Photo-stories of stigma among gay-identified men with HIV in small-town America: A qualitative exploration of voiced and visual accounts and intervention implications

Abstract

Background: Art-based interventions can improve well-being, particularly among people with life-changing illnesses. We conducted a pilot photo-story intervention with gay-identified men with HIV in the Midwest USA to help men express and manage HIV stigma; and assess the feasibility of arts-based interventions. Methods: Eight men took pictures, participated in three group and one individual discussion session, and planned and attended two public photograph exhibits. Theme and narrative analysis identified key stigma and feasibility themes in qualitative textual and visual data. Results: Men's images and discussions focused on three aspects of HIV stigma: (1) ignorance, (2) difficult disclosures and (3) isolation. Photo-stories facilitated men's ability to manage stigma by promoting (1) self-discovery and (2) social support. Conclusions: Participants' stigma experiences were significant. Stigma intervention solutions are needed at individual, relational, community and social levels. Art-based interventions such as photo-stories are promising strategies to identify and address stigma at all levels.