The purpose and aim of this research study was to describe and understand the lived experience of individuals living with HIV/AIDS while residing in a rural region of northern Appalachia from an emic perspective. Most HIV/AIDS research conducted in the Appalachian region has been conducted in the southern and central regions. Few research studies have been conducted in Northern Appalachia and this is the first phenomenology study exploring HIV/AIDS in Northern Appalachia.
The setting for this study was a rural region in northern Appalachia. The sample consisted of 15 individuals. Data were collected, transcribed, and coded using hermeneutic phenomenology using methods based on the Utrecht School. Major themes emerged from frequently occurring phrases and experiences described by the participants.
Six themes were identified: surviving the predators, walking the road to death, the brink, rebirth/second chance, creating a nest of safety, and living in the shadows. The participants found meaning in sharing the history of their life that led to infection with HIV/AIDS. The themes identified within the study provide insight into the struggles experienced by individuals living with HIV/AIDS in rural Northern Appalachia. The participants characterized the burdens they endure as living the shadows that they felt were not understood by the people of rural Northern Appalachia. By sharing their experiences, the participants hoped to encourage others and emphasize the need for obtaining support. Sharing their narrative helped the participants to find meaning in their experiences.
The findings of this study contribute to the nursing profession and other health related professions by providing insight into the struggles experienced by individuals living with HIV/AIDS in rural Northern Appalachia. Implications include assessing for past and current physical and emotional abuse among people living with HIV/AIDS (PLWHA), assessing for concerns associated with personal safety in the home environment and in the community, and providing early and appropriate referral for ongoing support over time. The study suggests the need for improving health and service delivery in a disease where stigmatization, discrimination, and fear still exist locally, nationally, and internationally.