Biographical Reinvention: An Asset-Based Approach to Understanding the World of Men Living with HIV in Indonesia

Abstract

HIV diagnosis and management have often caused disruption to the everyday life and imagined futures of people living with HIV, both at individual and social levels. This disruption has been conceptualised, in a rather dystopian way, as ‘biographical disruption’. This paper explores whether or not biographical disruption of living with HIV encourages men living with HIV (MLHIV; n = 40) in Yogyakarta and Belu, Indonesia, to reinvent their sense of self and future over time using internal and external assets. Our analysis uses the concepts of additive and subtractive resilience strategies, and we show how, rather than having a purely disrupted biography, participants talked about their experiences of ‘biographical reinvention’. Study participants were recruited using the snowball sampling technique, beginning with two HIV clinics as the settings. Data were collected using one-on-one in-depth interviews, and a qualitative framework analysis was used to guide step-by-step data analysis. The findings showed that, despite the disruptions in their everyday lives (i.e., mental health condition, work, activities, social relationships, etc.) following the HIV diagnosis and management, MLHIV in our study managed to utilise their internal assets or traits (i.e., hope, optimism, resilience) and mobilised external resources (i.e., support from families, friends and healthcare professionals) to cope with the disruptions. An interweaving of these internal assets and external resources enabled them to take on new activities and roles (additive resilience strategies) and give up health compromising behaviours (subtractive resilience strategies). These were effective for most MLHIV in our study, not only to cope with the HIV repercussions and improve their physical and mental health conditions, but to think or work on a ‘reinvented’ biography which encompassed resilience, hope and optimism for better health, life and future. The findings indicate the need for HIV interventions and healthcare systems that provide appropriate support for the development and maintenance of internal assets of PLHIV to enable them to cope with the repercussions of HIV and work on a ‘reinvented’ biography.