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An Exploratory Study of Barriers to Medical Treatment and Employment and Coping Strategies among HIV-positive Gay Men
The main purpose of this research was to explore the stigma-related experiences, barriers to medical treatment and employment, and coping strategies experienced by HIV-positive people. Social exclusion theory was applied and an antisocial exclusion policy was proposed. A qualitative research method was conducted using in-depth interviews. The interviewees included 7 HIV-positive gay men and 2 AIDS healthcare and social welfare experts between the 21st of September and the 24th of December, 2010. The results were as follows: 1. The HIV-positive participants experienced severe stress and trauma because of HIV disease. The HIV-positive participants themselves had a negative evaluation of AIDS. Most participants had experienced depression and thoughts of suicide. 2. The privacy of HIV status among HIV-positive participants was of great concern. The participants tend to conceal their illness. However, once their family members and friends had learned of their HIV status and accepted the truth, this resulted in great support for the participants. 3. The HIV-positive participants reported experiencing AIDS stigma, prejudice and discrimination not only from the general population but also from health professionals. 4. The HIV-positive participants were most concerned about medical treatment and expense, followed by the need of intimacy in a personal relationship. 5. The participants reported positive experiences of medical treatment from medical professionals in the Infectious Division, since some physicians transferred them to other doctors who treat HIV-positive persons in a friendly manner. In contrast, participants also reported medical treatment characterized by health professionals with negative attitudes, epithets, reactionary behavior, and problems with administrative services. 6. The main barrier to employment for the participants was disclosure of their positive HIV status when job-hunting. To avoid the HIV status being exposed, the participants tended to stay at the same job. Some participants reported being forced to quit due to their HIV-test results. These results showed that the employment rights for HIV-positive people are not completely enforced. 7. Most HIV-positive participants used multiple coping strategies including problem-focus and emotional-focus coping strategies against barriers and difficulties. However, HIV status confidentiality remained the main concern for the participants in the decision of whether to take action to fight for their rights. A strengthening of HIV/AIDS education for the general population and for healthcare professionals is recommended to enhance understanding and acceptance of HIV-positive people. In addition, the laws and policies enacted to protect the rights to medical treatment and employment for HIV-positive persons must be enforced. Moreover, counseling services are needed to assist newly HIV-positive persons living with HIV, while the development of HIV support networks are also needed to enhance adaptation and bestow a sense of belonging. Finally, the experts proposed increasing efforts toward the development of generic drugs for AIDS and efforts toward international bargaining to avoid huge financial burdens of medical treatment for HIV-positive people and governments.
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