This paper explores Scottish gay men's understandings of HIV testing within the context of changes stemming from the availability of new treatments for HIV. Transcripts of one-toone interviews with 18 gay men were analysed together with those from four focus groups (n= 19) concerning HIV testing, HIV status and HIV risk management. Interpretative Phenomenological Analysis was employed to identify recurrent themes. We focus upon a rise of HIV-optimism, risk-complacency and HIV fatigue and chart the apparent transformation of HIV diagnosis from ‘death sentence’ to ‘life sentence’. In turn, we explore how these changes have impacted upon HIV testing. As HIV management becomes increasingly medicalized, we highlight the ongoing need to attend to psychological and social issues.
Adam, P., Moreau-Gruet, F., Hamers, F., Delmas, M., Brunet, J., & Dubois-Arber, F. (1998). HIV/AIDS preventive attitudes and behaviour of French and Swiss gay men in the era of new treatments: a comparison of two national surveys. [642/34107] 12th World AIDS Conference, Geneva, 28 June–3 July.
2.
Bayer, R. (1991). Public health policy and the AIDS epidemic. An end to HIV exceptionalism?New England Journal of Medicine, 324, 1500–1504.
3.
Beardsell, S. (1994). Should wider HIV testing be encouraged on the grounds of HIV prevention?AIDS Care, 6, 5–19.
4.
Billington, A., Imrie, J., Chopin, M., Copas, A., Paragreen, S., & McOwan, A. (1999). Young gay and bisexual men and HIV testing in the time of combination therapy: any new barriers to testing? Paper presented at AIDS Impact: 4th International Conference on the Biopsychosocial Aspects of HIV Infection. Ottawa, Canada, 15–18 July.
5.
Bochow, M., Chiarotti, F., Davies, P., Dubois-Arber, F., Dur, W., Fouchard, J., Gruet, F., McManus, T., Markert, S., Sandfort, T., Sasse, H., Schiltz, M., Tielman, R., & Wasserfallen, F. (1994). Sexual behaviour of gay and bisexual men in eight European countries. AIDS Care, 5, 533–549.
6.
Brashers, D. E., Neidig, J. L., Cardillo, L. W., Dobbs, L. K., Russell, J. A., & Haas, S. M. (1999). ‘In an important way, I did die’: uncertainty and revival in persons living with HIV or AIDS. AIDS Care, 11(2), 201–219.
7.
Carne, C. A., Weller, I. V., Johnson, A. M., Loveday, C., Pearce, F., Hawkins, A., Smith, A., Williams, P., Tedder, R. S., & Adler, M. W. (1987). Prevalence of antibodies to human immunodeficiency virus, gonorrhoea rates, and changed sexual behaviour in homosexual men in London. The Lancet, 8534,656–658.
8.
Carr, A., Samaras, K., & Burton, S. et al. (1998). A syndrome of peripheral lipodystrophy, hyperlipidemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS, 12, F51–F58.
9.
Center for Disease Control (CDC) (1997). Update: trends in AIDS incidence, deaths and prevalence— United States, 1996. MMWR, 46, 861–867.
10.
Chippendale, S., French, P., & Miller, D. (1998). Reasons for HIV antibody testing: Plus ca change?International Journal of STD and AIDS, 9, 219–222.
11.
Communicable Disease Surveillance Centre (CDR) (1997). Changes in the incidence of AIDS and in AIDS deaths: the effects of antiretroviral treatment. CDR, 7, 381-381.
12.
Danziger, R. (1998). HIV testing for HIV prevention: a comparative analysis of policies in Britain, Hungary and Sweden. AIDS Care, 10, 563–570.
13.
Davies, P. M., Hickson, F. C. I., Weatherburn, P., & Hunt, A. J. (1993). AIDS: sex, gay men and AIDS. London: Falmer Press.
14.
Dawson, J., Fitzpatrick, R., McLean, J., Hart, G., & Boulton, M. (1991). Gay men's views and experiences of the HIV test. In P. Aggleton, G. Hart, & P. Davies (Eds.), AIDS responses, interventions and care. London: Falmer Press.
15.
De Cock, K. & Johnson, A. (1998). From exceptionalism to normalization: a reappraisal of attitudes and practice around HIV testing. British Medical Journal, 1998, 16, 290–293.
16.
Dietrich, U., Knechten, H., Jager, H., Husak, R., Ruppach, H., & von Briesen, H. (1998). High prevalence of protease resistance mutations in therapynaïve HIV—1 positive German seroconverters irrespective of viral subtype. [41208] 12th World AIDS Conference, Geneva, 28 June–3 July.
17.
Dube, M., Johnson, D., Currier, J., & Leedom, J. (1997). Protease inhibitor associated hyperglycemia. Lancet, 350(79), 713–714.
18.
Elford, J., Bolding, G., Maguire, M., & Sherr, L. (1998). New therapies for HIV and sexual risk behaviour among gay men in London. [23106] 12th World AIDS Conference, Geneva, 28 June–3 July.
19.
Flowers, P. & Church, S. (in press). To test or not? HIV antibody testing amongst gay men. Culture Health and Sexuality.
20.
Flowers, P. (2001). Gay men and HIV/AIDS risk-management, Health, 5, 50–75.
21.
Flowers, P., Duncan, B., & Knussen, C. (submitted). Re-appraising HIV testing amongst Scottish gay men: an exploration of the costs and benefits associated with learning one's HIV status. British Journal of Health Psychology.
