The Hierarchical Experience of Stigma in HIV/Hepatitis C Co-infected Gay Men

  • Gareth J. Owen


Drawing on qualitative research investigating the impact of HIV and Hepatitis C co-infection in gay men living in London, this chapter explores the complications arising when two sexually transmitted viral infections are stigmatised differently within a particular social group. Exploring the emotional impact of stigma in a gay male sexual subculture where ‘serosorting’ is used to select other HIV-positive men for unprotected sex, the narratives tell of how Hepatitis C was experienced as more stigmatising than HIV. This hierarchical stigmatisation complicated the disclosure of Hepatitis C and therefore threatened strategies of ‘HIV serosorting’ as a method of negotiated safety. Models of the hierarchical stigmatisation process and Hepatitis C transmission risk in gay male sexual subcultures are constructed from the data. The chapter also explores how stigma can both reinforce and disrupt the supportive camaraderie of subcultural communities in different circumstances. The findings suggest that health promotion in the gay community needs to particularly address the stigmatisation of Hepatitis C by raising awareness and facilitating greater empathetic ownership of Hepatitis C as a gay community issue.


Unprotected Anal Intercourse Sexual Rejection Stigmatization Process Sexual Subculture Sexual Practise 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



I thank all the men who shared their personal experiences of living with HIV/HCV co-infection and Mirek Boniecki of the Hepatitis C Trust who helped to clarify the development of ideas in this chapter. My thanks are also due to Nick Groves and Stuart Macwilliam for their invaluable critical comments during the writing process.


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  1. 1.Institute of Health Services ResearchUniversity of Exeter Medical SchoolExeterUK

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