and support. Policy Implications In some instances, conveying HIV diagnoses by phone may be more appropriate than recalling individuals to the clinic to deliver a positive HIV diagnosis in person.

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HIV Diagnosis as Both Biographical Disruption and Biographical Reinforcement: Experiences of HIV Diagnoses Among Recently Diagnosed People Living With HIV

Cited by 11 publications

References 53 publications

‘It’s like I have this weird superpower’: experiences of detectable and undetectable viral load among a cohort of recently diagnosed people living with HIV

‘It’s like I have this weird superpower’: experiences of detectable and undetectable viral load among a cohort of recently diagnosed people living with HIV

Biographical Reinvention: An Asset-Based Approach to Understanding the World of Men Living with HIV in Indonesia

Requesting HIV Results Be Conveyed in-Person: Perspectives of Clinicians and People Recently Diagnosed with HIV

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