Periodic Reporting for period 1 - HIVGAYM (Analysing the migration choices of HIV-positive gay men in England and France)
Période du rapport: 2018-03-01 au 2020-02-29
Despite new medical knowledge proving that people living with HIV who are on therapies and have an undetectable viral load cannot transmit the virus, discrimination and stigma towards people living with HIV persist. Gay men continue to be over-represented among people living with HIV. For them, HIV-phobia intersects with homophobia, impacting on their well-being and their life choices.
Previous research has shown there is a close correlation between migration and HIV; however, most existing studies rely on quantitative methodologies and/or focus on migration prior to HIV-infection. The living choices of gay men after contracting HIV continue to be understudied. This is a very relevant social issue, given the life expectancy of people with HIV now equals that of the general population, thus migration after testing positive to HIV does not mean anymore ‘move to die’. Against this lack in knowledge, especially in the European context, HIVGAYM investigates different migration trajectories (domestic; within the EU; from outside the EU) and life choices of different generations of gay men living with HIV in two European countries (England and Italy).
By building a comparative analysis in time and space, the main aim of the project is to analyze the complexity of factors shaping the decision to migrate- and then remain in a specific place- for gay men living with HIV through the use of qualitative research methods. To best achieve its aim, the project focuses on three sets of factors: i. material (represented by the configuration of the welfare regime in both countries (departure and arrival); ii. cultural/lifestyle; iii. relational (e.g. friendships, love). Beyond the main aim, the project has two further objectives. The first one is to assess the role of welfare and social institutions in producing or challenging HIV-related stigmatization through specific interventions, campaigns or discourses. The second is to understand the role of stigma (both ‘enacted’ and ‘felt’) in leading the decision to relocate somewhere else for gay men living with HIV.
Previous research has shown there is a close correlation between migration and HIV; however, most existing studies rely on quantitative methodologies and/or focus on migration prior to HIV-infection. The living choices of gay men after contracting HIV continue to be understudied. This is a very relevant social issue, given the life expectancy of people with HIV now equals that of the general population, thus migration after testing positive to HIV does not mean anymore ‘move to die’. Against this lack in knowledge, especially in the European context, HIVGAYM investigates different migration trajectories (domestic; within the EU; from outside the EU) and life choices of different generations of gay men living with HIV in two European countries (England and Italy).
By building a comparative analysis in time and space, the main aim of the project is to analyze the complexity of factors shaping the decision to migrate- and then remain in a specific place- for gay men living with HIV through the use of qualitative research methods. To best achieve its aim, the project focuses on three sets of factors: i. material (represented by the configuration of the welfare regime in both countries (departure and arrival); ii. cultural/lifestyle; iii. relational (e.g. friendships, love). Beyond the main aim, the project has two further objectives. The first one is to assess the role of welfare and social institutions in producing or challenging HIV-related stigmatization through specific interventions, campaigns or discourses. The second is to understand the role of stigma (both ‘enacted’ and ‘felt’) in leading the decision to relocate somewhere else for gay men living with HIV.
The project relied on a multi-method qualitative methodology including:
• an online survey both in English and Italian. It included 55 questions of different types (multiple choice; Likert scale; open). The questions covered multiple issues concerning the life choices and perspectives of the respondents, thus providing a fully rounded perspective on the relation between histories of migration, HIV, place and everyday life;
• 59 biographic interviews with gay men living with HIV in England and Italy using the biographic narrative interpretive method (BNIM). This method allows the exploration of a multiplicity of issues, thus favouring a complex analysis of social processes (as in the case of migration of gay men living with HIV);
• 12 semi-structured interviews with stakeholders (service providers, representatives of groups of people living with HIV, medical practitioners or nurses, policy makers);
• a Forum Theatre (FT) workshop (held in Bologna in February 2019), attended by 6 gay men living with HIV and conducted by two experts in FT techniques. In the workshop personal stories of oppression and violence were acted out by the participants themselves who had the possibility to explore strategies for action by replacing the protagonist of the scene. Data from the workshop were analyzed following thematic analysis, the results of which were compared (and/or contrasted) with the results of the interviews;
• critical discourse analysis of archival documents at the ‘Centro di Documentazione Flavia Madaschi’ located within the LGBTI Center ‘Il Cassero’ in Bologna, the LGBT Foundation’s archive at Manchester Central Library and the HIV/AIDS Testimonies archive at the British Library in London. In Bologna the analysis concerned material on gay men and HIV published on gay press and main national newspapers and magazines between the 1980s and 2008 [ca 250 documents analyzed]. In London and Manchester ca300 documents were analyzed (national press and gay press articles on HIV already selected in the LGBT Foundation’s archive; 30 interviews with people living with HIV recorded between 1995 and 2000 and then followed up between 2005 and 2008 in the HIV/AIDS Testimonies archive).
The main findings from the analysis of the collected data are the following:
• Felt stigma and the ‘second closet’ are still persistent in both countries.
• The main hypothesis of the project, i.e. migration representing a widespread response to reinvent one’s own life after testing positive to HIV, is confirmed by the results of the survey.
• Love, friendship and the presence of a vibrant gay community seem to be the main factors pushing researching participants to remain in the place they lived to.
• Free access to healthcare played a central role when deciding where to move to for the greatest majority of the interviewees.
• The legacy of stigmatizing public discourse around HIV/AIDS from the 1980s and the 1990s still persists, affecting also younger generations.
