title: The phenomenology of body image in men living with HIV.
abstract: Research into how people living with HIV or AIDS (PLWHA) experience and make sense of feared or actual body changes, such as lipodystrophy, is limited. The present study conducted in-depth interviews with gay men living with HIV. Interpretative phenomenological analysis (IPA) yielded themes across five domains. The ambiguity of early-stage lipodystrophy was a cause of distress. There was a drive to detect changes early, leading to anxiety, uncertainty and negative feelings about the body as well as possible misperception of change. In later stages, lipodystrophy was felt to be highly distinctive. Participants struggled to live with a shape that transgressed a body ideal. Feelings of loss of control were evident in both the increased ineffectiveness of strategies to maintain a desirable appearance and in the tendency for such changes to act as a visible marker of status. Conflicting feelings emerged in ideas of thinness and of health, with loss of fat seen as desirable in certain contexts. The study builds on previous research suggesting that the high value of appearance, particularly within gay communities, may lead to extreme compensatory behaviours. HIV places increased risk on a group highly vulnerable to body dissatisfaction and eating disorders. The study concludes with a cognitive-behavioural model of body image for PLWHA and suggestions for intervention. Further research is needed to validate the model and investigate whether the findings are generalisable. However, body image concerns should be acknowledged when addressing HIV-related health.
authors.affiliation: Department of Clinical Psychology, Royal Holloway, University of London, London, UK. jamie.kelly@nhs.net
authors.forename: Jamie Stephen
authors.initials: JS
authors.lastname: Kelly
authors.forename: Dawn
authors.initials: D
authors.lastname: Langdon
authors.forename: Lucy
authors.initials: L
authors.lastname: Serpell
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001294:Attitude to Health; D001828:Body Image; D005239:Fear; D015658:HIV Infections / Q000188:drug therapy; D039682:HIV-Associated Lipodystrophy Syndrome / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D055815:Young Adult