Spirituality among Young Men Who Have Sex with Men Living with HIV: A Qualitative Descriptive Study

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Warunee Fongkaew
Raweewan Pilaikiat
Pensri Eumkep


           Spirituality is considered a protective factor against negative health outcomes and risk behaviors among people living with HIV. To limit the spread of HIV infection among young men who have sex with men, knowledge of spirituality is needed in healthcare services. This study aimed to explore spirituality among young men who have sex with men living with HIV and 20 to 24 years old in Thailand. This qualitative descriptive study was conducted with 10 participants employing in-depth interviews at a tertiary hospital in lower northern Thailand January-August 2017. The data were analyzed by using qualitative content analysis.
          The rich findings provide insights into the spiritual dimension from a Thai Buddhist perspective among young men who have sex with men living with HIV for promoting health and changing their risky behaviors. Four main themes arose from data analysis: 1) experiencing spiritual distress following HIV diagnosis (fear of stigmatization, self-loathing, and hopelessness); 2) accepting the truth of having HIV (acknowledging previous misbehaviors, disclosing their HIV status, and seeking ways to remain healthy); 3) increasing good karma to prolong life (refraining from transmitting HIV to others and avoiding drinking alcohol to reduce risk behaviors); and 4) gaining spiritual well-being to live with HIV (having a spiritual anchor, having life goals, living with hope, and living in the moment). These findings contribute to the development of models or interventions to support young men who have sex with men living with HIV to reduce risk behaviors and promote spiritual well-being by using the religious teaching and religious practices as a guideline.

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Fongkaew W, Pilaikiat R, Eumkep P. Spirituality among Young Men Who Have Sex with Men Living with HIV: A Qualitative Descriptive Study. PRIJNR [Internet]. 2022 Mar. 5 [cited 2022 Sep. 27];26(2):313-26. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/256520
Original paper


Thienkrua W, Griensven FV, Mock PA, Dunne EF, Raengsakulrach B, Wimonsate W, et al. Young men who have sex with men at high risk for HIV, Bangkok MSM cohort study, Thailand 2006–2014. AIDS Behav [Internet].2018 Jul [cited 2021Sep 15]; 22(7):2137-46. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29138981

Smith ST, Blanchard J, Kools S, Butler D. Reconnecting to spirituality: Christian-identified adolescents and emerging adult young men’s journey from diagnosis of HIV to coping. J Relig Health [Internet]. 2017 Feb [cited 2021 Sep 15];56(1):188-204. Available from: https://www.ncbi.


Jiang T, Zhou X, Wang H, Luo M, Pan X, Ma Q, et.al. Psychosocial factors associated with quality of life in young men who have sex with men living with HIV/AIDS in Zhejiang, China. Int J Environ Res Public Health [Internet]. 2019 Aug [cited 2021 Sep 15]; 16(15):2667. Available from:


Song B, Yan C, Lin Y, Wang F, Wang L. Health-related quality of life in HIV-infected men who have sex with men in China: a cross-sectional study. Med Sci Monit [Internet]. 2016 Aug [cited 2021 Sep 15]; 22:2859-70. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC498


Brewer R, Hood KB, Moore M, Spieldenner A, Daunis C, Mukherjee S, et al. An exploratory study of resilience, HIV-related stigma, and HIV care outcomes among men who have sex with men (MSM) living with HIV in Louisiana. AIDS Behav [Internet]. 2020 Jan [cited 2021 Sep 15]; 24:2119-29. Available from: https://doi.org/10.1007/s10461-020-0277

Quinn K, Dickson-Gomez J. Homonegativity, religiosity, and the intersecting identities of young black men who have sex with men. AIDS Behav [Internet]. 2016 Jan [cited 2021 Sep 15]; 20(1):51-64. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26373283

Lassiter JM, Parsons JT. Religion and spirituality’s influences on HIV syndemics among MSM: a systematic review and conceptual model. AIDS Behav [Internet]. 2016 Feb [cited 2021 Sep 15]; 20(2):461-72. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26319130

Watkins TL, Simpson C, Cofield SS, Davies S, Kohler C, Usdan S. The relationship between HIV risk, high-risk behavior, religiosity, and spirituality among black men who have sex with men (MSM): an exploratory study. J Relig Health [Internet]. 2016 Apr [cited 2021 Sep 15]; 55(2):535-48. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26475314

Rahim NK, Waluyo A, Yona S. The relationship between self-efficacy and spirituality in condom use behavior among MSM-PLWHA in Bandung, Indonesia. J Public Health Res [Internet]. 2021 May [cited 2021 Sep 15]; 10(s1):2339. Available from: https://doi: 10.4081/jphr.2021.2339.

Drumhiller K, Nanin JE, Gaul1 Z, Sutton MY. The influence of religion and spirituality on HIV prevention among black and Latino men who have sex with men, New York City. J Relig Health [Internet]. 2018 Oct [cited 2021 Sep 15]; 57(5):1931-47. Available from: https://www.


