Academic journal article The Canadian Journal of Human Sexuality

Responding to the Support Needs of HIV Positive Lesbian, Gay and Bisexual Youth

Academic journal article The Canadian Journal of Human Sexuality

Responding to the Support Needs of HIV Positive Lesbian, Gay and Bisexual Youth

Article excerpt

ABSTRACT: Thirty-two HIV positive youth were interviewed regarding the challenges of living with HIV infection and barriers to HIV/AIDS and youth services. Participants reported emotional concerns arising from stigma, societal fears and misinformation regarding HIV. Thematic analysis of transcribed interview tapes identified 11 key themes, including initial periods of denial subsequent to testing positive for HIV, self-blame and shame regarding infection, judgements by family and peers, issues concerning disclosure, social isolation and loneliness. Participants also reported barriers in accessing sometimes urgently needed HIV/ AIDS services and other support services for youth. Possible reasons for and responses to these unmet service needs are presented.

Key words: Lesbian, gay, bisexual youth HIV Positive Emotional needs Service barriers Counselling

INTRODUCTION

While HIV seroprevalence is generally low among North American adolescents, the highest levels and rates of infection in this age group are observed among young gay men (Sweeney, Lindegren, Buehler, Onorato, & Janssen, 1995). Despite their having grown up as the "safer sex generation" and receiving intensive targetted HIV prevention strategies since the early 1990s, young gay and bisexual men continue to present with new infections (CDC HIV/AIDS Prevention, September, 1995; Health Canada, 1995; 1996; Lemp et al., 1994; Mansergh & Marks, 1998; Martindale et al., 1998). In Canada, the median age of HIV infection was 29.6 years for the period 1975-1984 and fell to 24.5 years for the period 1985-1990 suggesting numerous new infections among youth (Health Canada, 1995). Dufour et al.(1998) and Martindale et al.(1998) reported seroprevalence rates among young gay men of 0.3% in Montreal and 2.4% in Vancouver, respectively. Annual sero-incidence increases of 2% among young gay men have been reported in a Vancouver cohort study (Martindale et al., 1998), in which it is estimated that if such infection rates were generalized to the broad Canadian population of young gay men, it would result in many hundreds of new infections annually.

In the United States, HIV sero-prevalence rates among young gay men range from between 2.4% and 18.7% (Povinelli, Remafedi, & Tao, 1996; Seage et al., 1997; Valleroy et al., 1998). While seroprevalence is higher among older groups of gay men in the US, the incidence of new infections among 20- to 24-year-old gay youth is twice (4.4% annually) that of older groups of gay men (CDC HIV/AIDS Prevention, September, 1995; van Griensven et al., 1994).

A significant number of HIV positive (hereafter HIV+) young gay men are unaware of their HIV status and/or continue to have unprotected anal sex, suggesting increased likelihood of continued new infections (Hays, Kegeles, & Coates, 1997; Lemp et al., 1994; Rotheram-Borus & Futterman, 2000). If current infection trends continue, some estimate that two or three young gay men in ten will sero-convert by age thirty (de Wit, 1996).

Similar data concerning incidence and prevalence of HIV among lesbian and bisexual female youth are not as readily available. Lesbians have been considered to be only at "minimal, low or theoretical" risk for HIV infection given their low likelihood of exchanging bodily fluids during female-to-female sexual activities (Canadian AIDS Society, 1999). However, lesbians are not immune to HIV infection; some engage in activities that may expose them to HIV such as sharing needles, and occasional sexual activity with men, particularly during the coming-out process (Hunter, 1997; Rosario, Hunter, & Gwadz, 1996). In addition, studies that have examined depression and suicidality, rejection from family and peers, violence, homelessness, prostitution, and substance use suggest that lesbian and bisexual female youth are vulnerable to both social and sexual situations where HIV infection could occur (D'Augelli, 1996; Gibson, 1989; Gustavsson & MacEachron, 1998; O'Brien, Travers, & Bell, 1993; Remafedi et al. …

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