Gay men with HIV/AIDS often lack adequate social support networks. They face stigma and discrimination related to both their sexual orientation and HIV status. This can negatively impact their mental health and increase risky sexual behaviors. Developing community support programs that address cultural factors is important for improving disclosure of HIV status and reducing transmission risk among gay men.

1. The Lack of Social Support Networks for Gay Men with HIV/AIDS By: Jennifer Cooney

2. Terms Human Immunodeficiency Virus (HIV): virus disabling immune system: either of two strains of a retrovirus, HIV-1 or HIV-2, that destroys the immune system's helper T cells, the loss of which causes AIDS. Acquired Immune Deficiency Syndrome (AIDS):is an infectious disease caused by the human immunodeficiency virus (HIV). (Gale Encyclopedia of Medicine, 2008)

3. Significance The Center for Disease Control (CDC, 2009) estimates out of the 1,051,875 cases of reported AIDS diagnoses in the United States 494,937 have been diagnosed among men who have sexual relations with men. Social Networks are important because in gay HIV positive men because they can decrease : 1) Depression 2) Anxiety 3) Suicide Attempts 4) Risky Sexual behavior (Chauncey, Tobey, & Hays, 1990)

4. Social Supports Social Support: “ Interactive process through which emotional and instrumental support is obtained, particularly through one’s social networks (White & Cant,2003).” 1) Friends 2) Partners 3) Family 4) Community (Gay, Religious, HIV, Local)

5. Societal Issues HIV/AIDS was originally labeled a “gay-related immune deficiency” (Epstein, 1996). HIV/AIDS stigmatization exists within the general population as well as the gay community. Internalized homophobia by gay men has been linked to the belief that HIV transmission is a form of punishment as a result of their gay lifestyle which negatively affects health outcomes. (Hirsch & Enlow, 1984; Ross and Rosser, 1988; Quirk et al., 2006)

6. Why do Gay Men with HIV Lack Social Support? Have multiple lifestyle variables that are stigmatized in society: 1) Sexual Orientation 2) A life threatening disease HIV positive men face discriminationwithin their: 1) Community 2) Family: Lack of knowledge about HIV and inability to accept their orientation 3) Religious support systems 4) Peer Groups (Knight, pg. 229; Kadushin, 1999).

7. Stigma Stigma: “Any characteristic real or perceived that conveys a negative social identity (Quirk et al., 2006).” Herek and Capitanio (1999) found that blame, increased anger, and decreased sympathy was more likely to be directed toward an HIV positive gay man than a HIV positive heterosexual man.

8. Effects of Stigmatization 1) Risky sexual behaviors 2) Isolation 3) Loss of employment 4) Fear of disclosure of HIV status resulting in an increase of transmission within the community. (Hays, Chauncey, & Tobey, 1999; Knight, pg.229; Driskell et al., 2008)

9. Barriers for Disclosure Driskell et al. (2008) identified seven variables preventing gay men from disclosing their HIV infected status: 1) Rejection 2) Issues of Confidentiality 3) Missed sexual opportunities 4) Partners HIV status 5) Deferred responsibility 6) Sexual Partner Type 7) Public Sex Environment

10. Cultural Considerations African American gay HIV positive men: 1) Sexual orientation clashes with race, gender, and role expectations restricting disclosure of HIV status (Brooks et al., 2005). 2) Exhibit higher levels of internalized homophobia and reported lower levels of self-efficacy for disclosing their HIV status (O’Leary et al., 2007).

11. Other Cultural Considerations Latino gay HIV positive men: 1) Homosexuality is a sign of weakness and also thought to hurt or embarrass the family. 2) Latino gay youth with HIV report higher levels of spiritual hope and passive/avoidant coping responses. (Brooks et al., 2005; Rotheram-Borus et al., 1996)

12. Age, Gender and Religion Emlet(2006) found older individuals living with HIV/AIDS experience a duel oppression of ageism and the HIV stigma making it even harder for them to build social networks. Gay men are the most stigmatized group with HIV/AIDS and the name initially proposed for it was Gay Related Immune Deficiency (GRID). African American MSM are more likely than White men to rely on religion and denial to deal with the threat of AIDS. (Lesserman et al., 1992; Shilts, 1987)

13. What can we do to help? Develop prevention programs that serve HIV positive Gay men that explore: 1) Communities specific to gay HIV positive men, social support, and sexual risk behavior. 2) Seek to identify: Social vulnerability and personal resiliency in relation to HIV related disclosure practices and psychological well being. Reducing the spread of HIV can be increased by an increase in disclosure between men who have sex with men leading to safer sex. Help increase the “emotional attachments, alliances, and the ability to get advice (Lutgendorf et al.1998)” in gay men who have HIV. (Knight, pg.230; Hays, Chauncey, & Tobey, 1990)

14. References Babalola, S. (2007). Readiness for HIV testing among young people in Northern Nigeria: The roles of social norm and perceived stigma. Journal of AIDS and Behavior, 11, 759–769. Brooks, R. A, Etzel, M. A., Hinojos, E., Henry, C., Perez, M. (2005). What African American Male Adolescents are Telling us about HIV Infection among Their Peers: Cultural Approaches for HIV Prevention. Journal of AIDS Patient Care and STDs, 19(11), 737-744. Centers for Disease Control and Prevention. (2009). HIV/AIDS Surveillance Report. Retrieved July, 19, 2009, from http://www.cdc.gov/Features/DataStatistics.html Chauncey, S., Tobey, L., Hays, R. (1990). The Social Support Networks of Gay Men with AIDS. Journal of Community Psychology, 18 (4), 374-385. Courtenay-Quirk, C., Wolitski, R. J., Parsons, J. T., Gómez, C. A. (2006). Seropositive Urban Men's Study Team. Journal of AIDS Education and Prevention,18(1), 56-67.

15. References Driskell, R., Salomon, E., Mayer, K., Capistrant, B., & Safren, S. (2008). Barriers and facilitators of HIV disclosure: Perspectives from HIV infected men who have sex with men. Journal of HIV/AIDS & Social Services, 7(2), 135-156. Emlet, C. (2006). An examination of the social networks and social isolation in older and younger adults living with HIV/AIDS. Health and Social Work, 31(4), 299-308. Epstein, S. (1996). Impure science: AIDS, activism, and the politics of knowledge. Berkeley, CA: University of California Press. Gómez, C. A., Mason, B., Alvarado, N. J. (2005). The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men's relationships. Washington, DC, US: American Psychological Association Herek, G. M., Capitanio, J. P.,Widaman, K. F. (2003). Stigma, social risk, and health policy: Public attitudes toward HIV surveillance policies and the social construction of illness. Journal of Health Psychology, 22(5), 533-540.

16. References Hirsch, D. A., & Enlow, R. W.(1984). The effects of the acquired immune deficiency syndrome on gay life-style and the gay individual. In I. J. Selikoff, A. S. Teirsein, & S. Z. Hirschman (Eds.), Acquired immune deficiency syndrome: Annals of the New York Academy of Sciences (Vol. 437, pp. 273-282). New York: New York Academy of Sciences. Kadushin, G. (1999). Barriers to Social Support and Support Received from Their Families of Origin among Gay Men with HIV/aids. Health and Social Work, 24 Keogh, P. (2008). Morality, responsibility and risk: Negative gay men’s perceived proximityto HIV. AIDS Care, 20 (5), 576-581. Knight, K. R. (2005). The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men’s relationships. American Psychological Association, 217-231. Leserman, J., Perkins, D. O., Evans, D. L. (1992). Coping with the threat of AIDS: the role of social support. The American Journal of Psychiatry, 149(11), 1514-1520.

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