Süregelen Bir Müzakere Olarak “Kabul”: HIV ile Yaşayan Genç Yetişkinlerin Deneyimine İlişkin Yorumlayıcı Fenomenolojik Bir Analiz

Öz

Amaç: Bu çalışmanın amacı, HIV ile yaşayan genç yetişkinlerin kabul deneyimini gündelik yaşamlarında süregelen ve bağlama duyarlı bir süreç olarak nasıl deneyimlediklerini ve anlamlandırdıklarını incelemektir. Yöntem: Araştırma, yorumlayıcı fenomenolojik analiz yaklaşımıyla yürütülmüştür. Çalışma grubunu Türkiye’de HIV ile yaşayan, 24–30 yaş arasında, tanı üzerinden en az altı ay geçmiş olan dokuz genç yetişkin oluşturmuştur. Veriler, her katılımcıyla iki veya üç kez gerçekleştirilen yarı yapılandırılmış derinlemesine görüşmeler yoluyla toplanmıştır. Bulgular: Analiz sonucunda, kabul deneyimi “tanıyla tanışma” ve “HIV ile gündelik yaşamı müzakere etme” olmak üzere iki grup deneyim teması altında yapılandırılmıştır. Katılımcılar başlangıçta HIV’i yaşamlarından çıkarılamayacak kalıcı bir gerçeklik olarak tanımış, zaman içinde tedavi, sağlık profesyonelleri ve akranlarla karşılaşmalar, aynı zamanda kişisel deneyimler aracılığıyla HIV ile yaşamanın anlamını yeniden değerlendirmiştir. Buna göre, HIV ile yaşama deneyimi, gündelik yaşamın doğal akışı içinde zamanla arka plana çekilebilirken, romantik ilişkiler, tanının açıklanması, aile, iş ve sağlık hizmetleri gibi sosyal olarak anlamlı karşılaşmalarda yeniden görünür hâle gelebilmektedir. Sonuç: Bu bulgular, ruh sağlığı uzmanlarının HIV ile yaşayan genç yetişkinlerle çalışırken kabulü ulaşılması gereken nihai bir sonuç olarak değil, farklı yaşam bağlamlarında yeniden ele alınabilen bir süreç olarak değerlendirmelerinin ve müdahalelerini buna göre planlamalarının önemine işaret etmektedir.

Anahtar Kelimeler

• Kabul
• Sosyal Damgalama
• Kendini Açıklama
• Genç Yetişkin
• HIV

"Acceptance" as an Ongoing Negotiation: An Interpretative Phenomenological Analysis of the Experiences of Young Adults Living with HIV

Öz

Objective: This study aims to examine how young adults living with HIV experience and make sense of acceptance as an ongoing and context-sensitive process in their everyday lives. Method: The study was conducted using an interpretative phenomenological analysis approach. The study group consisted of nine young adults living with HIV in Türkiye who were aged 24–30 years and had received an HIV diagnosis at least six months previously. Data were collected through two or three in-depth, semi-structured interviews with each participant. Results: The analysis organized the experience of acceptance into two group experiential themes: “Encountering the Diagnosis” and “Negotiating Everyday Life with HIV.” Participants initially recognized HIV as an enduring reality that could not be removed from their lives and, over time, reconsidered the meaning of living with HIV through treatment, encounters with healthcare professionals and peers, and personal experiences. Accordingly, while the experience of living with HIV can recede into the background over time within the natural flow of everyday life, it can become visible again in socially meaningful encounters such as romantic relationships, disclosure of the diagnosis, family, work, and healthcare. Conclusion: These findings highlight the importance of mental health professionals working with young adults living with HIV viewing acceptance not as a final outcome to be achieved, but as a process that can be revisited across different life contexts, and planning their interventions accordingly.

Anahtar Kelimeler

• Acceptance
• Social Stigma
• HIV Disclosure
• Young Adult
• HIV

Kaynakça

1. Andersson GZ, Reinius M, Eriksson LE, Svedhem V, Esfahani FM, Deuba K et al. (2020) Stigma reduction interventions in people living with HIV to improve health-related quality of life. Lancet HIV, 7:e129-e140.
2. Andiç J (2023) Orda bir AIDS var uzakta! ViraVerita E-Journal: Interdisciplinary Encounters, 17:133-169.
3. Arnett JJ (2024) Emerging Adulthood: The Winding Road From The Late Teens Through The Twenties, 3rd ed. New York, Oxford University Press.
4. Aurpibul L, Tangmunkongvorakul A, Detsakunathiwatchara C, Masurin S, Srita A, Meeart P et al. (2023) Social effects of HIV disclosure, an ongoing challenge in young adults living with perinatal HIV: a qualitative study. Front Public Health, 11:1150419.
5. Bilardi JE, Hulme-Chambers A, Chen MY, Fairley CK, Huffam SE, Tomnay JE (2019) The role of stigma in the acceptance and disclosure of HIV among recently diagnosed men who have sex with men in Australia: a qualitative study. PLoS One, 14:e0224616.
6. Chan RCH, Hung FN, Mak WWS (2025) Evolving experiences of HIV stigma and their impact on well-being: a serial cross-sectional study of people living with HIV in Hong Kong from 2012 to 2022. SSM Ment Health, 7:100415.
7. Chaudoir SR, Fisher JD (2010) The disclosure processes model: understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull, 136:236-256.
8. Derlega VJ, Winstead BA, Greene K, Serovich J, Elwood WN (2004) Reasons for HIV disclosure/nondisclosure in close relationships: testing a model of HIV-disclosure decision making. J Soc Clin Psychol, 23:747-767.

