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Part 1. Personal Experience Interview and Analysis

1. Introduction

HIV diagnoses can impact an individual's sense of self and their interactions with the world around them (Brener et al., 2019). The assessment embarks on a comprehensive exploration of the experiences of an individual living with HIV, delving into the intricate interplay of personal narratives, societal constructs, and health challenges. The subject of this analysis is Mel, a resilient and candid individual who graciously shared her journey of living with HIV. As a heterosexual woman, Mel provides a distinct viewpoint in the largely male-focused discourse surrounding HIV. The foundation of this analysis is her background, experiences, and insights. Two fundamental theories will be then employed to analyse Mel's story: Michael Bury's explanation of biographical disruption and Julia Kristeva's conceptualization of abjection (Duman, 2019; Orsini & Kilty, 2021).

2. Context of the Interview

Mel was interviewed on [Date] at [Time] for about fifty-five minutes. For practical reasons, the interview took place via an online video conferencing platform. This interviewing style made the participant and the interviewer feel at ease and approachable, encouraging an honest and open discussion.

Mel, a female HIV-positive participant, is being interviewed. Throughout the session, her age was not brought up specifically. Mel declared herself a straight person. Her experiences and viewpoints as an HIV-positive individual were shared, and she provided insightful information about her journey and the difficulties she has encountered. Regarding our relationship, I conducted the interview; I led the discussion and posed questions to get Mel's experiences and points of view. The main goal of the professional and courteous exchange was to comprehend Mel's distinct viewpoint and gain knowledge from it. Mel is part of Positive Life New South Wales, a group that offers HIV-positive individuals support, advocacy, and education.

Mel was asked several insightful questions during the interview to grasp her experiences living with HIV fully. These questions covered a range of aspects of her journey, starting with how she handled the initial shock following her diagnosis and her initial response to the news. The conversation then turned to her interactions with medical staff and any discrimination or stigma she might have encountered there. Another important subject was how she disclosed her HIV status to new acquaintances or possible partners. She was also questioned about the difficulties and instances of discrimination she faced during this process. Mel also talked about the effects that having HIV has had on her relationships—both romantic and with her family and friends. She also discussed how society views HIV and the level of education in that area, expressing her hopes for greater awareness. The discussion covered a wide range of her experiences and viewpoints on living with HIV, including the coping techniques and support networks that have been crucial to her journey.

3. Discussion

Elements of theory

Two fundamental theories will be employed to analyse Mel's story: Michael Bury's explanation of biographical disruption and Julia Kristeva's conceptualization of rejection (Duman, 2019; Orsini & Kilty, 2021). Mel's situation is one in which the theory of rejection plays a crucial role in analysing the reactions of society and any discriminatory actions she might have experienced as a result of her HIV status (Duman, 2019; Kontomanolis et al., 2017). This theory explores how society labels some situations or people as "abject," resulting in stigmatisation and exclusion. This theory can help explain Mel's story by shedding light on how societal norms and prejudices may have influenced her experience as a heterosexual woman living with HIV, potentially leading to feelings of marginalisation and isolation. Moreover, the Biographical Disruption theory offers a useful framework for comprehending how HIV diagnosis and treatment can upset the coherence and continuity of a person's life story. Kilty & Orsini, 2021). Mel's experience may have been marked by significant shifts in her sense of self, her life trajectory, and her relationships, her identity, all of which can be attributed to the biographical disruption caused by living with a chronic illness (Wells et al., 2023).

Characteristics and their influence

Mel's experience of living with HIV is profoundly influenced by various individual characteristics that shape her journey. As a heterosexual woman, Mel's experience differs significantly from the predominantly male narrative surrounding HIV. Her gender plays a crucial role in how society perceives and interacts with her in the context of her diagnosis. For instance, the assumptions and stereotypes associated with HIV often centre around homosexual men, potentially leading to unique challenges for Mel in terms of societal recognition and support. Additionally, Mel's cultural background as a New Zealander living in Australia may impact her experience. Cultural nuances, healthcare systems, and support networks can vary between these two countries, potentially affecting her access to resources and the quality of care she receives. Her experience is further shaped by her socioeconomic status, which allows her to receive government-subsidized healthcare in Australia. Mel's access to critical medications and specialised care is made possible by this financial support, which may not be the case in other areas or for people with different financial circumstances.

