People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.
This article describes formative research (a pilot study, interviews, and focus groups) conducted as part of a feasibility test of 2 versions (Analysis vs. Planning) of a brief media literacy intervention titled Youth Message Development (YMD). The intervention targets high school student alcohol use with activities to understand persuasion strategies, increase counter-arguing, and then apply these new skills to ad analysis or a more engaging ad poster planning activity. Based on the theory of active involvement (Greene, 2013), the Planning curriculum is proposed to be more effective than the Analysis curriculum. Overall, results of the formative research indicated that students (N = 182) and mentors/teachers (N = 53) perceived the YMD Planning curriculum as more interesting, involving, and novel, and these ratings were associated with increased critical thinking about the impact of advertising, lower alcohol use intentions, and fewer positive expectations about the effects of alcohol use. Qualitative feedback indicated a need to supplement alcohol-focused ad stimuli with ads targeting other advertising images, use incentives and competition-based activities to further enhance student motivation, and provide flexibility to enhance the appropriateness of the curriculum to various settings. These concerns led to the development of a revised curriculum and plans for further study.
HIV+ African Americans face many challenges that may be addressed by increased social support. This manuscript presents the Brief Disclosure Intervention and explores strategies to tailor the intervention to facilitate disclosure, increase social support, and ameliorate health disparities among HIV+ African Americans. The disclosure decision‐making model served as the theoretical framework. HIV+ African Americans (N = 43) in New Jersey participated in structured interviews at 2 time points and half received the intervention. The intervention group reported increased disclosure efficacy and decreased disclosure anxiety and worry. Qualitative themes for disclosure issues included distress in social network, concern for others, and institutional support. Implications for theory and research, use and tailoring of the intervention, and decreasing health disparities are discussed.
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