Between two pandemics: Older, gay men&apos;s experiences across HIV/AIDS and COVID-19

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Abstract

Pandemics are a component of human life, and have had great bearing on the trajectory of human evolution. Historically, the biomedical aspects of pandemics have been overrepresented, but there is growing recognition of the degree to which pandemics are socially and culturally embedded, highlighting how virus perception is socially and politically informed. Older (50+), gay men represent a population who have experienced two global pandemics in their lifespans: HIV/AIDS and COVID-19. Although governments and health officials largely failed gay men during the HIV/AIDS pandemic, gay men represent an important source of pandemic information and their experiences have much to offer health professionals and policymakers. As such, a small but growing body of literature has compared gay men's experiences amidst the two pandemics. The current study drew on constructivist grounded theory methods to examine how living through the HIV/AIDS pandemic has influenced older gay men's perspectives of COVID-19. Twenty Canadian-based gay men aged 50+ participated in semi-structured interviews via Zoom. Analysis revealed three key processes: (1) uncertainty and the familiarity of loss, (2) witnessing pandemic inequities, and, (3) navigating constantly evolving (mis)information. We highlight the utility of this knowledge to informing future pandemic planning and policies.

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Most cited references 43

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Patients with mental health disorders in the COVID-19 epidemic

Hao Yao, Jian-Hua Chen, Yi-Feng Xu (2020)

More than 60 000 infections have been confirmed worldwide in the coronavirus disease 2019 (COVID-19) epidemic, with most of these cases in China. Global attention has largely been focused on the infected patients and the frontline responders, with some marginalised populations in society having been overlooked. Here, we write to express our concerns with regards to the effect of the epidemic on people with mental health disorders. Ignorance of the differential impact of the epidemic on these patients will not only hinder any aims to prevent further spread of COVID-19, but will also augment already existing health inequalities. In China, 173 million people are living with mental health disorders, 1 and neglect and stigma regarding these conditions still prevail in society. 2 When epidemics arise, people with mental health disorders are generally more susceptible to infections for several reasons. First, mental health disorders can increase the risk of infections, including pneumonia. 3 One report released on Feb 9, 2020, discussing a cluster of 50 cases of COVID-19 among inpatients in one psychiatric hospital in Wuhan, China, has raised concerns over the role of mental disorders in coronavirus transmission. 4 Possible explanations include cognitive impairment, little awareness of risk, and diminished efforts regarding personal protection in patients, as well as confined conditions in psychiatric wards. Second, once infected with severe acute respiratory syndrome coronavirus 2—which results in COVID-19—people with mental disorders can be exposed to more barriers in accessing timely health services, because of discrimination associated with mental ill-health in health-care settings. Additionally, mental health disorder comorbidities to COVID-19 will make the treatment more challenging and potentially less effective. 5 Third, the COVID-19 epidemic has caused a parallel epidemic of fear, anxiety, and depression. People with mental health conditions could be more substantially influenced by the emotional responses brought on by the COVID-19 epidemic, resulting in relapses or worsening of an already existing mental health condition because of high susceptibility to stress compared with the general population. Finally, many people with mental health disorders attend regular outpatient visits for evaluations and prescriptions. However, nationwide regulations on travel and quarantine have resulted in these regular visits becoming more difficult and impractical to attend. Few voices of this large but vulnerable population of people with mental health disorders have been heard during this epidemic. Epidemics never affect all populations equally and inequalities can always drive the spread of infections. As mental health and public health professionals, we call for adequate and necessary attention to people with mental health disorders in the COVID-19 epidemic.

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Bruce G. Link, Jo C. Phelan (1995)

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Stigma as a fundamental cause of population health inequalities.

Mark Hatzenbuehler, Jo C. Phelan, Bruce G. Link (2013)

Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.

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Author and article information

Journal

Journal ID (nlm-ta): SSM Qual Res Health

Journal ID (iso-abbrev): SSM Qual Res Health

Title: Ssm. Qualitative Research in Health

Publisher: The Authors. Published by Elsevier Ltd.

ISSN (Electronic): 2667-3215

Publication date PMC-release: 8 February 2023

Publication date (Electronic): 8 February 2023

Electronic Location Identifier: 100233

Affiliations

[a ]School of Nursing, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada

[b ]Institute on Aging & Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada

[c ]School of Public Health and Social Policy, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada

[d ]Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada

[e ]Department of Sociology and Social Anthropology, Dalhousie University, Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada

[f ]École de Santé Publique de l’Université de Montréal, 7101 Ave. du Parc Montreal, Quebec, H3N 1X9, Canada

[g ]Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Canada

[h ]UBC School of Social Work, 2080 West Mall, Vancouver, British Columbia, V6T 2Z3, Canada

Author notes

[∗ ]Corresponding author. School of Nursing, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada.

Article

Publisher Item ID: S2667-3215(23)00017-3 Publisher ID: 100233

DOI: 10.1016/j.ssmqr.2023.100233

PMC ID: 9905043

PubMed ID: 36777813

SO-VID: 5db71aff-2813-44f4-bfb3-be4587c4a2ba

License:

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

History

Date received : 14 November 2022

Date revision received : 6 February 2023

Date accepted : 7 February 2023

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