Chronic Disease Self-Management by People With HIV.
As HIV has transitioned into a chronic disease, reappraisal of clinical management has occurred with chronic disease self-management (CDSM) as one possibility. However, despite extensive work on CDSM across a range of diseases, little attention has focused on psychosocial contexts of the lives of people for whom programs are intended. This article reports semi-structured interviews used to explore health practices and motivations of 33 people with HIV (PWHIV) in Australia. Within participants' accounts, different forms of subjectivity and agency emerged with implications for how they understood and valued health-related behaviors. Four themes arose: health support and disclosure, social support and stigma, employment/structure, and health decisions beyond HIV. The experience of stigma and its intersection with CDSM remains relatively un-chartered. This study found stigma shapes agency and engagement with health. Decisions concerning health behaviors are often driven by perceived social and emotional benefit embedded in concerns of disclosure and stigma.
Monash University, Melbourne, Victoria, Australia La Trobe University, Melbourne, Victoria, Australia karalyn.mcdonald@monash.edu.
Karalyn
K
McDonald
University of New South Wales, Sydney, New South Wales, Australia.
Sean
S
Slavin
La Trobe University, Melbourne, Victoria, Australia.
Marian K
MK
Pitts
Monash University, Melbourne, Victoria, Australia Alfred Hospital, Melbourne, Victoria, Australia Burnet Institute, Melbourne, Victoria, Australia.
Julian H
JH
Elliott
D000293:Adolescent; D000328:Adult; D001315:Australia; D002908:Chronic Disease / Q000451:nursing*; D019468:Disease Management; D005260:Female; D015658:HIV Infections / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D012650:Self Disclosure; D000072339:Sexual and Gender Minorities / Q000523:psychology*; D057545:Social Stigma; D055815:Young Adult
Australia; HIV/AIDS; chronic; illness and disease; self-care; semi-structured interviews; stigma