Exploring Gay Men’s Experiences of Shame in Relation to Sexuality and HIV and the Implications for Sense of Self and Relationships

Background: For many researchers, the focus of their work exploring the negative consequences of identifying as a gay man living with HIV has centred around stigma. Yet, over the past few years many have questioned whether the broad definition of stigma alone is able to explain the negative implications of identifying both as a sexual minority but also the impacts living with HIV. More recently, some authors have begun to question whether the emotion of shame is of more central concern. However, there has been little investigative research into shame in relation to sexuality or HIV status.
Aims: Given the gaps within the literature, the study sought to explore whether shame was something experienced by gay men, and if so how they understood and experienced it in relation to both sexuality and HIV. The study also sought to investigate the impacts on both sense of self and relationships with others.
Methods: Drawing on a hermeneutic phenomenological epistemology, this study adopted a qualitative, interpretative phenomenological approach to exploring the shame experiences of 10 gay men living with HIV. The men were all recruited from central London NHS HIV community services and participated in semi-structured interviews.
Results: Five master themes were found across participant interviews 1) Sexuality: An Unacceptable Difference, 2) Managing an Unacceptable Self, 3) HIV: Rejection of the “Dirty” Self, 4) Negotiating a “Dirty” Identity, 5) Moving to a More Meaningful Self.
Conclusion: Despite arguments of the increasing acceptance of alternative sexual identities and the normalisation of HIV, the participants in the study reported experiencing shame as a distressing, layered emotion in response to living with two highly stigmatising identities. These layered experiences of shame often resulted in a sense of the self as inferior in comparison to heteronormative ideals and a number of unwanted difficulties within interpersonal relationships. However, participants also reported their HIV diagnosis as providing some meaning but after several years of difficulty. Implications for clinical practice, policy and research are discussed.