Experiences of the Orthodox Community Among Orthodox Jewish Gay Men

Sense of community includes elements such as sense of belonging, mutual interdependence, trust, shared goals and values, and shared history. It is associated with benefits for both the members and the community and is believed to be stronger in religious minority groups. This qualitative study describes the experiences of the Jewish Orthodox community among Orthodox Jewish gay men. In-depth interviews were conducted with 22 men about their experiences of being gay in their Orthodox communities. A content analysis revealed four themes: community as a home, community as a comprehensive provider, community as a strict behavior regulator, and community as punitive toward gay men. Findings suggest that Orthodox Jewish gay men have mixed feelings about their community; being satisfied with a community that provides for all their needs, but also living in constant fear of the negative consequences they and their families may endure if their homosexuality will be revealed. Recommendations for social work practice are provided.     

Lived Experience and Interpretation in Narrative Theory: Experiences of Living with HIV/AIDS

Narrative analysis builds on the strengths of qualitative research by examining the construction of meaning and symbolic systems in a framework that is explicitly temporal and that links research in the humanities with that in the social sciences. Qualitative methodologies often assume reported data accurately reflects the realities of lived experience. On the other hand some research drawing on cultural studies argues that the facts of a person's life are irrelevant. This paper argues for a middle way based on narrative theory that explores the interaction of objective events and their subjective interpretation. Further, narrative analysis enables exploration of the temporal structure of people's experiences focusing on both how a person's memories of the past and anticipations of the future influence their understanding and actions in the present. These points are developed drawing on the theory and methodology of both Symbolic Interactionism and Paul Ricoeur's Hermeneutics. The experiences of people living with HIV/AIDS are used to illustrate and explicate the usefulness of narrative analysis.     

Silence and Assumptions: Narratives on the Disclosure of HIV Status to Casual Sexual Partners and Serosorting in a Group of Gay Men in Barcelona

ABSTRACT

Disclosing HIV status and seeking sexual partners with the same serostatus (serosorting) are strategies used by some gay and bisexual men to have unprotected anal intercourse (UAI). This study aims to gain an understanding of the occurrence of disclosure and serosorting with casual sexual partners. A grounded approach was used to analyze 22 interviews with gay men from Barcelona. The results reveal that disclosure of serostatus or the seeking of sexual partners of the same HIV status are not behaviors in the repertoire of most HIV-negative men and were not even taken into account when they engaged in UAI with casual sexual partners. The opposite was observed in HIV-positive respondents who did consider the possibility of revealing their serostatus. Some relied on intuition or subjective elements to evaluate the HIV status of their occasional partners.     

Research with Gay Drug Users and the Interface with HIV

Abstract

Studying the co-occurrence of drug use and sexual risk behaviors among gay men poses special challenges for research. The importance of conducting such research, however, is underscored by current trends in the gay community, including increases in methamphetamine and club drug use. This increase has been associated with high-risk behavior for the transmission of HIV and other diseases (e.g., hepatitis B and hepatitis C). The author describes methodological issues related to initiating and conducting research among gay male drug users, and discusses how such research can guide more effective prevention, treatment, and policy initiatives related to drug abuse and HIV/AIDS.     

Strengthening the Capacity of Grandparents in Providing Care to Young Children Affected by HIV/AIDS

Abstract

Action for Children (AFC) is a non-governmental organization founded and registered with the government of Uganda in 1998 to rescue children from immediate danger and to advocate for their rights. AFC is working on a three-year pilot project entitled the Grandparents Action Support Project (GAS), designed and implemented to strengthen the capacity of grandparents providing care to HIV/AIDS orphans and vulnerable children under the age of eight, and to improve the overall welfare of the families taking care of these children. After only seven months, an interim program evaluation revealed that several effective innovative and pragmatic community-based strategies have been developed and implemented by participants. The Project has had a multiplier effect in participating communities in that ‘non-Project’ families are copying and learning from GAS Project homes. Challenges and future expansion of the Project are described.     

A Qualitative Analysis of Cultural and Social Vulnerabilities to HIV Infection Among Gay,Lesbian, and Bisexual Asian Youth

Abstract

The study reported here was undertaken to investigate cultural and social barriers that may increase HIV risk among gay, lesbian, and bisexual Asian youth. Interviews and focus groups were used to collect the data because they are well suited for this type of exploratory research. A total of 15 gay, lesbian, and bisexual Asian youth (7 females and 8 males) were recruited. Most of the participants (n = 11) self-identified as lesbian or gay. The mean age was 20.7, ranging from 17 to 24. Twelve participated in one of three focus groups while the remaining three were interviewed. Categories and themes identified include: (1) the lack of sex education at home, (2) homophobia in Asian families, (3) unresponsive health and social service providers, (4) lack of social support, (5) negative stereotypes, (6) ideal standards of beauty, and (7) negative perceptions of safer sex practices among Asian lesbian and bisexual women. HIV prevention strategies are suggested based on the recommendations and needs of our participants.     

