Desiring intimacy and building community: young, gay and living with HIV in the time of PrEP.

The negative effects of stigma on men living with HIV within gay communities are well-documented. However, few studies have examined the experience of intimacy for men living with HIV as a consequence of the widespread availability of pre-exposure prophylaxis (PrEP). This study explores the effect of PrEP adoption on the lives of men living with HIV in one of the first cities that made PrEP widely available, and where adoption had already been in place in treatment trials prior to FDA approval in 2012. In-depth, semi-structured interviews were conducted with six gay men living with HIV under 40 years old in San Francisco, California. Transcriptions were coded using interpretative phenomenological analysis. Four key themes relevant to experiential changes within the gay community post-PrEP rollout were identified: (i) the desire for intimate connection; (ii) remembered experiences of stigma; (iii) men who do not take PrEP are suspect; (iv) and an awareness of the changing meaning of HIV. The findings suggest that, post-PrEP rollout, men living with HIV are experiencing dating, sex and community in ways that reflect a general reduction in the experience of stigma surrounding their HIV status. This suggests an important social impact of PrEP in reducing HIV-related stigma beyond the primary prophylactic effect.

Shame, self-acceptance and disclosure in the lives of gay men living with HIV: an interpretative phenomenological analysis approach.

OBJECTIVE: HIV-related stigma is a major driver of poor prognosis for the treatment and reduced spread of HIV. The present article provides a qualitative analysis surrounding various themes related to stigma and shame as a result HIV. DESIGN: Eight gay men recruited from a community HIV clinic contacted the researchers in response to a study involving participation in a structured, eight-week group intervention for HIV-related stigma. Following this group, three men took part in open-ended interviews about their thoughts and experiences. METHODS: Interpretative phenomenological analysis was used to examine the participants' experiences surrounding shame and stigma related to living with HIV. RESULTS: Three superordinate themes were identified: social support and the disclosure of serostatus, stigma associated with serosorting and attempts to negotiate a spoiled identity. CONCLUSION: In San Francisco, a city with a great deal of acceptance surrounding HIV and a large, politically active community of persons living with HIV, gay men continue to struggle with disclosure and stigma. This stigma may be an unexpected result of a high degree of HIV testing and attempts by both HIV-positive and negative gay men to practise serosorting.