9. Friedland BA, Gottert A, Hows J, Baral SD, Sprague L, Nyblade L et al. (2020) The People Living with HIV Stigma Index 2.0: generating critical evidence for change worldwide. AIDS, 34(Suppl 1):S5-S18.
10. Guck TP, Goodman MD, Dobleman CJ, Fasanya HO, Tadros MB (2010) Relationship between acceptance of HIV/AIDS and functional outcomes assessed in a primary care setting. AIDS Care, 22:89-95.
11. Hays DG, Singh AA (2023) Qualitative Research In Education And Social Sciences, 2nd ed. San Diego, Cognella Academic Publishing.
12. Horter S, Thabede Z, Dlamini V, Bernays S, Stringer B, Mazibuko S et al. (2017) “Life is so easy on ART, once you accept it”: acceptance, denial and linkage to HIV care in Shiselweni, Swaziland. Soc Sci Med, 176:52-59.
13. Kasapoglu A, Saillard EK, Kaya N, Turan F (2011) AIDS related stigma in social relations: a qualitative study in Turkey. Qual Rep, 16:1496-1516.
14. Kınay S, Mercan MN, Stutterheim SE (2026) HIV stigma among health care providers in Türkiye: a cross-sectional analysis of knowledge, attitudes, and discriminatory behaviors. J Assoc Nurses AIDS Care, 37:e5-e19.
15. Kutnick AH, Gwadz MV, Cleland CM, Leonard NR, Freeman R, Ritchie AS et al. (2017) It’s a process: reactions to HIV diagnosis and engagement in HIV care among high-risk heterosexuals. Front Public Health, 5:100.
16. Nyongesa MK, Nasambu C, Mapenzi R, Koot HM, Cuijpers P, Newton CRJC et al. (2022) Psychosocial and mental health challenges faced by emerging adults living with HIV and support systems aiding their positive coping: a qualitative study from the Kenyan coast. BMC Public Health, 22:76.
17. Öktem P (2015) The role of the family in attributing meaning to living with HIV and its stigma in Turkey. Sage Open, 5:2158244015615165.
18. Park CL (2010) Making sense of the meaning literature: an integrative review of meaning making and its effects on adjustment to stressful life events. Psychol Bull, 136:257-301.
19. Plattner IE, Meiring N (2006) Living with HIV: the psychological relevance of meaning making. AIDS Care, 18:241-245.
20. Sağlık Bakanlığı (2025) HIV/AIDS istatistikleri, 1985-2024. https://hsgm.saglik.gov.tr/depo/birimler/bulasici-hastaliklar-ve-erken-uyari-db/Dokumanlar/Istatistikler/hiv-aids-2024.pdf (Accessed 01.10.2026).
21. Smith JA, Flowers P, Larkin M (2021) Interpretative Phenomenological Analysis: Theory, Method and Research, 2nd ed. London, Sage.
22. Smith T, Seeley J, Shahmanesh M, Psaros C, Munikwa C, Ngwenya N (2023) Influences on decision-making about disclosure of HIV status by adolescents and young adults living with HIV in KwaZulu-Natal, South Africa. Afr J AIDS Res, 22:306-315.
23. Stroumpouki T, Perrett S, Kasdovasilis P, Papatheodorou P, Paparizos V, Stavropoulou A (2020) “A journey towards acceptance”: the process of adapting to life with HIV in Greece. A qualitative study. Appl Nurs Res, 53:151249.
24. Stutterheim SE (2026) Why addressing HIV stigma should be our number one priority in the HIV response. HIV Res Clin Pract, 27:2638007.
25. Şenyürek G, Kavas MV, Ulman YI (2021) Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily. BMC Public Health, 21:904.
26. Uğurlu M, Karahan N (2022) Sexual health knowledge and influencing factors among health science students at a state university in Turkey. Eur J Contracept Reprod Health Care, 27:75-82.
27. UNAIDS (2025) Fact sheet 2025: Global HIV & AIDS statistics. https://www.unaids.org/sites/default/files/2025-07/2025_Global_HIV_Factsheet_en.pdf (Accessed 01.10.2026).
28. Uwamariya J, Nshunguyabahizi M, Nshimyumuremyi JN, Mukesharurema G, Ndayishimiye E, Kamali I et al. (2022) Rediscovering life after being diagnosed with HIV: a qualitative analysis of lived experiences of youth living with HIV in rural Rwanda. Front Reprod Health, 4:993916.
29. van der Elst EM, Abuna M, Agutu C, Ogada F, Galole A, Shikuku J et al. (2022) “Facilitating HIV status adjustment”: qualitative insights from the Tambua Mapema proof-of-concept study in Kenya. PLoS One, 17:e0261255.
30. van der Kooij YL, Kupková A, den Daas C, van den Berk GEL, Kleene MJT, Jansen HSE et al. (2021) Role of self-stigma in pathways from HIV-related stigma to quality of life among people living with HIV. AIDS Patient Care STDS, 35:231-238.
31. WHO (2026) HIV and AIDS. https://www.who.int/news-room/fact-sheets/detail/hiv-aids (Accessed 01.10.2026).
32. Xiao X, Chen C, Gao C, Wang H, Reynolds NR (2020) Ways of coping mediate the relationship between self-efficacy for managing HIV and acceptance of illness among people living with HIV. J Adv Nurs, 76:2945-2954.
33. Zhang Y, He C, Peasgood T, Hulse ESG, Fairley CK, Brown G et al. (2022) Use of quality-of-life instruments for people living with HIV: a global systematic review and meta-analysis. J Int AIDS Soc, 25:e25902.