"I Heard He Got the Package": African American Men's Experiences of Living with HIV/AIDS

Since the widespread availability of life-extending medications including protease inhibitors such as Crixivan, and more recent multi-class combination drugs such as Atripla, HIV/AIDS has been considered a chronic illness in the United States (Allday, 2011). Consequently, more individuals are living with HIV/AIDS. In the United States, approximately 50,000 individuals are diagnosed with HIV annually and 1.2 million individuals are living with HIV/AIDS (National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, 2012).). The experiences of people living with HIV/AIDS (PLWHAs) and, more specifically, how people incorporate HIV/AIDS into their identities, has been the subject of several studies (e.g., Baumgartner, 2007; Dozier, 1997; Gurevich, 1996; Lewis, 1997; Sandstrom, 1990; Tewksbury & McGaughey, 1998). However, the experiences of African American men has not been the focus and since an increasing number of African American men are living with HIV/AIDS, it is important to focus on their experiences (National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, 2011). Individuals do not experience living with a disease in a vacuum (Meleis, 2000). Various contexts including the interpersonal context (e.g., support and stigma), sociocultural context (e.g., race, class, gender), temporal context (e.g., historical time and developmental stage), and situational contexts (e.g., pregnancy) (Ickovics, Thayaparan, & Ethier, 2001) affect people's experiences of living with HIV/AIDS. For example, Dovidio and Fiske (2012) explored how racial bias against people of color contributed to "health disparities" (p. 945). They noted that implicit physician and patient biases contributed to disparate medical treatment. Contexts not only affect how individuals live with HIV/AIDS but also how they make it part of who they are. Identity theorists assert that individuals are comprised of many roles or identities that form a stable self (Serpe, 1987). When a person contracts HIV or AIDS, he/she must make their HIV/AIDS role or identity part of his/her larger Self. Race, class, (Baumgartner, 2012a) and various aspects of time (Baumgartner, 2012b) were shown to influence access to resources and/or the disclosure process of PLWHAs which affected the HIV/AIDS identity incorporation process. In addition, support and stigma have been shown to influence the HIV/AIDS incorporation process (Gurevich, 1996). Although, the effects of various contexts on the HIV/AIDS identity process have been researched, the studies concern the experiences of very few African American men. Since African American men account for 70% of the new infections among Blacks in the United States, it is important to know their experiences of living with HIV/AIDS (National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, 2013),. Specifically, I wanted to know how African American men incorporated HIV/AIDS into their identities and how various contexts affected the incorporation process. Literature Review Researchers have studied the experiences of African American men living with HIV/AIDS regarding risk behaviors (Bond, Wheeler, Millett, LaPollo, Carson, & Liau, 2009; Spikes, Purcell, Williams, Chen, Ding, & Sullivan, 2009), anti-retroviral adherence and discrimination of African American men (Bogart, Wagner, Galvan, & Klein, 2010), and factors that affect HIV-positive men gay and bisexual men living with HIV/AIDS (Han, Lauby, Bond, LaPollo, & Rutledge, 2010). In contrast, HIV/AIDS identity incorporation studies have focused on women (Dozier, 1997; Gurevich, 1996), primarily or exclusively White gay or bisexual men (Lewis, 1994; Sandstrom, 1990; Tsarenko & Polonsky, 2011) primary White men and women (Baumgartner, 2007), and African American and White men and women (Baumgartner & David, 2009). Themes common to the incorporation process included: diagnosis with an accompanying emotional reaction (Baumgartner, 2007; Baumgartner & David, 2009; Dozier, 1997; Gurevich, 1996; Tsarenko & Polonsky, 2011), learning more about HIV/AIDS (Baumgartner, 2007; Baumgartner & David, 2009; Dozier, 1997) and eventual acceptance or integration of the disease into one's identity (Baumgartner, 2007; Baumgartner & David, 2009; Dozier, 1997; Gurevich, 1996; Sandstrom, 1990; Tsarenko & Polonsky, 2011). …