Counselling approaches of Newly Diagnosed Gay men testing HIV positive in BC:

Learning from those already Infected

BC Gay Men’s Health SummitTuesday November 10th

Context

• We conducted research with a sample of HIV positive gay men to better understand the need of HIV positive gay men at time of diagnosis.

• The information was gathered to guide the development of a post diagnosis intervention

Method

• We recruited 20 HIV positive gay men though community organizations, posters in gay venues and ads on gay websites.

• Eligible participants were invited for an interview that lasted about one hour.

• Interviews were recorded and transcribed and then analyzed thematically.

Sample

• 20 participants from metro Vancouver

• Diagnosed between 2000 and 2008• Age from 23- 58 (Mean 42 years old)• Ethnicities : 12 Caucasians, 3

Aboriginals, 1 Asian, 4 Mixed.

Diagnosis

“Have you ever seen the television commercial where a woman goes in to see the doctor and he says “I’m afraid you have cancer”. And the doctor goes on and on. And all the sudden you don’t hear him anymore. The audio just goes out. It sort of like that, it really is. I’m not certain what my doctor said. All I heard was that I was positive and I don’t have Hep C.”

Diagnosis

“I just went blank. Everything just went blank. I actually had my car parked in the parking lot and I took the bus to go back home. So just to tell in which state of mind I was. [The doctor] told me to contact St-Paul’s Hospital and I had to change my doctor. It was very cold and very short.”

Diagnosis as loss

“ I remember just thinking: I got this thing inside of me and I can’t get it out. I had to mourn the loss of the normal, healthy person that I was and now I’ve got this thing inside of me.”

“There were so many things that started bubbling up to the surface. I knew I wasn’t in control anymore and I think that’s the most important thing, I had lost control of my life. Something else was going to be in control now and it wasn’t me… “

Emotional support

“I would have liked counselling. Just somebody to talk about things.”

“On a emotional level, nothing was there.”

“When you find those result, you get really depressed. You need attention from someone close to you.”

Who to talk to?

“It’s very different when you tell someone who’s HIV negative, that you’re HIV positive, than telling someone who’s HIV positive that you’re HIV positive. It’s a very different thing. It’s like if you’re recently widowed, talking to another widow. They have an idea of what you’re going through as opposed to someone who has no idea what you’re going through. What’s going on with you emotionally. What’s down the road and all that stuff.”

Who to talk to?

“Talking to someone who’s already HIV positive would’ve made more sense in my therapy to calm me down.”

“I would have been more comfortable to talk to a gay male, who is already infected”.

Barriers to access ASOs

“I just was never made aware of what was available. I wish I would’ve known before. ”

About the application process: “ It’s been more of nuisance to go and

get it filled.”

Barriers to access ASOs

“ The first time I went there, I had the impression of walking into a drug addict clinic.”

“I remember walking there and just the smell of the place, I was disgust by the smell of the place. Everything was kind of falling apart.”

Support from HIV+ friends

“ A friend of mine who was HIV positive and a volunteer [in a ASO] kind of grabbed me by the hand and push me towards AIDS organizations and encourage me to join… Which I did.”

“Because of my age and having a lot of friends that have been diagnosed, the first thing I did was gather up application forms and look online to get the support groups I needed behind me. “

Support from HIV+ friends

“I got a friend of mine to come with me to some [PWA event], cause for me the social networking was really important. To talk to people, just hearing other people’s stories and … you know, what they might be going through, and what I might go through in the future and stuff like that.”

Support from HIV+ friends

“I’ve been exposed to HIV positive guys for a long time, so… I basically got everything I needed to know from them.”

“ I wish I had someone there who was HIV positive who’s been through this before, you know like a big brother.”

In summary

• HIV diagnosis is a traumatic event• Psycho-social needs are ignored at

time of diagnosis• Newly diagnosed gay men want to

talk to other HIV + gay men• Men who had HIV positive gay men in

their social support network coped better with their diagnosis.

What should be the focus?

What do gay men need to cope with HIV Diagnosis?

Do they need counselling? Do they need a social support

network of other HIV positive gay guys?

Or do they need both?

Acknowledgements

• Malcolm Steinberg• Justin Go• Captain Snowdon• The CIHR study Team• The study participants