The needs of others: The norms of self-management skills training and the differing priorities of asylum seekers with HIV

Abstract

This paper challenges the notion of a shared social identity resulting from a self care skills training programme through exploring the engagement, experience and outcomes of participants from different social groups: sub-Saharan asylum seekers and gay men. In the former group norms and values about priorities and management of HIV differed significantly from the programme’s underlying philosophy of individualism. Some needs were similar, but learning self-management skills was not the priority it was for gay men as pressing needs arising from their asylum status (to address social problems, access welfare and achieve marginal residential status) overwhelmed self care attempts. A focus on self-efficacy and individual behaviour change is likely to leave unaddressed social and material needs, inadvertently adding insult to injury. However, alternative benefits included sharing ‘experience’ and the perceived ‘problem’ that being an asylum seeker posed to other people. The contexts of location, needs, identities and social position are important in understanding self care support innovations.

Key Words:

• HIV/AIDS
• self-management
• socially patterned needs
• ethnography
• sociology