‘Waiting at the dinner table for scraps’: a qualitative study of the help-seeking experiences of heterosexual men living with HIV infection
- 1Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
- 2Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
- 3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- 4Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- 5Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- 6Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- 7Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- 8Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada
- 9Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Correspondence to Dr Tony Antoniou;
- Received 30 November 2011
- Accepted 18 June 2012
- Published 17 July 2012
Objectives To characterise the help-seeking experiences of heterosexual men living with HIV infection and explain these experiences in relation to the broader social relations and discourses in which they are embedded.
Design Qualitative study using focus groups and theoretically informed constructionist grounded theory.
Setting With one exception, focus groups were conducted in the offices of community-based AIDS service organisations across Ontario, Canada.
Participants 40 HIV-infected heterosexual men aged 18 years or older.
Results Heterosexual men living with HIV perceive themselves to be relegated to the margins of a health care and service field that was developed historically within a context that privileges the priorities of gay men and heterosexual women living with the virus. Specifically, gay men are better positioned than heterosexual men when vying for the services and recognition of AIDS service organisations due to their social capital within these agencies, thereby benefiting by virtue of their membership with the group perceived to control the decision-making apparatuses when resource allocation and programme development are at stake. Relative to women, heterosexual men are poorly positioned due to their negative symbolic capital, derived from being perceived as the ‘guilty’ parties in the context of heterosexual HIV transmission. As a result, the material and support needs of women have been prioritised, while those of heterosexual men living with HIV remain largely unaddressed.
Conclusions Heterosexual men living with HIV are operating within a health and service field that has not kept pace with their increased representation among the population of persons living with the virus. Researchers, clinicians and policy makers should strive to integrate heterosexual men living with HIV in decision making and community-based research initiatives that build capacity among this group while simultaneously generating a research and policy agenda specific to the concerns of this growing demographic.
To cite: Antoniou T, Loutfy MR, Glazier RH, et al. ‘Waiting at the dinner table for scraps’: a qualitative study of the help-seeking experiences of heterosexual men living with HIV infection. BMJ Open 2012;2:e000697. doi:10.1136/bmjopen-2011-000697
Contributors Study concept and design: TA (guarantor), MRL, RHG, CS. Analysis and interpretation of data: TA, MRL, RHG, CS. Acquisition of data: TA. Drafting of the manuscript: TA. Critical revision of manuscript: TA, MRL, RHG and CS. Administrative, technical or material support: TA.
Funding This study was supported by research funds from the Canadian Institute for Health Research (grant number CBR-99149). The sponsor had no role in the design and conduct of the study; in the collection, analysis and interpretation of the data or in the preparation, review or approval of the manuscript. The opinions, results and conclusions reported in this paper are those of the authors and are independent from the funding sources. TA is supported by a post-doctoral fellowship from the Ontario HIV Treatment Network and a fellowship from the Primary Health Care System Program. CS and MRL are the recipients of salary support from the Ontario HIV Treatment Network and the Canadian Institutes for Health Research, respectively.
Competing interests During the past 3 years, TA has received unrestricted research grants from Glaxo-Smith-Kline Inc., Merck and Pfizer for different studies and MRL from Abbott Laboratories, Merck Frosst Canada Ltd, Pfizer and ViiV Healthcare.
Patient consent Obtained.
Ethics approval Ethics approval was provided by Women's College Hospital and University of Toronto.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data available.
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