A decade of researching the social aspects of HIV and AIDS

Published: December 13, 2014

THE LANCET
Lesley Doyal
Original Article:  bit.ly/1qEjryV

My active involvement with HIV research began in 2005, after Professor Jane Anderson invited me to talk about gender to health workers involved in HIV services in the UK. Over coffee afterwards she discussed her desire to find out more about the lives of the African women for whom she was providing clinical care. I was keen to help, using my knowledge of qualitative research in the sociology of health. We, therefore, planned a collaborative study of the experiences of African women living with HIV who were receiving health care in a London hospital.

Our first study reflected the growing interest worldwide in the effects of HIV on poor women as the pandemic became increasingly “feminised”. As expected, the concerns of many participants were focused on their children, with most women living far from extended families whose members might have been a source of support. Familiar themes of both economic and physical insecurity emerged as did the complexity of relationships with intimate partners whose status might be positive, negative, or unknown, and who might or might not be willing to offer support.

After this initial study, we decided to compare these findings with the experiences of men infected with HIV, both those who identified themselves as heterosexual and men who had sex with other men (MSM). Separate studies of the two groups were undertaken to ensure that both gender and sexuality received the necessary attention. Surprisingly perhaps, our study of self-defined heterosexual men was one of the first to be done in any setting. The lives of these men after diagnosis have been largely invisible. One of the reasons for this soon became apparent to us as those men we approached seemed less willing than their female counterparts to discuss their illness. Most importantly, many men commented on the incompatibility they experienced between the physical and psychological “weakness” associated with HIV and AIDS and the social expectations placed on them as men. They told us about what they regarded as their inability to “perform” satisfactorily—as workers and sex partners—that they felt to be especially shameful. Moving on to our study of MSM, we again found ourselves in new territory. Unlike heterosexual men, this group has been more extensively researched in the richer parts of the world where they were the earliest “victims” of the pandemic and many had become HIV/AIDS activists. However, a similar willingness to discuss their situation was not found among the men in our study, many of whom were afraid to reveal their sexual identities. Indeed, a number talked to us about what they saw as the existential impossibility of being both gay and an African.

Full text of article available at link below:  bit.ly/1qEjryV
 

Leave a Reply