Theory analysis

Mel's experiences are consistent with the theories of biographical disruption and rejection, which offer insightful frameworks for comprehending the nuances of her HIV journey. According to Kontomanolis et al. (2017), abjection centres on feelings of impurity or disgust when they come into contact with something that defies accepted boundaries or standards. In Mel's story, the stigma associated with HIV in society serves as a metaphor for impurity. Because she is HIV positive, she sometimes finds herself in circumstances where people might perceive her as "impure" or "contaminated." Boundary blurring involves a blurring of boundaries between self and other, where the 'abject' is seen as something threatening the integrity of the self (Duman, 2019; Arias-Colmenero et al., 2020). It is evident when Mel negotiates to disclose her status, which can challenge the conventional boundaries of intimacy and trust. Abjection has a profound psychological impact, often leading to feelings of unease, discomfort, and even revulsion in response to the 'abject' object or condition (Arias-Colmenero et al., 2020). Mel's experiences with healthcare professionals, where she encounters insensitivity and discomfort, highlight the psychological impact of abjection. Societal exclusion explores how societies tend to marginalize or exclude individuals or groups who are associated with the 'abject,' viewing them as deviant or impure indicated by Mel's discussions about discrimination and the need for education on HIV (Stangl et al., 2022).

Biographical disruption focuses on how certain events, particularly those related to health and illness, can disrupt an individual's established life narrative (Wells et al., 2023). Mel's diagnosis of HIV represents a significant life event. It disrupts the trajectory of her life, prompting a reevaluation of her goals, relationships, and prospects. Reconstruction of identity involves reevaluating one's sense of self, roles, and identity after a significant health diagnosis (Kerr et al., 2019). Mel grapples with how to integrate her HIV status into her sense of self and how others perceive her. Shift in priorities emphasises how the experience of a chronic illness can lead to a re-prioritization of values, goals, and responsibilities, often necessitating adjustments in day-to-day life (Campbell, 2021). Managing her health and well-being becomes a central focus, potentially requiring adjustments in Time with her children. Biographical disruption encompasses the struggles individuals undergo in adjusting to the transformed circumstances brought about by illness, and the strategies they utilize to navigate these shifts (Campbell, 2021). For Mel, grappling with healthcare encounters and disclosing her status exemplifies the hurdles she confronts. Her resilience and advocacy underscore her coping mechanisms.

Literature reference

The framework by Khurshid et al. (2022) provides a comprehensive understanding of the multifaceted issue of stigma in individuals living with HIV. Mel's experience resonates with this framework as she highlighted encountering stigma in various contexts, including healthcare settings. The framework's emphasis on addressing stigma aligns with Mel's advocacy for education and sensitivity in healthcare interactions. This study by Senyurek et al. (2021) resonates with Mel's account of encountering insensitive or uninformed healthcare professionals. The research by Goldhammer et al. (2021) explores coping mechanisms used by people living with HIV. Mel's focus on education, her involvement in support groups, and her proactive disclosure strategy align with the coping mechanisms covered in this study. A study by Roming and Howard (2019) examines the connection between social support, coping mechanisms, and the quality of life for HIV-positive people. Mel's emphasis on the value of open communication and support from family and friends is consistent with the research's findings. Arias-Colmenero et al. (2020) present an overview of patient experiences related to HIV diagnosis through their systematic review. Mel's description of her experience receiving a diagnosis is consistent with some of the psychological and emotional reactions that this study has emphasised. It highlights the importance of using supportive and caring healthcare procedures when diagnosing patients.

Conclusion

The investigation into Mel's experiences as an HIV-positive person has shed light on the significant influence that personal narratives and societal conceptions have on a person's experience living with a chronic illness. We learned a great deal about the intricacies of Mel's experience—from facing social stigma to reassessing her identity and priorities—by applying Abjection and Biographical Disruption.Mel's resilience and advocacy stand as a testament to the strength of individuals navigating the challenges of HIV. This analysis calls for a broader understanding and compassion within the healthcare community, challenging stigmas and fostering a more inclusive environment for individuals like Mel.

Part 2: Critical Discussion and Revision of Assessment 2 Questions

  • Questions of Assessment 2
  • Was this the only country you have been to besides Vietnam?
  • Are you going to live in Australia indefinitely? If yes, why?
  • What made you leave Vietnam, and why Australia?
  • How have you found Australia over the past five years? Have you managed to adapt?
  • Are there any aspects you have found difficult since moving here, like finances, language, and culture?

