It’s Complicated: Religion and the HIV/AIDS Epidemic Among Black Same-Gender-Loving Men in the South Open Access

Barber, Charles (Summer 2019)

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Through a phenomenological-ethnographic lens, this dissertation examines the ways religion and spirituality intersect with the HIV/AIDS epidemic among Black men who have sex with men, BMSM, in Atlanta, GA. The goal of this work is to draw attention to the cultural and phenomenological aspects of lived religious and spiritual experience, which are not normally taken into account or measured by those in the health sciences or in healthcare provision. Through the unique power of personal narrative, this dissertation highlights the complexities of the intersections of religion and spirituality in the lives of HIV-positive BMSM, who are in care at one of Atlanta's leading providers comprehensive of providers of HIV/AIDS care. Coupled with the narratives of healthcare providers, this work gives a rare glimpse into the way lifeworlds of providers and patients intersect. It thickly describes how religion and spirituality can overlap with the health of BMSM in ways that can be health-positive, e.g. engaging in safer sex practices, getting into/remaining in the HIV care continuum, feeling as though they have social support, and/or a greater sense of emotional or physical well-being. Conversely, it also points to how religion and spirituality can overlap with the health of BMSM in ways that are health-negative, e.g. engaging in risky sexual activity or drug use, leading to a culture of silence and shame around same-sex sexual desire and HIV/AIDS, which can result in: the lack of HIV status disclosure, lower engagement in the HIV continuum of care, the loss of social support and social capital, and/or decreased emotional or physical well-being.

Table of Contents

Introduction Introduction to an Epidemic 1

Chapter 1 Conceptualizing the Role of Religion and Spirituality in the Health Journey with HIV 23

Chapter 2 In The Life: Growing Up and Life before HIV Diagnosis 43

Chapter 3 In The Life: Responding to Life with HIV 81

Chapter 4 In Their Words: Religion and Spirituality in the Healthcare Setting 115

Chapter 5 Provider’s Stories: Religion and Spirituality in the Healthcare Setting 135

Chapter 6 Concluding Perspectives: Addressing Religion and Spirituality through Lived Experience 166

Works Cited 177

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