• Italian participants living in England describe dynamics of sexual racialization from the part of British men very similar to the dynamics narrated by non-White participants living in Italy.
• Participants in vulnerable situations (refugees; asylum seekers; people with further disabilities; welfare benefit recipients) experience distress, anxiety and other mental health issues. In their narratives, they frame these as the negative consequences of the action of State institutions.
• The use of recreational drugs for sex is widespread among the interviewees. The main reasons associated with the use of recreational drugs are enhanced sexual pleasure and sociability.
• an online survey both in English and Italian. It included 55 questions of different types (multiple choice; Likert scale; open). The questions covered multiple issues concerning the life choices and perspectives of the respondents, thus providing a fully rounded perspective on the relation between histories of migration, HIV, place and everyday life;
• 59 biographic interviews with gay men living with HIV in England and Italy using the biographic narrative interpretive method (BNIM). This method allows the exploration of a multiplicity of issues, thus favouring a complex analysis of social processes (as in the case of migration of gay men living with HIV);
• 12 semi-structured interviews with stakeholders (service providers, representatives of groups of people living with HIV, medical practitioners or nurses, policy makers);
• a Forum Theatre (FT) workshop (held in Bologna in February 2019), attended by 6 gay men living with HIV and conducted by two experts in FT techniques. In the workshop personal stories of oppression and violence were acted out by the participants themselves who had the possibility to explore strategies for action by replacing the protagonist of the scene. Data from the workshop were analyzed following thematic analysis, the results of which were compared (and/or contrasted) with the results of the interviews;
• critical discourse analysis of archival documents at the ‘Centro di Documentazione Flavia Madaschi’ located within the LGBTI Center ‘Il Cassero’ in Bologna, the LGBT Foundation’s archive at Manchester Central Library and the HIV/AIDS Testimonies archive at the British Library in London. In Bologna the analysis concerned material on gay men and HIV published on gay press and main national newspapers and magazines between the 1980s and 2008 [ca 250 documents analyzed]. In London and Manchester ca300 documents were analyzed (national press and gay press articles on HIV already selected in the LGBT Foundation’s archive; 30 interviews with people living with HIV recorded between 1995 and 2000 and then followed up between 2005 and 2008 in the HIV/AIDS Testimonies archive).
The main findings from the analysis of the collected data are the following:
• Felt stigma and the ‘second closet’ are still persistent in both countries.
• The main hypothesis of the project, i.e. migration representing a widespread response to reinvent one’s own life after testing positive to HIV, is confirmed by the results of the survey.
• Love, friendship and the presence of a vibrant gay community seem to be the main factors pushing researching participants to remain in the place they lived to.
• Free access to healthcare played a central role when deciding where to move to for the greatest majority of the interviewees.
• The legacy of stigmatizing public discourse around HIV/AIDS from the 1980s and the 1990s still persists, affecting also younger generations.
• Italian participants living in England describe dynamics of sexual racialization from the part of British men very similar to the dynamics narrated by non-White participants living in Italy.
• Participants in vulnerable situations (refugees; asylum seekers; people with further disabilities; welfare benefit recipients) experience distress, anxiety and other mental health issues. In their narratives, they frame these as the negative consequences of the action of State institutions.
• The use of recreational drugs for sex is widespread among the interviewees. The main reasons associated with the use of recreational drugs are enhanced sexual pleasure and sociability.
By assigning a central role to the biographic narratives of gay men living with HIV, HIVGAYM contributes to a complex, relational, situated and multi-dimensional understanding of the issues faced by people living with HIV in their daily life. The project has produced a large amount of qualitative data, leading to publications around several issues (e.g. the use of recreational drugs to enhance sexual pleasure for gay men living with HIV; the impact of the welfare system and the perception of place in leading the choice to migrate after getting HIV; the challenges of conducting fieldwork with a stigmatized social group). The project’s results and outputs have therefore the potential to influence debates across several disciplines.
Results from the projects have been presented at several national and international academic conferences. HIVGAYM aimed also at reaching a wide audience beyond academia, including:
• gay men living with HIV (through dedicated meetings organized by NGOs and service providers in several cities);
• the general public (through a Facebook page and publication of non-academic pieces; moreover, two public events were organized in Leicester and Manchester);
• service providers and activists (through dissemination at events addressed at them such as the Chemsex forum and the Italian AIDS Conference);
• policy makers (through dissemination at events addressed at them and the publication of policy recommendations on the project’s website).
Thanks to the engagement with different publics, HIVGAYM has led to the creation of new research networks and research funding applications, bringing together scholars from different fields and based in different countries, and NGOs/service providers.
Results from the projects have been presented at several national and international academic conferences. HIVGAYM aimed also at reaching a wide audience beyond academia, including:
• gay men living with HIV (through dedicated meetings organized by NGOs and service providers in several cities);
• the general public (through a Facebook page and publication of non-academic pieces; moreover, two public events were organized in Leicester and Manchester);
• service providers and activists (through dissemination at events addressed at them such as the Chemsex forum and the Italian AIDS Conference);
• policy makers (through dissemination at events addressed at them and the publication of policy recommendations on the project’s website).
Thanks to the engagement with different publics, HIVGAYM has led to the creation of new research networks and research funding applications, bringing together scholars from different fields and based in different countries, and NGOs/service providers.