Discourses on sexual responsibility in a group of MSM living with HIV in Spain
P. Fernández Dávila1,2, A. Morales Carmona1, K. Zaragoza Lorca1
1Stop Sida, Research Unit, Barcelona, Spain, 2Universitat Ramon Llull, Faculty of Psycology, Physical and Educational Sciences Blanquerna, Barcelona, Spain
Background: To describe and understand the discourses on sexual care and responsibility in a group of men who have sex with men (MSM) living with HIV.
Methods: A qualitative study was carried out with 78 men (27-65 aged): 35 individual interviews and 43 in 5 discussion groups, in the cities of Barcelona, Madrid and Palma de Mallorca. The sampling criteria was that eighteen months had passed after a HIV diagnosis was established.
Results: Three distinct discourses about sexual responsibility were observed:
(1) unique responsibility: the HIV-positive man is who should protect himself in order to protect others. This discourse is based on an ethical positioning (altruistic), in which the duty and obligation to protect others is a priority;
(2) shared responsibility: both parties agree and/or consent to have a sexual risk practice although those who tend to use this discourse ultimately assume, in practice, the entire responsibility, and
(3) self-responsibility: individualistic approach, each cares of himself, although the type of emotional bond with others may affect the decision to care or not (there is some commitment to protect someone when it is felt something for that person).
Conclusions: A better understanding of the discourses around responsibility could help us to shape the type and content of interventions aimed at HIV-positive MSM. This could increase the effectiveness of HIV prevention programs. However, it is necessary to know more about the relationship between discourses of responsibility and behaviour as well as emotional state and stress within a sexual relationship as possible outcomes of the burden associated with that responsibility.