Understanding the Influence of Loneliness on HIV Risk Behavior in Young Men Who Have Sex with Men

In this study we used grounded theory methodology to understand the influence of loneliness in YMSM in terms of HIV risk behavior. Twenty-two YMSM, 18–29 years of age, of HIV-negative/unknown status were interviewed. Results indicated that loneliness is defined in two ways: emotional and social. A cyclical pattern emerged that included negative symptoms, “self-treatment” of loneliness through drug use and sex, temporary relief, remorse related to engaging in HIV risk behaviors, negative self-image, and ultimately the reemergence of initial loneliness symptoms. Results suggest that loneliness in YMSM plays a greater role in HIV-related behavior than previously understood. A preliminary explanatory model, implications, and directions for future research are discussed.     

Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs

HIV/AIDS research has mostly focused on younger gay men. This cross-sectional study originated from a larger study of 316 respondents to include a subsample of 38 midlife and older gay men living with HIV/AIDS. The study explores physical and mental health utilization rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalized homophobia were also examined. A total of 65.8% of the HIV/AIDS participants received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalized homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are provided.     

The Relationship Among Population Size,Requests for Bareback Sex,and HIV Serostatus in Men Who Have Sex With Men Using the Internet to Meet Sexual Partners

Recent research has indicated the use of the Internet to meet sexual partners among men who have sex with men (MSM) is increasing. This medium also serves as a major source for social and sexual networking among MSM who live in more rural areas. In addition, data suggest the use of the Internet to initiate sexual relationships among this population may increase the risk of transmission of sexually transmitted infections, including HIV. The purpose of this study was to examine differences between self-reported HIV serostatus and requests for condomless bareback (BB) sex among a sample of Florida MSM (n = 483) using a popular Internet sexual networking site to meet sexual partners. Specifically, these variables were assessed in relation to population size among the site's seven geographic regions within the state. Findings indicated an overall statistically significant relationship among requests for BB sex and self-reported HIV serostatus. However, there was not a significant relationship among these variables and geographic region. Thus, although previous data have emphasized the importance of different HIV prevention strategies among rural versus urban MSM, there may not be major differences in HIV serostatus and requests for unsafe sexual practices among these men who use the Internet to meet sexual partners in comparison to MSM in more populated areas.     

Trust and Sexual Interaction: The Significance of the Internet on the Sex life and Sexual Risk Behaviors Of Gay and Bisexual Men in Spain

ABSTRACT

This study provides an understanding of the significance of the use of the Internet to find sexual partners, its impact on sexual life, and how it is linked to unprotected sex among gay and bisexual men. A grounded approach was used to analyze interviews with 31 men (aged 19 to 46 years) from Madrid, Barcelona, and Bilbao/San Sebastián, Spain. The results reveal that the Internet is impacting the form and style of life of many men, and particularly their experience of sexuality. Many men regard their sexual experiences with casual partners met through the Internet as unsatisfactory or frustrating. The men provided several reasons behind the search for sexual partners via the Internet: Some interviewees sought to channel needs other than the sexual (company, affection, stable partner). Trust and assumptions built into the virtual interaction become a key to understanding why some men have unprotected sex with partners met on the Internet.     

An in-depth mixed-methods approach to Ryan White HIV/AIDS care program comprehensive needs assessment from the Northeast Georgia Public Health District: The significance of patient privacy,psychological health,and social stigma to care

We apply a social-ecological interpretive framework to understanding relationships among patient privacy, psychological health, social stigma, and continuity in care in the HIV treatment cascade in the rural southeastern US. This research was conducted as part of the 2013 comprehensive needs assessment for the Northeast Georgia Ryan White Consortium using an anthropologically informed mixed-methods design, and a deductive-inductive approach to thematic analysis of qualitative data obtained in interviews and focus groups with service providers and service utilizers. Our comprehensive needs assessment yielded two key components. First, we identified salient phenomena influencing introduction to, retention among, and satisfaction of patients in the Ryan White-coordinated treatment cascade in NE-GA. Second, we formulated actionable recommendations around leverage points identified in the current district-wide system of care. Results highlight spatial, institutional, and interpersonal aspects of the system of care that intersect around issues of patient privacy, psychological health, and social stigma. These intersections constitute pathways by which persons living with HIV are exposed to stigma and other negative social signals regarding their health status without sufficient access to behavioral health services. These negative issues, in turn, can erect significant barriers to long-term continuity in care.