Lived experiences of spiritual conflict among LGBT individuals living with HIV in Lampung, Bengkulu, and Depok, Indonesia: A phenomenological study
Abstract
Background & Aim: Spiritual conflict among LGBT individuals living with HIV may arise from intersecting sexual or gender identity, religious beliefs, and illness-related meanings. This study explored lived experiences of spiritual conflict in Lampung, Bengkulu, and Depok, Indonesia.
Methods & Materials: This descriptive phenomenological study used Colaizzi’s seven-step method. Twenty purposively recruited participants (14 gay men, three bisexual men, and three transgender women) completed in-depth interviews from July to August 2026. Interviews addressed faith, identity, HIV diagnosis, spiritual struggle, coping, and reconciliation. Analysis identified significant statements, formulated meanings, clustered themes, and developed an essential structure. Trustworthiness was supported by member checking, reflexive journaling, peer debriefing, expert review, and an audit trail.
Results: Five themes and 17 subthemes emerged: (1) recognizing the contradiction between faith and desire; (2) living with guilt and spiritual distress; (3) interpreting HIV as a spiritual turning point; (4) negotiating identity and faith; and (5) seeking reconciliation with God. Participants described tension between religious teachings and identity, guilt, self-blame, fear of divine punishment, spiritual distance, meaning reconstruction, and reconciliation. Spiritual conflict was overlapping and recursive rather than uniform or sequential. Participants moved between guilt and hope, spiritual distance and religious engagement, and self-rejection and acceptance. HIV diagnosis often prompted reflection, although its spiritual meaning varied.
Conclusion: Spiritual conflict involved ongoing identity negotiation, moral interpretation, meaning reconstruction, and reconciliation. Spirituality could be both a source of distress and a resource for adaptation.
2. Kamila A, Widyawati W, Hasanbasri M, Hakimi M. Capturing the HIV-related social exclusion practices experienced by key populations through photovoice: An interpretative phenomenological study. Reproductive Health. 2024 Jul 15;21(1):107.
3. Nevendorff L, Pedrana A, Bourne A, Traeger M, Sindunata E, Reswana WA, Alharbi RM, Stoové M. Characterizing socioecological markers of differentiated HIV risk among men who have sex with men in Indonesia. AIDS and Behavior. 2024 Feb;28(2):657-68.
4. Jain R, Wong CS, Tan RK. Fear really comes from the unknowns: exploring the impact of HIV stigma and discrimination on quality of life for people living with HIV in Singapore through the minority stress model. Sexual Health. 2024 Sep 9;21(5):SH23204.
5. Amirudin I, Agung W, Muhammad A, Dhian Luluh R, Nor A, Riska Hediya P. The experience of double stigma among LGBT people living with HIV in Lampung, Indonesia: A qualitative study. Nursing Practice Today. 2026;13(2):230-41.
6. Hutahaean BSH, Stutterheim SE, Jonas KJ. Religion, Faith, and Spirituality as Barriers and Facilitators to Antiretroviral Therapy Initiation Among People with HIV in Indonesia. AIDS Patient Care and STDs. 2025;39(4):160-72.
7. Fauk NK, Ward PR, Hawke K, Mwanri L. Cultural and religious determinants of HIV transmission: A qualitative study with people living with HIV in Belu and Yogyakarta, Indonesia. PLOS ONE. 2021;16(11):e0257906.
8. Amirudin I, Aziyan, N., Akbar, M. A., Agung Waluyo, & Astuti Yuni Nursasi. Exploration of lived experiences among LGBT individuals living with HIV/AIDS: A phenomenological study. Gaster. 2026;24(1).
9. Amirudin I, Waluyo A, Sujianto U, Akbar MA, Nursasi AY, Ayubi D. Experiences of People Living with HIV and Tuberculosis amid Fear, Guilt, and Silence: A Qualitative Study. Nurse Media Journal of Nursing. 2026;16(1):17.
10. Ramadhan FR. Of agency, Allah, and authority: the making of a divine trial among Muslims with same-sex attraction in Indonesia. Journal of the Royal Anthropological Institute. 2024;30:150-67.
11. Rahmawati S, Poerwandari E. Tracing the Integration Journey: A Qualitative Study of Conflict Between Gender/Sexuality Identity and Religiosity Among LGBTQ Individuals in Indonesia. KnE Social Sciences. 2024.
