This interpretive phenomenological study of gay men with asymptomatic HIV-infection examined how experiences with HIV infection, and beliefs about health, illness, HIV, immune function monitoring and treatment options, shaped personal meanings and coping patterns. The study design included in-depth conversations with asymptomatic HIV-positive gay men. Transcriptions of these conversations and field notes were treated as meaningful texts.

Both health-seeking and high-risk behaviors were explored within the context of the thoughts, beliefs, feelings, and experiences related to living with asymptomatic HIV infection in the gay community. Narrative accounts of lived experiences were elicited through 17 in-depth, semi-structured conversations supplemented by extensive participant-observation data including conversations with and observations of gay men in the investigator's extended social network.

While interview topics and lines of inquiry were established beforehand, they were subordinated to the issues and concerns of the participants. Four paradigm case stories are presented to introduce the ongoing informal discourse among gay men with asymptomatic HIV infection. A major purpose of the study was to articulate that discourse so that it might proceed more publicly, be taken more seriously; develop more fully and contribute more meaningfully to an understanding of gay men living with asymptomatic HIV infection. To this end, ideologies about health and illness were explored in relation to standard and alternative health practices.

Participants included both men who were not monitoring their T-cells and those who were. Health care in general and T-cells in particular held a variety of symbolic meanings for the participants. Symbolic meanings for T-cells ranged from a "male fetishism" with meaningless numbers to an absolute indication of one's level of health; from normalized nonsense to report cards. The power of these symbols was evident in the emotional and behavioral reactions they evoked--terror, denial, anxiety, anger, sadness, despair, uncertainty and self-doubt. But T-cell counts, whether relatively high or simply stable, sometimes functioned to provide a measure of hope, providing both a weapon against overwhelming uncertainty and an impetus for lifestyle and treatment changes.