Academic journal article Journal of Marital and Family Therapy

Does Family Matter to HIV-Positive Men Who Have Sex with Men?

Academic journal article Journal of Marital and Family Therapy

Does Family Matter to HIV-Positive Men Who Have Sex with Men?

Article excerpt

Most studies have indicated that friends or families of choice provide more support to HIV-positive men who have sex with men (MSM) than members of the family of origin. The creation of families of choice by MSM has been viewed as a means of creating a support system in the absence of traditional family. The purpose of this study is to explore if HIV-positive MSM believe family of origin is important. Data were drawn from a qualitative study of HIV disclosure to family. Responses to the question, "How important is family to you?" are explored. Results suggest that for many HIV-positive MSM, relationships with family of origin are very important. While not definitive, data to be presented are provocative and challenge notions of the significance of family of origin to marginalized populations.

Under the most restrictive conditions, family can be defined as being "of origin" or those persons to whom, through blood, adoption, or marriage, someone is related. In marginalized communities whose members have depended on friends or family "of choice" for support and affection, this restrictive definition draws ire. Weston (1991) suggested that gay men and lesbians may create and maintain families of choice not only due to experiences of rejection from their biological families, but also because of perceptions of exclusion from traditional societal definitions of family. Men who have sex with men (MSM)1 have a justified argument for seeking inclusivity of others into the family designation. Researchers investigating the role of social support in the lives of MSM have focused on the vital role that friends play in their Uves, possibly replacing or usurping the role of biological family. Traditional family surrogacy may be due to perceptions developed over time in the gay community that family of origin is not only unhelpful but harsh, rejecting, and condescending. This perception, not otherwise documented in the literature, is problematic because HIV-positive MSM in particular need increased support from family to alleviate the numerous burdens HIV imposes. Despite the defensible position that MSM may not view family as important, it is reasonable to invite the question whether family of origin is significant in the lives of HIV-positive MSM.

There can be benefits of receiving social support from family of origin related to HIV disease management, such as increased medication adherence (Murphy, Roberts, Marelich, & Hoffman, 2000). However, receiving health-related assistance requires disclosing one's HIV status (Huber, 1996). Studies of HIV positive women suggest that those who disclose their HIV status to family and friends do so because they want to preserve honesty in the relationship, to gain social support, and to avoid the anxieties of concealing their HIV status (Simoni et al., 1995). These results were later supported in another study finding that HIV-positive adults who disclose their HIV status to family and friends experience greater social support from those relationships (Kalichman, DiMarco, Austin, Luke, & Di-Fonzo, 2003). Although results are somewhat equivocal (see Chidwick & Borrill, 1996; Kimberly & Serovich, 1999; McCann & Wadsworth, 1992), most studies have indicated that friends provide more support to HIV-positive MSM than family members (Friedland, Renwick, & McCoIl, 1996; Hays, Catania, McKusick, & Coates, 1990; Hays, Chauncey, & Tobey, 1990; Hays, Magee, & Chauncey, 1994; Johnston, Stall, & Smith, 1995; Namir, Alumbaugh, Fawzy, & Wolcott, 1989; Schwarzer, DunkelSchetter, & Kemeny, 1994).

It is important to note a number of difficulties or plausible oversights to these studies. For example, it is probable that family represent a small proportion of the total number of people in the social network of HIV-positive persons. In these instances, friends may be both more plentiful and available to provide assistance. Support for this position comes from Barbee, Derlega, Sherburne, and Grimshaw (1998), who found the more siblings an HIV-positive person had, the fewer supportive behaviors they experienced from friends. …

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