Sunday, October 18, 2015

Stigma, Subsistence, Intimacy, Face, Filial Piety, and Mental Health Problems among Newly HIV-Diagnosed Men Who Have Sex with Men in China

High rates of mental health problems among people living with HIV (PLWH) have been widely reported in the literature; however, an understanding of the socioecological contexts of these presentations remains limited, particularly in China. In order to explore potential socioecological factors associated with mental health problems among newly diagnosed HIV-infected migrant men who have sex with men (MSM), we employed a life profile approach conducting semi-structured in-depth interviews with 31 newly diagnosed HIV-infected MSM residing in a city in Southern China. Participants’ life profile accounts outlined their concerns, including internalized stigma, subsistence living, difficulties finding a lover or a stable partner, loss of face, and deviation from filial piety. We contend that targeted interventions should address socioecological issues such as migrant adversities, social suffering, and cultural trauma when providing culturally based mental health services for this marginalized population within the context of Chinese society...

I haven’t been back to my hometown for 9 years. Honestly speaking, I feel I am very dirty [because of his HIV infection and his homosexual activities with many boys and men in his hometown] … If there are too many tongzhi, it will be awfully serious and this society will be ruined … I don’t like this circle from the bottom of my heart … This circle is really very “dirty.” Actually, I bear very big stress in these years. The stress of being a tongzhi is already very big. After being diagnosed with HIV positive, I feel the stress is much bigger than that of being a tongzhi … I now have lost confidence with everyone in Shenzhen, and people are untrustworthy indeed...

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My boss introduced me to a physician-in-chief in XX Hospital to check up and tested it out as HIV positive … Later he asked me to go home for a rest. That meant I was fired. Bosses are all like this. Whoever hears about HIV will not accept it at all.
My workload was too heavy in June, and my body could not bear it. I was extremely gloomy, depressed and lost interest. I worked 12 hours per day, and stayed up late at night, but my salary was low, less than RMB 2,000 (about USD 310)...
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I feel it is really difficult to look for a partner … Even in the circle of HIV-positive people, the people like me who are lowly educated, lack of training in working skills or technologies, and in low income are difficult to look for someone.
In this circle, people are neither frank nor honest to each other, and they are wary of each other. There is a kind of estrangement among them. On the one hand they want to look for real love, but on the other hand they worry about being hurt if they devote their love … I feel I even have lost the opportunity to look for partners now...
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Table 1

Summary of the Characteristics of Participants (Newly Diagnosed HIV-Infected Men Who Have Sex With Men [N = 31])
CharacteristicsN (%)
Age, years
 18-258 (25.81)
 26-3519 (61.29)
 36-404 (12.90)
Duration since diagnosis
 1-2 months15 (48.39)
 3-4 months11 (35.49)
 5-6 months5 (16.13)
Occupation
 Office10 (32.26)
 Service/seller5 (16.13)
 Technician9 (29.03)
 Laborer4 (12.90)
 Sex worker1 (3.23)
 Jobless2 (6.45)
Education
 College8 (25.81)
 High/technological school17 (54.84)
 Secondary school6 (19.35)
Monthly income (RMB)
 More than 6,0003 (9.68)
 3,000-6,00012 (38.71)
 Less than 3,00014 (45.16)
 No income2 (6.45)
Sexual identity
 Homosexual28 (90.32)
 Bisexual3 (9.68)
Married5 (16.13)
On ART8 (25.81)
Note. RMB = Renminbi yuan; $1 U.S. = 6.80 RMB in 2010; ART = antiretroviral therapy.

Full article at: http://goo.gl/HNsdor

By: Haochu (Howard) Li, PhD, postdoctoral scholarEleanor Holroyd, PhD, ProfessorJoseph Lau, PhD, Professor, andXiaoming Li, PhD, Professor
College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
  

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