2.Critical Discussion of Original Questions

The initial set of questions shows an effort to learn more about Loc's history, his experience migrating, and the difficulties he has managing his diabetes. They might not, however, adequately address the emotional and psychosocial facets of Loc's experience because their primary focus is on factual data. The questions ask about Loc's immigration history and his motivations for relocating to Australia, but they don't go into detail about how this big life transition has affected his emotional health or ability to control his diabetes. Although Loc's adjustment to Australia is mentioned in the original questions, there is no particular mention of any possible linguistic or cultural obstacles that might be preventing him from properly managing his diabetes. Although difficulties with money, language, and cultural acclimatisation are mentioned, the questions do not delve into the potential effects of these issues on Loc's general well-being or mental health. Furthermore, it would be beneficial to specifically address Loc's social support network in the original questions, including any possible sources of assistance outside of his daughter. A more nuanced approach to comprehending Loc's experience would be beneficial for the questions; for example, they could delve into his feelings of isolation, any support networks he may have, and how he views his role as an Uber driver in relation to his identity and sense of purpose.

3.Improved New Questions

  • What changes in diet and diabetes care have you noticed in your day-to-day life as a result of adjusting to a new nation and culture?

Rationale: This inquiry aims to comprehend the practical and emotional difficulties that Loc may encounter as a result of adjusting to a new culture. Additionally, it prompts Loc to consider how these changes might affect his management of his diabetes (Riska Rohmawati et al., 2022).

  • Can you share any specific instances where language barriers have posed challenges in accessing healthcare or understanding diabetes-related information?

Rationale: This question addresses a potential barrier to effective diabetes management and allows Loc to express any difficulties he may have faced in communicating with healthcare providers (Adu et al., 2019).

  • In what ways do you find fulfilment and a sense of purpose in your current role as an Uber driver, and how does this contribute to your overall well-being?

Rationale: This question acknowledges Loc's occupation and its significance in his life. It provides insight into his sense of identity and purpose, which can impact his overall health and well-being (Massey et al., 2019).

  • How do you envision your long-term future in Australia, and what are your aspirations for your health and well-being in the years to come?

Rationale: This question encourages Loc to reflect on his long-term goals and aspirations, providing valuable information for tailoring a care plan that aligns with his vision for the future (van Bruggen et al., 2021).

  • Are there any specific cultural practices or traditions from Vietnam that hold importance to you in the context of managing your diabetes? How can we incorporate these practices into your care plan?

Rationale: This question recognizes the significance of cultural practices in Loc's life and allows for a collaborative approach to diabetes management that respects his cultural identity (Abdulrhim et al., 2021).

References

Part A

‌Arias-Colmenero, T., Pérez-Morente, M. Á., Ramos-Morcillo, A. J., Capilla-Díaz, C., Ruzafa-Martínez, M., & Hueso-Montoro, C. (2020). Experiences and attitudes of people with HIV/AIDS: A systematic review of qualitative studies. International Journal of Environmental Research and Public Health , 17 (2), 639. https://doi.org/10.3390/ijerph17020639

Brener, L., Broady, T., Cama, E., Hopwood, M., de Wit, J. B. F., & Treloar, C. (2019). The role of social support in moderating the relationship between HIV centrality, internalised stigma and psychological distress for people living with HIV. AIDS Care , 1–8. https://doi.org/10.1080/09540121.2019.1659914

‌Campbell, C. K. (2021). Structural and intersectional biographical disruption: The case of HIV disclosure among a sample of black gay and bisexual men. Social Science & Medicine , 280 , 114046. https://doi.org/10.1016/j.socscimed.2021.114046

Duman, Ç. (2019). Kristevan Abject and HIV/AIDS: Jamaica Kincaid's My Brother and Sapphire's Push. Journal of American Studies of Turkey, 50 , 35-62. https://search.trdizin.gov.tr/tr/yayin/detay/333817/kristevan-abject-and-hivaids-jamaica-kincaids-my-brother-and-sapphires-push

Goldhammer, H., Marc, L. G., Chavis, N. S., Psihopaidas, D., Massaquoi, M., Cahill, S., Nortrup, E., Dawson Rose, C., Meyers, J., Mayer, K. H., Cohen, S. M., & Keuroghlian, A. S. (2021). Interventions for addressing trauma among people with HIV: a narrative review. AIDS Care , 1–10. https://doi.org/10.1080/09540121.2021.1984382

