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Friends and peers. The responses in this subcategory represent the difficulties the participants have experienced in their relationships with friends and/or peers within the context of HIV. Self-isolation and distancing from friends appear to be common themes voiced by the participants. This distancing appears self-protective in that by avoiding friendships the participants can avoid the pain that may be inflicted by friends who are unsupportive of their HIV status. "Since I was diagnosed, I never usually interact with people that much, I interact but not on a friend to friend basis ... I don't keep a lot of friends." "So, by being positive, you look at people a lot different ... now I know I really need to get my life together and start looking at my friends ... the kind of stuff so-called friends have used hurts you."
Families. Responses in this subcategory reflect the difficult experiences that the participants have had with either their own family members or their significant other's family. Rejection by family members appeared to be a theme for the participants. Some participants felt exiled, either from their own families or the families of their significant others. "I think maybe, well, everybody [in my family] is turning against me and trying to push me away," said one. Another commented, "[His mother] loved me at first ... then once she found out, she didn't want me in her house anymore. It's like I'm killing her son."
Intimate/dating partners. These responses reflect the difficulties that the participants have had either in contemplating or establishing intimate relationships. One theme that appeared concerns infecting a partner. This concern might reflect the participant's fear, or perhaps the participant is being told by those around him or her that he or she should not become sexually involved with a partner. "I mean, personally, I don't want to get in no relationship, especially that I'm HIV positive and can infect somebody. I don't want no relationship at all." "The difficult part of it is, okay, it's like I found somebody but certain people are trying to stop us from being together [because of HIV], and that's difficult for me."
Finally, one theme questions whether anyone would be willing to be in an intimate relationship with an HIV-infected person. One participant mentioned the difficulties inherent in such a relationship, as well as the risks.
Psychological Burden of HIV
HIV and stress. These responses allude to the stressful nature of living with a life-threatening illness. Participants indicated that life was stressful before they found out they were HIV-positive; the HIV diagnosis either created stress or compounded the stress they were already experiencing. "I was going through a lot of stressful things and then I found out I was HIV positive, that just made it harder for me." Another response was, "I got an attitude problem now ... I guess with all the stress and everything."
HIV and negative affect. This theme encompasses some of the psychological responses to HIV, particularly those that create negative affective states. Negative-affect responses can include depression, anxiety, loneliness, and helplessness. Most of the participants report having experiences with these emotions. Some of those responses were: "My life was different, it wasn't a lot different, but it was different because I didn't have to think about this, to take special care and stuff like that ... when I found out about this, I was depressed and stuff like that, that make it worse." "I mean, it's kinda, it's not, it doesn't really give you a headache, but when you think about this life that you have now and your life that you had before, it was, well, it was just so much easier, that other life." "I think I'm more tolerant toward certain things ... it definitely changed my views of sickness ... I understand that kind of helplessness," and "You know, I don't want to stay alone all my life. I want to stay with somebody. Yeah, friends or relationship, or somebody. I don't want to stay alone."
Reflection Exercise #4
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Table of Contents
Several qualitative studies have already found that gay and bisexual men using the preventative medication PrEP have reported benefits in terms of reduced anxiety about HIV, but until now there has been scarcely any quantitative data to confirm this. Now, an Australian study shows a statistically significant reduction in HIV anxiety among men who were eligible for PrEP and who were using it.
A study from rural Tanzania, published online ahead of print in HIV Medicine, provides more evidence on the importance of appropriate management of clinically relevant drug-drug interactions for people living with HIV who are on antiretroviral therapy. As life expectancy of people living with HIV has increased due to improved access to antiretroviral therapy (ART), co-morbidities and co-medications are also on the rise. But appropriate management of clinically relevant drug-drug interactions is sub-optimal, especially in low-resource settings.
A Canadian study which compared the HIV status of gay men’s recent sexual partners with what would be expected if they chose partners regardless of status has found that HIV-negative men who used PrEP were nearly twice as likely to have HIV-positive partners as those who did not. It also found that men using PrEP were more likely to have sex with other PrEP users than with men not using PrEP. Conversely, non-users were more likely to have sex with non-users.
The incidence of invasive pneumococcal disease and community-acquired pneumonia remains high among people living with HIV, investigators from the Netherlands report in Clinical Infectious Diseases. Rates of these serious lung infections were highest among people not taking anti-HIV drugs and with CD4 cell count below 500.
New cases of hepatitis C virus (HCV) infection among Canadian gay and bisexual men taking pre-exposure prophylaxis (PrEP) were uncommon compared with rates previously reported in Europe, according to research presented this week at the AASLD Liver Meeting in Boston.