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A tale of two epidemics: gay men's mental health and the biomedicalisation of HIV prevention and care in Toronto
Author(s) -
Gaspar Mark,
Marshall Zack,
Rodrigues Ricky,
Adam Barry D.,
Brennan David J.,
Hart Trevor A.,
Grace Daniel
Publication year - 2019
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/1467-9566.12884
Subject(s) - psychosocial , mental health , distress , mental distress , medicine , human immunodeficiency virus (hiv) , stigma (botany) , stressor , men who have sex with men , psychology , homosexuality , ambivalence , qualitative research , psychological intervention , psychiatry , gerontology , clinical psychology , syphilis , family medicine , social psychology , sociology , social science , psychoanalysis
There is mounting urgency regarding the mental health of gay, bisexual and other men who have sex with men ( GBM ). We examined how GBM are understanding the relationship between HIV and their mental health given the increasing biomedicalisation of HIV prevention and care. Our Grounded Theory analysis derived from qualitative interviews with 24 GBM living in Toronto, Canada, including both HIV ‐negative and HIV ‐positive men. Participants understood biomedical advances, such as undetectable viral load and pre‐exposure prophylaxis (Pr EP ), as providing some relief from HIV ‐related distress. However, they offered ambivalent perspectives on the biomedicalisation of HIV . Some considered non‐ HIV ‐specific stressors (e.g. unemployment, racial discrimination) more significant than HIV ‐related concerns. These men expressed HIV ‐related distress as being under control due to biomedical advances or as always negligible when compared to non‐ HIV ‐specific stressors. Others emphasised the ongoing mental health implications of HIV (e.g. enduring risk and stigma). We describe a tension between optimistic responses to biomedicine's ability to ease the psychosocial burdens associated with HIV and the inability for biomedicine to address the social and economic determinants driving the dual epidemics of HIV and mental distress amongst GBM . We argue for more socio‐material analysis over further sexual behavioural analysis of GBM mental health disparities.