Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide, SA 5000, Australia.
Institute of Resource Governance and Social Change, Kupang 85227, Indonesia.
Int J Environ Res Public Health. 2023 Aug 20;20(16):6616. doi: 10.3390/ijerph20166616.
HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at individual and social levels. This disruption has been conceptualised, in a rather dystopian way, as 'biographical disruption'. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV; = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of 'biographical reinvention'. Study participants were recruited using the snowball sampling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a 'reinvented' biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a 'reinvented' biography.
艾滋病毒的诊断和管理常常扰乱艾滋病毒感染者的日常生活和对未来的想象,无论是在个人层面还是在社会层面。这种扰乱以一种相当反乌托邦的方式被概念化为“传记性扰乱”。本文探讨了艾滋病毒感染者(MLHIV;n=40)是否通过利用内部和外部资产,随着时间的推移重新塑造自己的自我意识和未来,从而克服这种扰乱。我们的分析使用了附加和减去弹性策略的概念,并展示了参与者如何在没有纯粹被扰乱的传记的情况下,谈论他们的“传记重塑”经历。研究参与者是通过滚雪球抽样技术招募的,从两个艾滋病毒诊所开始作为研究地点。使用一对一的深入访谈收集数据,并使用定性框架分析来指导逐步数据分析。研究结果表明,尽管艾滋病毒的诊断和管理给他们的日常生活带来了扰乱(例如心理健康状况、工作、活动、社交关系等),但我们研究中的 MLHIV 设法利用他们的内部资产或特质(例如希望、乐观、韧性)和调动外部资源(例如来自家庭、朋友和医疗保健专业人员的支持)来应对这些扰乱。这些内部资产和外部资源的交织使他们能够承担新的活动和角色(附加弹性策略)并放弃损害健康的行为(减去弹性策略)。这些对我们研究中的大多数 MLHIV 都是有效的,不仅有助于应对艾滋病毒的影响,改善他们的身心健康,还能思考或致力于一个包含韧性、希望和乐观的“重塑”传记,以实现更好的健康、生活和未来。研究结果表明,艾滋病毒干预措施和医疗保健系统需要提供适当的支持,以帮助 PLHIV 发展和维护内部资产,使他们能够应对艾滋病毒的影响,并致力于“重塑”传记。