Young people who have grown
up with perinatally acquired HIV in wealthy nations are increasingly
transitioning into adult care settings which expect more independence and
self-regulation than paediatric care.
Drawing on the first qualitative study on
growing up with HIV in Australia, this paper examines
"responsibilisation" narratives in semi-structured interviews
conducted with young people with HIV and their paediatric and adult care
providers. Three dominant narratives were identified: responsibilisation as
imperative, practice and contest. This suggests that while young people growing
up with HIV in an advanced liberal setting such as Australia may value the
independence of adult care, and appreciate the need to take responsibility for
their health, the practices involved in becoming a responsible health citizen
are shaped by individual histories and circumstances, and in some cases, can
lead to serious contestation and conflict with care providers.
Placing a
stronger emphasis on what young people can gain from taking an active role in
managing their health may more successfully foster responsibilisation, rather
than focusing on what they will lose. Clinicians could benefit from greater
support regarding how to engage young people with the elements of
responsibilisation likely to resonate more meaningfully at different points in
their lives.
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- 1 Centre for Social Research in Health , UNSW Australia , Sydney , Australia.
- 2 Short St Centre Sexual Health Service, South East Sydney Local Health District , Sydney , Australia.
- 3 Paediatric HIV Service , Sydney Children's Hospital , Sydney , Australia.
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