Academic journal article Social Work

A Group Design for HIV-Negative Gay Men

Academic journal article Social Work

A Group Design for HIV-Negative Gay Men

Article excerpt

The AIDS epidemic has profound psychosocial significance for the gay community. Many urban gay communities, which include both HIV-negative and HIV-positive men, have met the challenges of the HIV epidemic with ingenuity, resilience, unparalleled behavior changes, and volunteerism and giving (Paul, Hays, & Coates, 1995). Gay men were the first to respond to the epidemic (Popham et al., 1983) and to date have accounted for the largest number of AIDS cases (Centers for Disease Control and Prevention [CDC], 1994). Moreover, gay men continue to be largely responsible for implementing programs to reduce the incidence of HIV infection among themselves. However, some gay men experience an extreme sense of hopelessness, an inability to imagine a viable future, and related psychological issues that must be recognized and addressed (Odets, 1994).

For more than a decade, social workers and other health care practitioners have concentrated their efforts on the psychosocial needs of gay men infected with HIV and those living with AIDS (Dane, 1989; Dowd, 1995; Icard, Schilling, El-Bassel, & Young, 1992; Lopez & Getzel, 1984; Nichols, 1986; Sheran, 1995). Gay men not infected with HIV, however, are significantly under-represented in the social work and psychotherapeutic literature. HIV-negative gay men are potential survivors of a community devastated by AIDS and as such have psychosocial needs that differ from those of HIV-positive gay men. When these needs are neglected, psychosocial functioning may decrease, thus increasing risk for HIV infection. As HIV infection rates continue to rise steadily among gay men (Stall, 1994), it is imperative that HIV education, services, and prevention programs differentiate between HIV-negative and HIV-positive gay men.

This article focuses on HIV-negative gay men and their psychosocial needs and examines one design for group work practice. The author discusses establishing a time-limited therapy group for HIV-negative gay men, including formulating a group focus and goals, screening group members, and establishing a group structure, and explains the stages of group therapy that were developed for this population. A case study and discussion are presented.

The material in this article was taken from the author's clinical experience leading five time-limited therapy groups at the New York Blood Center Project ACHIEVE, an HIV vaccine research initiative in New York City. The goal of this project is to study HIV-negative gay men's sexual practices and incidence of new HIV infection to ascertain whether this population is a suitable group to participate in upcoming trials of vaccines (personal communication with B. Koblin, epidemiologist, New York Blood Center, September 20, 1995). Group members were self-referred HIV-negative gay men residing in a large urban community. Ages ranged from 26 to 54. The men were white or Latino and were college educated.

The author acknowledges the difficulty in writing about this population, particularly when using the terms "gay" and "HIV negative," without perpetuating myths of sameness. The reader is asked to consider that every generalization must be re-assessed when applied to the individual and that the lives of HIV-negative gay men are as varied as those of the people reading this article.

Literature Review

Psychosocial Issues

The literature on the impact of the AIDS epidemic on HIV-negative gay men's psychosocial functioning is just emerging. It is clear, however, that the AIDS epidemic has exacerbated specific developmental issues that are common to many HIV-negative gay men as they form a cohesive "gay identity": exclusion, lack of validation, loss, and guilt (Isay, 1989; Isensee, 1991; Oders, 1994, 1995a, 1995b).

The literature has shown pervasive evidence of AIDS stigmatization (for example, discrimination and violence) of those who are at risk for contracting HIV (Dane & Miller, 1992; Patton, 1992; Paul et al. …

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