STIGMA AND RESILIENCE: LIVED EXPERIENCES OF PEOPLE WITH HIV IN A NORTHERN COMMUNITY by Orlando McLeish B.Sc., Northern Caribbean University, 2007 THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTERS OF SCIENCE IN COMMUNITY HEALTH SCIENCES UNIVERSITY OF NORTHERN BRITISH COLUMBIA May 2015 © Orlando McLeish, 2015 UMI Number: 1526498 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Di!ss0?t&ioriPublishing UMI 1526498 Published by ProQuest LLC 2015. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 ii Abstract Stigma is a reality for millions of individuals who are living with HIV/AIDS and is accompanied with many challenges, however individuals are resilient in spite of the negative impacts of stigma. The purpose of this research was to explore and highlight the lived experience of people living with HIV-related stigma in Prince George, secondly, to understand the impacts of stigma, and thirdly, to identify the ways in which those living with HIV/AIDS respond to stigma. The research draws on hermeneutics phenomenology as this enables the exploration of participants’ experiences of stigma and resilience. Findings that have emerged from the thematic analysis have shown that stigma both enacted and felt is still prevalent in the lives of the participants. Also, participants’ experienced various challenges such as: mental health problems, substance abuse, financial problems and the lack of relationships. However, despite these challenges, participants reported feeling optimistic and hopeful as well as experiencing spiritual growth, finding a sense of purpose while living with their diagnosis. Overall participants in the study are adapting to their hardship and choosing not to be victims of HIV but survivors and fighters. Table of Contents Abstract..................................................................................................................................... ii Table of Contents ..................................................................................................................... iii List of Table............................................................................................................................. vi Dedication ............................................................................................................................... vii Acknowledgement ................................................................................................................. viii Chapter One: Introduction .........................................................................................................1 Background .............................................................................................................3 Purpose of Study .....................................................................................................5 Significance of Study ............................................................................................. 6 Motivations for Conducting the Study ................................................................... 7 Outline for the Thesis .................................................................................................................9 Chapter 2: Literature Review...................................................................................................11 Stigma......................................................................................................................................11 Goffmans’ Theory of Stigma................................................................................12 Resilience .................................................................................................................................15 Resilience Process .................................................................................................18 Resilient characteristics ...............................................................................19 HIV/AIDS................................................................................................................................21 HIV in Canada ..................................................................................................... 22 Northern British Columbia ......................................................................... 23 HIV and Stigma....................................................................................................24 Impacts of stigma.........................................................................................28 Summary ..................................................................................................................................32 Chapter 3: Methodology..........................................................................................................33 Phenomenological Framework ............................................................................ 34 Hermeneutics phenomenology ....................................................................36 Relationship Building and Cultural Safety ...........................................................37 Study context and site selection............................................................................39 Participants ..................................................................................................40 Data Collection .....................................................................................................40 iv Interview procedure .....................................................................................40 Analysis ................................................................................................................ 43 T ranscription ................................................................................................43 Limitations ........................................................................................................... 45 Rigor..................................................................................................................... 46 Personal reflexivity......................................................................................47 Member (participant) checking .................................................................. 48 Ethical Considerations ......................................................................................... 49 Summary ..................................................................................................................................50 Chapter Four: Findings ............................................................................................................51 Demographics.......................................................................................................51 Lived experiences of stigma.................................................................................53 Enacted stigma .............................................................................................53 Felt stigma...................................................................................................59 Challenges............................................................................................................ 61 Relationship .................................................................................................62 Financial challenges ....................................................................................63 Disclosure challenge................................................................................... 65 Recreational Drugs ......................................................................................66 Mental health ...............................................................................................68 Response ...............................................................................................................71 Educating self and others .............................................................................71 Resilience ..............................................................................................................73 Inner resource/ inner qualities .....................................................................74 Support from families and friends ............................................................... 76 Support from AIDS service organization (ASO).........................................78 Giving Back/Activism.................................................................................81 Acceptance ...................................................................................................82 Taking better care of self.............................................................................83 Summary ..................................................................................................................................84 Chapter 5: Discussion ..............................................................................................................86 Stigma experiences and challenges