22.
Flowers, P., Duncan, B., & Frankis, J (2000). Community, responsibility and culpability: HIV risk-management amongst Scottish gay men. Journal of Community and Applied Social Psychology, 10,285–300.
23.
Gill, N. (1998). Promoting testing is no substitute for recognizing risk. British Medical Journal, 316,295–296.
24.
Goldberg, D., Scott, G., Weir, M., Cameron, S., Peutherer, J., McMillan, A., Leadbetter, G., Scoular, A., Codere, G., & Allardice, G. (1998). HIV infection among homosexual/bisexual males attending genitourinary clinics in Scotland. Sexually Transmitted Infections, 74, 185–188.
25.
Hak, T. (1999). Mis-use and under-use of focus groups in medical sociology. Abstract 128, BSA Medical Sociology Conference, 24–26 September, York.
26.
Hammer, S., Katzenstein, D., Hughes, M., Gundacker, H., Scholley, R., & Hanbrich, R. (1996). A trial comparing nucleoside monotherapy with combination therapy in HIV infected adults with CD4 cell counts between 200–500 per cubic millimeter. New England Journal of Medicine, 335, 1081–1090.
27.
Hart, G., Flowers, P., Der, G., & Frankis, J. (1999). Gay men's HIV-related sexual risk behaviour in Scotland. Sexually Transmitted Infections, 75,242–246.
28.
Hays, R., Paul, J., Ekstrand, M., Kegeles, S., Stall, R., & Coates, T. (1997). Actual versus perceived HIV status, sexual behaviours and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV positive and untested. AIDS, 11, 1495–1502.
29.
Hickson, F., Reid, D., Henderson, L., Weatherburn, P., & Keogh, P. (1998). Treatment advances, risk taking and HIV testing history among gay men in the UK. [14159] 12th World AIDS Conference, Geneva, 28 June–3 July.
30.
Higgins, D., Galavotti, C., & O'Reilly, K. (1991). Evidence of the effects of HIV and antibody counselling and testing on risk behaviours. Journal of American Medical Association, 226, 2419–2429.
31.
Jalbert, Y. & Masson, R. (1998). Returning to work when are you are on triple therapy: the reality. Poster 13448 12th World AIDS Conference, Geneva, 28 June–3 July.
32.
Kelly. J., Hoffman, R., Rompa, D., & Gray, M. (1998). Protease inhibitor combination therapies and perceptions of gay men regarding AIDS severity and the need to maintain safer sex. AIDS, 12, F91–F95.
33.
Kitzinger, J. (1995). Introducing focus groups. British Medical Journal, 311, 299–302.
34.
McCann, K. & Wadsworth, E. (1991) The experience of having a positive HIV antibody test. AIDS Care, 3, 43–53.
35.
Miller, K. D., Jones, E., Yanovski, J. A. et al. (1998) Visceral abdominal-fat accumulation associated with use of idinavir. Lancet, 351, 871–875.
36.
Mosen, D., Wenger, N., Shapiro, M., Anderson, R., & Cunningham, W. (1998). Is access to medical care associated with receipt of HIV testing and counselling?AIDS Care, 10, 617–628.
37.
Myers, T., Haubrich, D., Cockerill, R., Calzavara, L., Millson, M., & Bowlby, A. (1999). The HIV test experience study: An analysis of test providers' and test recipients' descriptions and critical appraisals of the HIV antibody test experience. Copies of the report available from aidssida@cpha.ca or Canadian HIV/AIDS Clearinghouse, 400–1565 Carling Avenue, Ottawa, Ontario, KIZ 8RI.
38.
Nicholson, M. (1998). Metabolic concerns. AIDS treatment update, 67, 1–4.
39.
Ostrow, D., McKirnan, D., Vanable, P., & Hope, B. (1998). The impact of new combination HIV therapies on knowledge, attitudes and behaviours among Chicago gay men. [43260] 12th World AIDS Conference, Geneva, 28 June–3 July.
40.
Remien, R. (1998a). HIV medical advances and couples. Focus: A Guide to AIDS Research an Counselling, 13, 1–4.
41.
Remien, R. (1998b). HAART, attitudes and risk behaviour among serodiscordant male couples. [14136] 12th World AIDS Conference, Geneva, 28 June–3 July.
42.
Remien, R., Halkitis, P., O'Leary, A., & Hays, R. (1998). Perceptions, attitudes, and sexual risk among HIV-positive men with undetectable plasma viral loads. [23389] 12th World AIDS Conference, Geneva, 28 June–3 July.
43.
Siegel, K., Levine, M., Brooks, C., & Kern, R. (1989). The motives for gay men for taking or not taking the HIV antibody test. Social Problems, 36, 368–383.
44.
Smith, J. A., Jarman, M., & Osborn, M. (1999). Doing interpretative phenomenological analysis. In M. Murray & K. Chamberlain (Eds.), Qualitative health psychology: theories and methods (pp. 218–240). London: Sage.
45.
Smith, J. A. (1996). Beyond the divide between cognition and discourse: using interpretative phenomenological analysis in health psychology. Psychology and Health, 11, 261–271.
46.
Weatherburn, P., Anderson, W., Hickson, F., & Keogh, P. (1998) The impacts of combination therapies on the lives of people with HIV. [24260], 12th World AIDS Conference, Geneva, 28 June–3 July.
