Doctoral Dissertations

Date of Award

8-1994

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Nursing

Major Professor

Martha Raile Alligood

Committee Members

Albert T. Ichiki, Sandra Thomas, Betsy Smith, Daniel Ely

Abstract

The purpose of this study was threefold: (l) to investigate the relationships among immunity, internalized stigma of AIDS, internalized homophobia, emotional intimacy, and functional status in homosexual men seropositive for the H\iman Immunodeficiency Virus; (2) to investigate the relationships among immunity, internalized stigma of AIDS, internalized homophobia, emotional intimacy, and functional status in homosexual men seronegative for the Human Immunodeficiency Virus; and (3) to test Roy's Theory of the Person as an Adaptive System which served as the guiding framework for the interpretation of the findings. Holistic adaptive responses of the Person Living with AIDS (PLWA) were described using the variables immunity, internalized stigma of AIDS, internalized homophobia, emotional intimacy, and functional status. Immunity was proposed as a manifestation of the physiological adaptive mode. Internalized stigma of AIDS and internalized homophobia were proposed as manifestations of the self-concept adaptive mode. Functional status was proposed as a manifestation of the role function adaptive mode. These variables were chosen because of the great significance placed on them by the PLWA and because they are conceptually linked to the Roy Adaptation Model. A cross-sectional, correlational study was conducted in a research group of 24 homosexual males who were seropositive for Human Immunodeficiency virus (HIV) and in a comparison sample of 23 homosexual males who were seronegative for HIV. Four instruments were conceptually linked to these variables, to the Theory of the Person as an Adaptive System, and to the Roy Adaptation Model. These questionnaires were the: (1) Phillips Stigma of AIDS Questionnaire (PSAQ-2) [internalized stigma of AIDS], (2) Nungesser's Homosexual Attitudes Inventory [internalized homophobia], (3) Autonomy and Relatedness Inventory [emotional intimacy], and (4) Sickness Impact Profile [functional status. Lymphocyte subset enumerations and mitogen blastogenesis responsiveness were used to operationalize immunity. At the time blood was drawn for lymphocyte enumerations and mitogen blastogenesis responsiveness, the participants were asked to complete the research instruments. The completed instruments were mailed to the researcher. Significant relationships were observed among the proposed variables. Significant relationships between the psychosocial variables of cognator and the immune variables of regulator provide partial support for Roy's Theory of the Person as an Adaptive System and serve to further validate the Roy Adaptation Model. A theory of internalized stigma was proposed, and PSAQ-2 was developed to operationalize the concept of internalized stigma of AIDS.

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