12. Falewicz A, Szcześniak M, Rybarski R, Chmiel M, Wilt JA, Zarzycka B. Polish Validation of a 14-Item Version of the Religious and Spiritual Struggles Scale (RSS-14): Factorial Structure, Psychometric Properties, and Clinical Correlates. Journal of Religion and Health. 2023;62(5):3579-603.
13. Bukhori B, Hidayanti E, Situmorang DDB. Religious coping strategies for people with HIV/AIDS (PLWHA) Muslims in Indonesia: A qualitative study with a telling-the-stories. Heliyon. 2022;8(12):e12208.
14. Nogueira VPF, Gomes AMT, Mercês MCD, Couto PLS, Yarid SD, Andrade P. Spirituality, religiosity, and their representations for people living with HIV: daily life and its experiences. Revista da Escola de Enfermagem da USP. 2023;57:e20220394.
15. Morrow R, Rodriguez, A., & King, N. Colaizzi’s Descriptive Phenomenological Method. . The Psychologist. 2015;28(8):643-4.
16. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care. 2007;19(6):349-57.
17. Campbell S, Greenwood M, Prior S, Shearer T, Walkem K, Young S, et al. Purposive sampling: Complex or simple? Research case examples. Journal of Research in Nursing. 2020;25(8):652-61.
18. Ahmed SK. The pillars of trustworthiness in qualitative research. Journal of Medicine, Surgery, and Public Health. 2024 Apr 1;2:100051.
19. Council for International Organizations of Medical Sciences. International ethical guidelines for health-related research involving humans: Prepared by the Council for International Organizations of Medical Sciences (CIOMS) in collaboration with the World Health Organization (WHO). Council for International Organizations of Medical Sciences; 2016 Dec 6.
20. Valente T, Silva L, Fernandes Rodrigues A. Spiritual Needs as Expressed by People Living with HIV: A Systematic Review. Religions. 2022;13:342.
21. Derakhshanpour S, Akbarzadeh M, Bagheri S, Yazdanpanahi Z, Keshtvarz Hesam Abadi A. Spiritual health and experience of suffering in patients with HIV/ AIDS in Shiraz, Iran. HIV & AIDS Review. 2023;22(3):261-8.
22. Chi D, de Terte I, Gardner D. Posttraumatic Growth and Posttraumatic Stress Symptoms in People with HIV. AIDS and Behavior. 2022;26(11):3688-99.
23. Park CL. Meaning-making following trauma. Frontiers in Psychology. 2022 Mar 23;13:844891.
24. Etengoff C, Lefevor GT, Huynh KD, Rodriguez EM, Luong E. Development and Validation of the Sexual Minority and Religious Identity Integration (SMRII) Scale. Journal of Homosexuality. 2024;71(7):1727-56.
25. Wolf JK, Platt LF. Religion and sexual identities. Current Opinion in Psychology. 2022;48:101495.
26. Helminen EC, Ducar DM, Scheer JR, Parke KL, Morton ML, Felver JC. Self-Compassion, Minority Stress, and Mental Health in Sexual and Gender Minority Populations: A Meta-Analysis and Systematic Review. Clinical Psychology. 2023;30(1):26-39.
27. Koc Y, Sahin H, Garner A, Anderson J. Societal acceptance increases Muslim-Gay identity integration for highly religious individuals… but only when the ingroup status is stable. Self and Identity. 2021;21:299-316.
28. Puchalski C, Romer AL. Taking a Spiritual History Allows Clinicians to Understand Patients More Fully. Journal of Palliative Medicine. 2000;3(1):129-37.
29. Borneman T, Ferrell B, Puchalski CM. Evaluation of the FICA Tool for Spiritual Assessment. Journal of Pain and Symptom Management. 2010;40(2):163-73.
30. Balboni TA, Fitchett G, Handzo GF, Johnson KS, Koenig HG, Pargament KI, Puchalski CM, Sinclair S, Taylor EJ, Steinhauser KE. State of the science of spirituality and palliative care research part II: Screening, assessment, and interventions. Journal of Pain and Symptom Management. 2017 Sep 1;54(3):441-53.
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| LGBT; HIV; spiritual conflict; spirituality; religious identity; lived experience; phenomenology; nursing care | ||
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