A Retest of Two HIV Disclosure Theories: The Women's Story

Abstract

The purpose of this study was to evaluate the applicability of two theories of HIV disclosure previously tested with men. Participants included 125 HIV-positive women enrolled in a larger, longitudinal study of HIV disclosure and mental health. Structural equation modeling was used to analyze the proposed theoretical models. The disease progression model contained two single-indicator exogenous variables (disease progression) and one endogenous latent variable (disclosure). The original consequences model contained two single-indicator exogenous variables (disease progression), two single-indicator endogenous variables (consequences), and one endogenous latent variable (disclosure). The revised consequences model contained two single-indicator exogenous variables (consequences) and one endogenous latent variable (disclosure). The results of this study support the revised consequences theory and an earlier claim that disease progression may not be a direct predictor of HIV disclosure. This suggests that women may evaluate the consequences of disclosure to family and friends, particularly the reward, before the disclosure occurs.

Intimacy and Sexual Decision Making: Exploring the Perspective of HIV Positive Women Over 50

“…The Consequence Theory of HIV disclosure has been studied in women, and posits that an individual will weigh the possible consequences of disclosure before making a decision to disclose their status. 28,29 Some evidence suggests that women may tend to prioritize the needs of others over their own needs when evaluating the consequences of disclosure. 29 Brief interventions based in principles of cognitive behavioral therapy may be helpful in this context.…”

“…28,29 Some evidence suggests that women may tend to prioritize the needs of others over their own needs when evaluating the consequences of disclosure. 29 Brief interventions based in principles of cognitive behavioral therapy may be helpful in this context. Specifically, providers can help women identify fears around disclosure, identify the pros and cons of disclosure, and teach effective communication skills.…”

Advancing methodology in the study of HIV status disclosure: The importance of considering disclosure target and intent

“…Several reviewers highlighted the need for improved measurement (e.g. Obermeyer et al, 2011;Smith et al, 2008), and several authors proposed models to guide research on disclosure (Bairan et al, 2007;Bird & Voisin, 2011;Chaudoir & Fisher, 2010;Chaudoir et al, 2011;Mayfield Arnold et al, 2008;Serovich et al, 2008) and stigma (Bos et al, 2013;Earnshaw & Chaudoir, 2009;Mahajan et al, 2008). However, although most research has focused on the broader process of increasing one's disclosure levels from none or few confidants to the entire social network, the existing theoretical models interpreted all empirical evidence in terms of causes and consequences of single disclosure events.…”

Examining the Role of Serostatus Disclosure on Unprotected Sex Among People Living with HIV

“…22 Alternatively, consequence theory proposes that the decision to disclose one's HIV serostatus occurs after a conscientious analysis of the anticipated positive and negative outcomes of that decision. 23 Empirical studies of consequence theory have shown to predict disclosure to friends and family members, but not to sexual partners. 22,26 Finally, the disclosure processes model improves upon previous theories by recognizing the role played by the antecedent goals of disclosure, the mediating processes of disclosure decisions, and the outcomes of these decisions.…”

“…[23][24][25][26][27] We know there are differences in sexual risk behavior patterns between HIV-infected MSM, men who have sex with women (MSW), and women who have sex with men (WSM). [28][29][30][31][32][33] These differences suggest that the costs, benefits, and outcomes associated with serostatus disclosure may also differ between groups.…”