Kerr, D. J. R., Deane, F. P., & Crowe, T. P. (2019). Narrative identity reconstruction as adaptive growth during mental health recovery: A narrative coaching boardgame approach. Frontiers in Psychology , 10 . https://doi.org/10.3389/fpsyg.2019.00994

Khurshid, K., Dutta, T., Khan, K. S., Haider, S. A., Ahmed, U. A., Jatoi, H., Tahir, M., Sarfraz, R., Pasha, A., Khan, M., & Ali, M. (2022). Addressing stigma among persons living with HIV through the Sujaag project in Pakistan: A socioecological analysis. Journal of Social Issues . https://doi.org/10.1111/josi.12547

Kontomanolis, E. N., Michalopoulos, S., Gkasdaris, G., & Fasoulakis, Z. (2017). The social stigma of HIV–AIDS: society’s role. HIV/AIDS - Research and Palliative Care , Volume 9 (9), 111–118. https://doi.org/10.2147/hiv.s129992

Orsini, M., & Kilty, J. M. (2021). When biographical disruption meets HIV exceptionalism: Reshaping illness identities in the shadow of criminalization. Sociology of Health & Illness , 43 (5), 1136–1153. https://doi.org/10.1111/1467-9566.13290

Roming, S., & Howard, K. (2019). Coping with stress in college: an examination of spirituality, social support, and quality of life. Mental Health, Religion & Culture , 22 (8), 1–12. https://doi.org/10.1080/13674676.2019.1674794

Senyurek, G., Kavas, M. V., & Ulman, Y. I. (2021). Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare profestarget="_blank" rel="nofollow"href="https://doi.org/10.1186/s12889-021-10881-y"> https://doi.org/10.1186/s12889-021-10881-y

‌Stangl, A. L., Pliakas, T., Izazola-Licea, J. A., Ayala, G., Beattie, T. S., Ferguson, L., Orza, L., Mathur, S., Pulerwitz, J., Iovita, A., & Bendaud, V. (2022). Removing the societal and legal impediments to the HIV response: An evidence-based framework for 2025 and beyond. PLOS ONE , 17 (2), e0264249. https://doi.org/10.1371/journal.pone.0264249

Wells, N., Murphy, D., Ellard, J., Philpot, S. P., & Prestage, G. (2023). HIV diagnosis as both biographical disruption and biographical reinforcement: Experiences of HIV diagnoses among recently diagnosed people living with HIV. Qualitative Health Research , 33 (3), 165–175. https://doi.org/10.1177/10497323221146467

Part B

‌‌Abdulrhim, S., Sankaralingam, S., Ibrahim, M. I. M., Diab, M. I., Hussain, M. A. M., Al Raey, H., Ismail, M. T., & Awaisu, A. (2021). Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service. BMC Health Services Research , 21 (1). https://doi.org/10.1186/s12913-021-06183-z

Adu, M. D., Malabu, U. H., Malau-Aduli, A. E. O., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLOS ONE , 14 (6), e0217771. https://doi.org/ 10.1371/journal.pone.0217771

Massey, C. N., Feig, E. H., Duque-Serrano, L., Wexler, D., Moskowitz, J. T., & Huffman, J. C. (2019). Well-being interventions for individuals with diabetes: A systematic review. Diabetes Research and Clinical Practice , 147 , 118–133. https://doi.org/10.1016/j.diabres.2018.11.014

Riska Rohmawati, Lono Wijayanti, Rahayu Anggraini, Ratna Yunita Sari, Imamatul Faizah, & Dany Irawan. (2022). Diabetes mellitus lifestyle management as an efforts to improve quality of life for Diabetes mellitus patients. Community Service Journal of Indonesia , 4 (2), 34–39. https://doi.org/10.36720/csji.v4i2.407

van Bruggen, S., Kasteleyn, M. J., Rauh, S. P., Meijer, J. S., Busch, K. J. G., Numans, M. E., & Chavannes, N. H. (2021). Experiences with tailoring of primary diabetes care in well-organised general practices: a mixed-methods study. BMC Health Services Research , 21 (1). https://doi.org/10.1186/s12913-021-07198-2

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