The Impact of HIV to Intimacy and Sexual Behaviours of Gay Couples in Serodiscordant Relationships in Taiwan: a Qualitative Pilot Study
DOI:
https://doi.org/10.12970/2309-0529.2014.02.01.4Keywords:
Male gay couple, intimate relationship, sexual behaviours, HIV/AIDS, serodiscordant couple (mixed-status couple).Abstract
Purpose: This study aims to understand the impact of one partner’s seroconversion to intimacy and sexual relationships of gay couples, and the adaptive methods taken by both partners. Method: Qualitative analyses were performed on the contents of counselling sessions with 6 consented HIV serodiscordant gay couples. Findings: 1) The main challenge by HIV to couple are sexual and intimate relationship. Both partners tend to conceal, or be vague, in communicating their sero-status, prior sexual history, feelings and emotions and their understanding of HIV. 2) HIV replaces prior commitments within relationships. New rules of conduct are established and both partners demands ‘transparency’ within relationship. Care-taking becomes a way of intimacy expression, and new forms of commitments are established in order to rebuild dyad relationships. 3) Various methods are taken by gay couples to reduce the risks of HIV transmission, such as reducing the frequency of sexual activities, or terminating relationships, finding sexual partners who are also seropositive, or engaging in extra-partnership sexual activities; 4) Safe sex and intimacy appear to be in conflict with each other. Conclusions: HIV/AIDS interventions include helping clients to reinterpret and reconstruct the meaning of ‘HIV-related issues’, to establish new roles and connections within partner relationship, to improve ways of communication, and to advocacy of safe sex with risk-management or risk reduction practices discussed in the study, for example changing sexual positions, reducing acts involving insertions, ejaculation outside of body.References
[1] Center for Disease Control, R.O.C. 2013 Statistics of HIV/AIDS. http://www.cdc.gov.tw/public/Attachment/ 9121110281371.xls (accessed Oct. 4, 2013) (in Chinese).
[2] Rhodes T, Cusick L. Love and intimacy in relationship risk management: HIV positive people and their sexual partners. Socio Heal Illne 2000; 22: 1-26. http://dx.doi.org/10.1111/1467-9566.00189
[3] Palmer R, Bor R. The challenges to intimacy and sexual relationships for gay men in HIV serodiscordant relationships: a pilot study. J Mar Fami Thera 2001; 27: 419-31. http://dx.doi.org/10.1111/j.1752-0606.2001.tb00337.x
[4] Beckerman NL. Couples of Mixed HIV Status: Clinical Issues and Interventions. New York: The Haworth Press. 2005
[5] Mancilla M. Troshinsky L. Love in The Time of HIV: The Gay Man’s Guide to Sex, Dating, and Relationships. New York: The Guilford Press 2003.
[6] Tsai CM, Hsu SC. ‘Love’ or ‘obstacle’? A pilot study of the impact of HIV on the interactions between serodiscordant gay couples. J Dep Social Work, NTU 2009; 19: 1-40 (in Chinese).
[7] Leask C, Elford J, Bor R, Miller R, Johnson M. Selective disclosure: A pilot investigation into changes in family relationships since HIV diagnosis. J Fami Thera 1997; 19: 59-69. http://dx.doi.org/10.1111/1467-6427.00038
[8] Greenan DE, Tunnell G. Couple Therapy with Gay Men. New York: The Guilford Press 2003.
[9] Murphy D, Ellard J, Newman C. Serodiscordance in regular relationships. Soc Res Issue Paper 2003; 2: 1-4.
[10] Jamieson L. Intimacy: Personal Relationships in Modern Societies. Translated by M. Tsai, Taipei, Socio, 2002 (in Chinese).
[11] Heller PE. Intimacy and safer sex. Focus: Gui AIDS Res Couns 1999; 14: 1-4.
[12] Crabtree BF, Miller WL. ed. Doing Qualitative Research. Translated by Huang, H. and others, Taipei: Weber 2007 (in Chinese).
[13] Wu YS. Struggling between Self-Exposure and Disclosure -- An Ethnographic Study of the Intimate Relationship among the HIV Infected Gays. Master Thesis, Tzu Chi University, Hualien, ROC, 2004 (in Chinese).
[14] Martin JI. Gay men and intimacy: missing link in HIV prevention. Gui AIDS Res Couns 1999; 14: 5-8.
[15] Bunnell RE, Nassozi J, Marum E, et al. Living with discordance: knowledge, challenges, and prevention strategies of HIV-discordant couples in Uganda. AIDS Care 2005; 17: 999-1012. http://dx.doi.org/10.1080/09540120500100718
[16] De Amorim CM, Szapiro AM. Analyzing the risk problem in couples with serodiscordance. Ciênc Saúde Coletiva [online] 2008; 13: 1859-68.
[17] Reis RK, Gir E. Vulnerability and prevention of sexual HIV transmission among HIV/AIDS serodiscordant couples. Rev Esc Enferm USP 2009; 43: 657-63. http://dx.doi.org/10.1590/S0080-62342009000300023
[18] Centers for Disease Control and Prevention. Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States: recommendations from the U.S. Department of Health and Human Services. Morbidity and Mortality Weekly Report 2005; 54(RR-2): 1-28.
