HIV Stress Exchange: Queer Men, Intergenerational Stress, and Intimacy amidst the Time of HIV

Background: HIV remains a principal inequity for queer men across the U.S. Artificially, gay men are divided into a “younger” cohort that has always known about HIV, and an "elder" one that experienced a time without HIV and the onslaught of AIDS. Advances in prevention have cultivated a confusing discourse for gay men. On one hand, HIV is a “chronic condition”, which occludes psychosocial effects for men of all statuses; parallel, multiple technologies exist to “not get” or transmit HIV, which over individualizes responsibility and belies inequities. Still, HIV-related stress persists amongst queer men, and regarding HIV as discourse has not been well-represented in prevention and care.

Methods: This empirical study is a response, seeking to build an HIV-informed model of theory and practice, entitled HIV Stress Exchange. A Queer Discourse Study was conducted on 20 in-depth interviews with younger and elder gay/queer men of all HIV statuses. Parallel, a Social Semiotic Analysis was conducted on 123 material resources (e.g., photos) collected from the men.

Results: In all, this data gave voice to the ways in which HIV is given life in discourse and what meanings it holds in their embodied identities, lives, and relationships. First, whereas HIV does not hold much outward voice, these men (regardless of HIV status) acknowledge enduring stress in relationships, in particular sexual. Second, the men deploy various prevention behaviors: dominant practices (e.g., condoms, PrEP), resilient survival strategies (e.g., creative testing uses), and frank political contestations. Third, dominate HIV discourses beleaguer the development of positive gay/queer intimacy. In all, five themes materialized across the interviews and material resources: HIV as “in-/validated”, “un-/voiced”, “un-/intelligible”, holding “intimacy/-ies”, and being “PrEP/-ared”.

Conclusion: Based on the findings, the conceptual model for HIV Stress Exchange is presented along with an HIV-informed model for LGBTQ+-affirmative practice. These results provide context for what it means to live long-term under this age of HIV, whether or not infected -- and contributes a social theory for the intergenerational transmission of HIV as social discourse, as these most often unvoiced experiences of living long-term are unintelligible but find traction in everyday communication.