title: Positive futures? The impact of HIV infection on achieving health, wealth and future planning.
abstract: Although HIV is now cast as a chronic condition with favourable clinical outcomes under new treatments, it is unclear how living with HIV affects expectations and planning for the future. This mixed-methods study aimed to investigate UK gay men's expectations of their own future when living with HIV, and to identify the heath and social interventions required to enhance roles, participation and personal fulfilment. A preliminary focus group identified relevant domains of enquiry for a subsequent online cross-sectional survey. A total of 347 gay men living in the UK with HIV participated in the survey, and 56.6% were currently on treatment. However, high 7-day prevalence of psychological and physical symptoms was identified (42.6% in pain, 80.2% worrying); 57.8% perceived reduced career options due to their infection and 71.8% reduced life expectancy. Being on treatment was not significantly associated with perceived life expectancy. Coded open-ended survey data identified eight principle themes related to goal planning and attainment. The integrated open and closed data items offer an understanding of barriers and challenges that focus on poor mental health due to clinical inattention, discrimination and stigma, poor career and job opportunities due to benefit and workplace inflexibility and lack of understanding, a lack of personal goals and associated skills deficit related to confidence and self esteem. Gay men living with HIV require an integrated holistic approach to wellbeing that incorporates clinical, social and individual intervention in order to lead productive lives with maximum benefit from treatment gains.
authors.affiliation: Department of Palliative Care, King's College London, London, UK. richard.harding@kcl.ac.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Tim
authors.initials: T
authors.lastname: Molloy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D008297:Male; D008875:Middle Aged; D011287:Prejudice; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept