Body image research

[jsk3030]

Hi
I am a Trainee Clinical Psychologist in London and I am currently designing a study investigating the experiences of gay men on HIV meds. I am particulalry interested in the impact of the meds on appearance and how this affects people. From informal reports it seems that many men's concerns about body changes are often not acknowledged or validated by clinicians. What are significant physical changes in the eye of the sufferer are unnoticeable or 'overlooked' by the medical professional. I am interested in whether this has been the case for many receivers of HAART and how they experience this. In addition, there are many sociocultural pressures on physical attractiveness in gay men, leading to increased vulnerability to body disatisfaction and eating problems. Is this an important issue for gay men and a major consideration when accepting treatment? Has it led to subsequent difficulties, either socially or psychologically?
I am going to carry out a handful of interviews in a clinic in London and would be very grateful if anybody can offer any suggestions for topics to cover or questions to ask. Is body image a major concern of your own and are there particular issues you think it would be interesting for me to explore?
Thank you very much for your time
Jamie

[wellington]

I'm not the spokesperson for gay men, so I can only offer what it has meant to me.

I've always been of a lean build - thank my dad's side of the family for that gene. I eat what I want, when I want. I don't pay much attention to what other people think of me - it's what I feel about myself that's paramount.

Before beginning HAART, I had dropped almost 25% of my body mass as a result of PCP. After that was cured, I began to put the mass back on because I was just way too thin - comparatively to what I was prior to getting ill. I've put back on all the mass and a little bit more. Now, my focus is on trimming up a little so I can resume the physique I've maintained for about the last 25 years.

So, aside from that brief blip on my appearance radar, I'd say there are no significant lingering affects related to HIV or medication.

[ACinKC]

Question for you Mr. Trainee....

Why is it just for GAY men?  If my body gets outta whack you can bet the ol wifey aint gonna wanna hang on to the buffalo hump while riding the slick willy pole ride!!!

[wellington]

Maybe it's one of "those" clinics

[ACinKC]

You Gay guys are SOOOOO lucky gettin your own clinics and all!  LOL   

[newt]

1. You will please post the full study protocol, including details of local ethics committee approval, community participation in the steering group/study design, supervisor(s), or make this information available via the web or email.

2. Please supply an email address for enquiries.

3. Which London clinic?

4. Why only gay men? You should see what a vanishing bum n thighs does for the self-esteem of an African woman (etc etc, good point ACinKC).

5. Is the subjective perception to be correlated with objective measurement eg DEXA scans etc, and weighted for HAART regime (eg literature shows AZT, d4T more likely to cause fat loss than tenofovir, abacavir) and length of diagnosis plus treatment history.

6. "sufferer" is er, bad word, bad word.

7. Following Weatherburn et al I don't count different groups of gay men/"men who have sex with men" as a homogeneous group with a common conception of self, therefore conclude that your study is based on a category mistake.  There may be a narrow (or even wide) sub-group of gay men that fit into your framework, but selecting carefully for participation in this sub-group may lead to a bias in the design because it excludes gay men who don't give a shit about pecs, Aussie Bum caks etc.

8. I can assure you, not looking like Skeletor crossed with Mr Burns is a serious wish when using combo, it's a real downer, gay or not.  You don;t really need to study that one.

Have I been hard? I am trying to encourage you to think harder, to involve some of the smart community people in the study, to do something useful to HIV-positive people rather than your ClinPsych qualification. And make the study protocol available etc.

Horne & Fisher et al (among others elsewhere) may have answered this already, or provide supporting evidence for the study, in a paper presented at the 7th BHIVA Conference (2001) - "Beliefs about HIV and HAART and the decision to accept or reject HAART", published in HIV Medicine vol2 issue 3:

"RESULTS: Twenty-three (66%) patients accepted HAART and 12 (34%) refused. The decision to accept or decline HAART was in influenced by personal beliefs about HIV and HAART. Declining HAART was associated with doubts about its personal necessity (t = ± 3.12; P < 0.005) and to a range of concerns about potential adverse effects (t = 2.58; P < 0.05). Individuals were significantly more likely to accept HAART if their perceptions of personal necessity outweighed their concerns about adverse effects of HAART (t = ± 4.18; P < 0.001) and if they had experienced more HIV-related symptoms (t = ± 2.10; P < 0.05), especially if these fluctuated over time (t = ±2.55; P < 0.05)."

