How do siblings make sense of their experiences when one is HIV positive?

Owing to advances in HIV treatment, adolescents are now living long and healthy lives into adulthood and beyond. Research has been conducted in order to investigate the psychological and emotional responses of those who are HIV positive. However, there is a paucity of empirical research that investigates those responses in the siblings of adolescents who are diagnosed with HIV but who are not HIV positive themselves. This is an important area for research as clinicians recognise that healthy siblings of chronically unwell young people experience significant difficulties. Therefore, this project aimed to explore the psychosocial impact HIV is having on HIV discordant siblings, as well as considering the impact of this on the sibling relationship. Five sibling pairs (aged between 14 and 21), each consisting of one HIV positive and one HIV negative sibling, participated in face-to-face interviews with the author. This data was then subjected to Grounded Theory analysis which revealed 15 sub categories for the HIV positive group and 12 for the HIV negative group. Subcategories were subsequently arranged into a coherent framework before a group analysis was explored and a theoretical formulation describing the findings is offered. The theoretical formulation describes how the core categories that emerged from the research interact with one another whilst also detailing the systemic impact of HIV on the cognitive, affective and behavioural responses of participants. It emerged that both sibling groups struggle with the demands of secrecy in relation to HIV; both siblings manage disclosure anxiety and the threat of being exposed resulting from societal and cultural stigma associated with HIV. The sibling bond appears to be important to both. A family coping strategy of avoidance emerged for all families in that siblings offered a much needed source of support in discussing the taboo topic of HIV, often not openly discussed within the family. Participants discussed the influence HIV has had on their lives and the benefits of this were explored. The theoretical formulations proposed by this project are considered within the context of the existing literature and implications for future research and clinical practice are discussed.