Carrico AW, Storholm ED, Flentje A, Arnold EA, Pollack LM, Neilands TB, et al. Spirituality/religiosity, substance use, and HIV testing among young black men who have sex with men. Drug Alcohol Depend [Internet]. 2017 May [cited 2021 Sep 15]; 174:106-12. Available from:


Watkins TL, Simpson C, Cofield SS, Davies S, Kohler C, Usdan S. The relationship of religiosity, spirituality, substance abuse, and depression among black men who have sex with men (MSM). J Relig Health [Internet]. 2016 Feb [cited 2021 Sep 15]; 55(1):255-68. Available from:


Adong J, Lindan C, Fatch R, Emenyonu NI, Muyindike WR, Ngabirano C, et al. The relationship between spirituality/religiousness and unhealthy alcohol use among HIV-infected adults in southwestern Uganda. AIDS Behav [Internet]. 2018 Jun [cited 2021 Sep 15]; 22(6):1802-13. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708153/

Dangerfield II DT, Williams JE, Bass AS, Wynter T, Bluthenthal RN. Exploring religiosity and spirituality in the sexual decision‑making of black gay and bisexual men. J Relig Health [Internet]. 2019 Jun [cited 2021 Sep 15]; 58:1792–802. Available from: https://link.springer.com/article/10.1007/s10943-019-00845-3

Murgia C, Notarnicola I, Rocco G, Stievano A. Spirituality in nursing: a concept analysis. Nurs. Ethics [Internet]. 2020 Apr [cited 2021 Sep 15]; 27(5):1327-43. Available from:https://doi.org/10.1177%2F0969733020909534

Lalani N. Meanings and interpretations of spirituality in nursing and health. Religions [Internet]. 2020 Aug [cited 2021 Sep 15]; 11(9):428. Available from: https://doi.org/10.3390/rel11090428

Winzer L, Samutachak B, Gray RS. Religiosity, spirituality, and happiness in Thailand from the perspective of Buddhism. JPSS [Internet]. 2018 Oct [cited 2022 Jan 4]; 26(4):332-43.Available from: https://doi: 10.25133/JPSSv26n4.023

Phaovanich W. Communicating social support for Thai men who have sex with men with HIV/AIDS. [Doctoral dissertation]. Bangkok University; 2018. Available from:http://dspace.bu.ac.th/jspui/bitstream/123456789/3657/1/wuttichai.phao.pdf

Keyes CF. Thailand: Buddhist kingdom as modern nation state. New York: Routledge; 2019.

Mahatthanadull S, Mahatthanadull S. The five precepts: criteria and the promotion of individual and social peace. JIABU [Internet]. 2018 [cited 2021 Sep 15]; Special edition on Vesak celebrations conference: 180–93.

Sapsirisavat V, Phanuphak N, Keadpudsa S, Egan JE, Pussadee K, Klaytong P, et al. Psychosocial and behavioral characteristics of high-risk men who have sex with men (MSM) of unknown HIV positive serostatus in Bangkok, Thailand. AIDS Behav [Internet]. 2016 Dec [cited 2021 Sep 15]; 20(Suppl 3):386-97.Available from: https://pubmed.ncbi.nlm.nih.gov/27553027/

Zhang L, Phanuphak N, Henderson K, Nonenoy S, Srikaew S, Shattock AJ, et al. Scaling up of HIV treatment for men who have sex with men in Bangkok: a modelling and costing study. Lancet HIV [Internet]. 2015 May [cited 2021 Sep 15]; 2(5):E200-7. Available from: http://dx.doi.org/


Lincoln YS, Guba EG. Naturalistic inquiry. Beverly Hills: Sage; 1985.

Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res [Internet]. 2017 Nov [cited 2022 Jan 8]; 24(4):1-8. Available from: http://doi:10.1177/2333393617742282

Turale S. A brief introduction to qualitative description: a research design worth using. Pacific Rim Int J Nurs Res [Internet]. 2020 Jul [cited 2022 Jan 8]; 24(3):289-91.Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/243180

Sandelowski M. Focus on research methods: whatever happened to qualitative description? Res Nurs Health [Internet]. 2000 Aug [cited 2021 Sep 15]; 23(4):334-40.Available from: https://doi: 10.1002/1098-240x(200008)23:4<334:aid-nur9>3.0.co;2-g

Nkomo TS, Kufankomwe MJ. HIV and AIDS and selfforgiveness: the views of a group of people living with HIV and AIDS in Ekurhuleni, Johannesburg, South Africa J Hum Behav Soc Environ [Internet]. 2020 Jun [cited 2021 Sep 15]; 30(5): 649-65. Available from: https://doi.


Balthip K, McSherry W, Nilmanat K. Spirituality and dignity of Thai adolescents living with HIV. Religions [Internet]. 2017 Nov [cited 2021 Sep 15]; 8(12):257. Available from:https://doi.org/10.3390/rel8120257

Roojanavech S, Badr LK, Doyle J. What variables including spirituality determine early sexual initiation among Thai adolescents? Pediatr Dimens [Internet]. 2016 Feb [cited 2021 Sep 15]; 1(1):34-8. Available from:https://www.oatext.com/pdf/PD-1-108.pdf

Weathers E, McCarthy G, Coffey A. Concept analysis of spirituality: an evolutionary approach. Nurs Forum [Internet]. 2016 Apr [cited 2021 Sep 15]; 51(2):79-96. Available from: https://pubmed.ncbi.nlm.nih.gov/25644366/

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