ABSTRACT

This qualitative study employed a cross sectional focus group design to explore how older gay men living with HIV, experience, perceive, and engage with advance care planning (ACP). Seven gay men 50+, residing in Montreal, Canada, participated in a focus group that was audio-recorded, transcribed, and thematically analyzed. Findings suggested that social isolation, preoccupations with day-to-day living, and managing disclosures related to sexual orientation and HIV status created barriers to these men’s capacities to think about let alone talk about future care. These findings challenge current conceptualizations of ACP, which position reflection as an individual process that precedes allocating a decision-maker and communicating care preferences. Analyses further revealed that relational connections helped create a space where ACP could occur for participants. Hence, improving the uptake of ACP amongst older gay men with HIV may require interventions that embed such discussions into broader programs aimed at building support and community.

摘要

这项定性研究采用横断面焦点小组设计来探索感染 HIV 的老年男同性恋者如何体验、感知和参与预先护理计划 (ACP)。居住在加拿大蒙特利尔的七名 50 岁以上的男同性恋者参加了一个焦点小组，该小组进行了录音、转录和主题分析。调查结果表明，社会孤立、对日常生活的关注以及管理与性取向和艾滋病毒状况相关的披露对这些男性的思考能力造成了障碍，更不用说说话了关于未来的护理。这些发现挑战了当前的 ACP 概念化，将反思定位为在分配决策者和传达护理偏好之前的个人过程。分析进一步表明，关系联系有助于为参与者创造一个可以进行 ACP 的空间。因此，提高感染艾滋病毒的老年男同性恋者对 ACP 的吸收可能需要采取干预措施，将此类讨论纳入旨在建立支持和社区的更广泛的项目中。