Hazardous terrain and over the edge: the survival of HIV-positive heterosexual, minority men.
The purpose of this study was to describe and explore the experience and perceptions of heterosexual minority men living with and surviving HIV infection. This descriptive, exploratory qualitative study used in-depth interviews that were guided by Rosenstock's health belief model and Ajzen's theory of planned behavior. A purposive sample of 18 HIV-positive heterosexual, minority men were accrued from an outpatient HIV/AIDS clinic in upstate New York and a community-based AIDS service organization in New York City. The findings revealed that the experience of surviving HIV infection encompassed several stages. The men of this study described the choices they made in adolescence that led them down a trail of life that may be metaphorically described as "hazardous terrain," as the majority became involved in substance use or other illicit activities. With the diagnosis of HIV infection came a "Falling Off" stage, in which the participants went "over the edge" and initially were afraid to die but realized at this point that they were okay but vulnerable. The next stage was "Hanging On," in which they attempted to gain control, reevaluated priorities, and developed a new perspective on life and health. In the "Pulling Up" stage, participants realized that the rescue team included self, God, family, and friends, with self-rescue occurring on emotional, physical, and spiritual levels. As the participants reached the "Turning Around" stage, they began to accept responsibility for their health, focused on their abilities rather than their limitations, and reframed their perspectives to living with rather than dying from HIV infection. This study has implications for health-education programs, AIDS prevention, health assessment, and interventions for HIV-positive, heterosexual, minority men.