In the 1980s, gay men in Australia, New Zealand and internationally had their social networks decimated, and their lives shaped by the HIV epidemic (14).  Many long-term survivors have suffered the loss of lovers, partners, friends, and their community. For some, in the early days of the HIV epidemic in particular, the grief of gay men who lost their partners was often not acknowledged by families and the broader society.  In many cases, this group was told they would not survive for long; now they are ageing, having spent their youth expecting to die, and witnessing many of their friends and supporters die.   

In the late 1990s, US author Eric Rofes wrote that the ‘mass psychic numbing, fragmentation and suffering experienced by gay men is analogous to that suffered by survivors of genocide and wars’ and suggested that methods that aid such survivors may be more adaptable to people with HIV than traditional models of grieving (15).  It is increasingly recognised that some long-term survivors experience symptoms usually associated with post-traumatic stress disorder (referred to by some as ‘AIDS survivor syndrome’) (16). HIV-related ‘post-traumatic growth has also been examined (17-19). 

Knowledge of and awareness of these contextual issues highlight the need for trauma-informed approaches to assessment and care planning for long-term survivors (20).