Academic journal article The Qualitative Report

The Perceived Effect of the Sociocultural Context on HIV/AIDS Identity Incorporation

Academic journal article The Qualitative Report

The Perceived Effect of the Sociocultural Context on HIV/AIDS Identity Incorporation

Article excerpt

The human immunodeficiency virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) is considered a chronic illness in countries where combination antiretroviral therapy (cART) is available (Edelman, Gordon, & Justice, 2011). The number of people living with HIV worldwide has increased from 26.2 million in 1999 to 33.3 million in 2009. In North America, it has risen from 1.2 million in 2001 to 1.5 million in 2009 (UNAIDS, 2010). In the United States, AIDS-related deaths decreased 69% between 1994 and 2007 (UNAIDS, 2009).

Individuals live with HIV/AIDS in a variety of contexts. These contexts include the sociocultural (e.g., race, class, gender, and culture), interpersonal (e.g., support and stigma), temporal (e.g., historical time or developmental stage in an individual's life), and situational (e.g., contexts specific to a person's experience such as pregnancy) (Ickovics, Thayaparan, & Ethier, 2001). Contexts influence the experience of living with HIV/AIDS. For example, a person's race affects access to healthcare. African Americans generally receive lower "quality health care than Whites, even after adjusting for income, education, and health care plan characteristics" (Klonoff, 2009, p. 49). Research studies showed that African Americans living with HIV/AIDS received life-extending medications, specifically protease inhibitors (PIs), later than Whites (Wong et al., 2004). African Americans and poor individuals perceived discrimination from health care providers when being treated for HIV/AIDS (Bird, Bogard, & Delahanty, 2004). In addition, scholars noted that women and minorities did not have as equal access to HIV/AIDS experimental drug trials as White men (Jones, Messmer, Charron, & Parns, 2002). Race and gender affect the experience of stigmatization in people living with HIV/AIDS (PLWHAs). African Americans living with HIV/AIDS tended to believe they were more discriminated against or morally judged for having HIV/AIDS whereas Whites feared interpersonal rejection (Rao, Pryor, Gaddist, & Mayer, 2008). Women living with HIV/AIDS believed they are more stigmatized because they are held to a higher sexual standard than men and judged more harshly for contracting HIV/AIDS (Lekas, Siegel, & Schrimshaw, 2006).

Context not only influences the experience of living with HIV/AIDS; it affects how individuals incorporate the HIV/AIDS identity into the self. Because HIV/AIDS is a chronic illness, individuals need to make it part of who they are. Identity theorists maintain that people possess multiple identities that form a stable self (Serpe, 1987). The self is formed through interaction with others and remains stable. Identities are "parts of the Self--internalized positional designations that represent the person's participation in structured role relationships" (Stryker & Serpe, 1982, p. 206). Identities are synonymous with role relationships. For example, a man could have the identities of father, partner, tennis player, and prostate cancer survivor. These identities make up a stable self. In addition, the salience of each identity depends on the strength of relationships associated with that identity (Serpe, 1987). A highly salient identity is invoked in a greater number of social situations than an identity with lower salience.

Researchers have investigated the incorporation process of the HIV/AIDS identity into one's self (Baumgartner, 2007; Baumgartner & David, 2009; Dozier, 1997; Gurevich, 1996; Lewis, 1994; Sandstrom, 1990; Tewksbury & McGaughey, 1998). Most of the scholarship that discusses HIV/AIDS identity incorporation and context concerns the impact of the interpersonal context on the process (Baumgartner, 2007; Baumgartner & David, 2009; Dozier, 1997; Gurevich, 1996; Lewis, 1994; Sandstrom, 1990; Tewksbury & McGaughey, 1998). There is less research on the impact of sociocultural context on the incorporation of the HIV/AIDS identity into the self. …

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