- matt

[GSOgymrat]

I think the poster is just trying to get an idea for a study and hasn't worked out the details yet.

[Markmt]

Been on meds for two years I am 44 I dont feel I eat too much but I am unhappily overweight . I dont know if its the meds, age, slow metabolism or a mixture of all. I think the question would be valid for any gender and sexuality.

[Iggy]

.

[ACinKC]

Uhhhh yeah... what Newt said.

[Matty the Damned]

Why do apprentice pyschologists always take such a ham-fisted approach to these things? I guess it's due to the fact that psychology isn't a real science anyway.

MtD
(Who is a snooty sociologist)

[jsk3030]

I am very sorry if I’ve insulted anybody. Rereading my initial posting I realise it does appear clumsy and thoughtless. Thanks for your points, Newt. I am still at a very early stage in designing this study and it is clear that there are a lot of things for me to consider.
I agree that physical changes caused by HIV meds affect everyone regardless of sexuality, sex etc. I think that my reasoning for focusing on gay men is that studies suggest that they have increased vulnerability to body dissatisfaction and related problems. There seem to be greater, or different, pressures on physical appearance than on heterosexual men and this may affect their experiences with HAART. But I agree that appearance is important to everyone, regardless of who they sleep with. Although gay men are by no means a homogenous group, and that it’s such a blunt label to use, I thought that it would be helpful to focus on that specific population.
I am still very new to the area of HIV research and intervention and I am still learning. I hope to get community group involvement in the study if it goes ahead. And as for psychologists tending to be aloof and hamfisted, yep, I’d be the first to agree! I think it’s slowly changing though. I hope…
jamie

[RobT]

I have always had a bad image problem. I do not think that being on meds factored into it that much. I know that it was a factor, but my image problem has always been there.
I feel sick if I do not go to the gym. I usually spend an hr plus per day, but my work and school schedule does not give me that opportunity. I now go when I can. I need to get an exercise ball and workout @ home, when I cannot make it to the gym. I usually workout my legs, chest/abs, and upper body @ the gym; which I can do @ home.
I limit what I can eat, cuz I feel sick if I over eat. I know that if I do those 2 things, then I will get fat. 2 me, there is nothing worse than being both HIV and fat.

RobT

[bear60]

What Newt said.!!!

[Eldon]

Hello Jsk3030, it is Eldon.


Newt does have a valid point when you read over his post.


Have the BEST Day!

[BillyPsych]

Jamie:  There have been quiet a few replys to your initial question.  And "yes" there have been numerous other clinical studies looking at body dysmorphia and HAART.  But to answer just your question about whether or not clinicians consider these changes when suggesting HAART, it has been my experience (and only mine, so I can't speak for other people) that those possible body changes FAR outweigh the benefits and from a biological view they do have a valid argument.  From a psychological standpoint the view is somewhat different and medical clinicians typically primarily only look at the biology whereas the patient takes BOTH into consideration.

So for me:  YES, I would have to think harder about taking a medication that may give me a big ole hump.  Let's face it, I'm a little vain.

Billy

If my comment offended anyone I certainly did not mean for that happen.

[alive2]

Question for you Mr. Trainee....

Why is it just for GAY men?  If my body gets outta whack you can bet the ol wifey aint gonna wanna hang on to the buffalo hump while riding the slick willy pole ride!!!

yes sir i do agree with this statement.im not gay but why is it just a gay study?is this your premise as to your sexual orientation?because it isnt to well received by myself being left out because i mongea on carpet.i have no problems at all with people who have a different lifestyle at all,its part of life to have diversity and to the research should reflect the same.also i would like to add the newt has said many very smart things in responce to the original post.i hope noones toes feel like im stepping on them,im running over them to get a word in thats all.take care