‘It’s a dark cloud’: experiences of social undermining among people living with HIV in New Mexico

ABSTRACT

Social undermining as a strong predictor of adverse health outcomes in people living with HIV (PLWH), yet little is known about the experiences that constitute social undermining in this population. We led community-engaged research to identify and understand experiences of social undermining of PLWH in largely rural, minority-majority Southwestern communities. While past research focused on stigma-related experiences, participants in this study also told stories that shared their feelings of being undermined by lack of patient-centered care that they did not attribute to stigma, but to bureaucratic and impersonal service provision that marginalized them. These experiences create stress and serve as barriers for participants’ well-being and care. By bringing to the front experiences and mechanisms of social undermining, these findings advance theory, research, and practice regarding social undermining and living with HIV in diverse communities.

KEYWORDS:

• Health disparities
• HIV/AIDS
• marginalization
• mistreatment
• sensemaking
• social support
• social undermining
• social negativity
• stigma

Acknowledgements

The authors would like to thank Drs. Magdalena Avila, Ashley Archiopoli, Ricky Hill, and Godfried Asante for their help in data collection, HIV service providers and activists for their help and support, and most of all, those who opened their hearts and shared their life-stories with us, thank you.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the New Mexico Department of Health and Infectious Disease Bureau [FY11UNM021041].