HIV and Gay Men : Clinical, Social and Psychological Aspects

'There have been books on HIV histories and clinical virology; on pathophysiology of HIV disease; on gay men, too, but here, in one volume, key aspects of HIV and gay men: clinical, social and psychological perspectives are brought together, under one cover. Jaspal and Bayley have produced a truly contemporary text. This is a "must" for contemporary practitioners; those of us old enough to remember the early days, to see how they have improved, and those young enough to know little about it. I will certainly commend this text to my students.' --Professor David Evans, OBE, NTF. University of Greenwich 'This book is essential reading for clinical practitioners trying to gain insights into what makes people think, feel and behave in certain ways--a precondition for the success of any medical innovation and intervention--for people living with HIV/AIDS trying to live as normal a life as possible, and, of course, for anybody interested in the social psychological study of health and illness.' --Professor Brigitte Nerlich, University of Nottingham This book focuses on the clinical, social and psychological aspects of HIV among gay men and examines the complex factors that can contribute to HIV risk in this key population. With the target to end all HIV transmissions in the UK by 2030 in mind, Jaspal and Bayley combine elements of HIV medicine and social psychology to identify the remaining barriers to effective HIV prevention among gay men. The authors take the reader on a journey through the history of HIV, its science and epidemiology and its future, demonstrating the vital role of history, society and psychology in understanding the trajectory of the virus. Underpinned by theories from social psychology and clinical snapshots from practice, this book considers how psychological constructs, such as identity, risk and sexuality, can impinge on physical health outcomes. This refreshing and thought-provoking text is an invaluable resource for scholars, clinicians and students working in the field of HIV Acknowledgements Contents List of Figures 1: Understanding the Clinical and Social Psychological Aspects of HIV Introduction Some Definitions HIV Risk or HIV Outcomes? The Focus on Gay Men Clinical and Social Psychological Aspects Case Studies Gay Men in Contemporary Britain What Is Next for HIV? Why a Multidisciplinary Book on HIV among Gay Men? Overview of the Book References 2: HIV: Its History, Science and Epidemiology Introduction The Origins of HIV SIV The First Human Infections Initial Medical Responses to HIV/AIDS Early AIDS Treatments HIV/AIDS in the UK The First Public Health Campaign in the UK The Slow March to Controlling the Virus HIV Today: An Epidemiological Snapshot Overview References 3: Sexuality and HIV Risk in Gay Men The Biology of HIV Risk The Social Psychology of HIV Risk Attitudes Towards Condoms The Fear Factor Sense of Invincibility Personality Traits Social Norms Identity Concerns Risky Sexual Behaviours Sexual Compulsivity Chemsex Geospatial Gay Mobile Social Networking Applications Gay Saunas Gay Cruising Overview References 4: HIV Prevention The HIV Prevention Landscape Adherence to the Norm of Condom Use HIV Testing Promoting STI Testing and Treatment The Emergence and Use of Post-exposure Prophylaxis The Advent of Pre-exposure Prophylaxis The Clinical Aspects of PrEP Social and Political Aspects of PrEP Treatment as Prevention Other Prevention Options: Microbicides and Circumcision The Search for a Vaccine Overview References 5: HIV Diagnosis, Management and Prognosis HIV: Its Effects and Treatment HIV Virology and Patient Prognosis Innate Immunity HIV Seroconversion Chronic Inflammation and HIV HIV Treatment Nucleoside Reverse Transcriptase Inhibitors Non-nucleoside Reverse Transcriptase Inhibitors Protease Inhibitors Integrase Strand Transfer Inhibitors CCR5 Receptor Inhibitors HIV Treatment Failure and Resistance Generics Choosing an Effective HIV Treatment Regimen HIV Viral Load Renal Function HLA B*5701 Co-infections Concomitant Medicines HIV Resistance Test Patient Acceptability Social Background Future of HIV Treatment Overview References 6: HIV and Mental Health What Is Mental Health? Explaining Mental Health in HIV The Biological Paradigm The Social Psychological Paradigm The Psychobiological Paradigm Social Stigma Identity and Mental Health Mental Health Disorders among Gay Men Living with HIV Depression Anxiety Suicidal Ideation Coping Predicting Poor Mental and Sexual Health Outcomes Situational Stressors and Negative Psychological Self-Schemata Coping with Threats to Identity Overview References 7: Intersecting Identities Introduction Definitions Ethnicity Sexual Orientation and Identity BAME Communities in the UK Demography and Sociology HIV Epidemiology Theories of Social Knowledge and Intersecting Identities Social Representations Theory Psychological Coherence The Psychological Impact of Intersecting Identities Deriving a Sexual Identity from Sexual Orientation Challenges to Psychological Coherence Maintaining Belongingness in Valued Ingroups Intersecting Identities, Social Stressors and HIV Racism Homophobia Overview References 8: Looking to the Future: Eradication by 2030? Introduction The Key Components of HIV Prevention and Treatment The Importance of Combination HIV Prevention The Future of HIV Prevention Final Thoughts References Acronyms References Index