How HIV patients construct liveable identities in a shame based culture: the case of Singapore

Ho, Lai Peng; Goh, Esther C. L.

Although research has been conducted on identity work for people suffering from chronic diseases (Charmaz, 2002; Kralik, 2002; Whitehead, 2006) , there is a scarcity of literature on the process of identity reconstruction as a response to having HIV, especially since the advent of effective treatment, which supposedly allows many with HIV to live symptom free, conceal their HIV status, and treat it as a chronic disease. The present health discourse on "normalization" is one where people with HIV are encouraged to adhere to their treatment regimen as medication will facilitate the re-establishment of normality (Mattes, 2014) . However, studies have shown that people with HIV only partially incorporated this notion of normality as they are socially embedded in a network of relationships beyond medical interventions, and social contexts are not taken into consideration in the rhetoric of normalization (Beckmann, 2013; Moyer, 2012) . These studies showed that people with HIV preferred to hide their HIV identity as they thought that it impeded their progress towards returning to a "normal" life (Beckmann, 2013; Moyer, 2012) . Some researchers also argued that although HIV has features of a chronic disease, it does not meet the goal of regaining normality as medical treatment, which should facilitate people with HIV to "regain control, create order, reduce dependence on others and to feel 'normal' again", did not fully materialize (Russell et al., 2007) . A main impediment to normalization is stigma, which has not been significantly reduced in the post-ART era (Lekas, Siegel, & Schrimshaw, 2006) . Research has shown that HIV is more stigmatized than other medical conditions (Fife & Wright, 2000; Mak et al., 2006) . Thus, while the present health discourse promises to fulfil the desire of people with HIV for normalization, their experiences may not live up to this promise (Mattes, 2014) .