Formation of Personal HIV Disclosure Policies among HIV-Positive Men Who Have Sex with Men

Abstract

Given the increasing emphasis on ''prevention with positives'' programs designed to promote HIV transmission risk reduction among people living with HIV=AIDS, better understanding of influences upon serostatus disclosure in sexual situations is needed. Based on grounded theory analyses of individual interviews, this exploratory research hypothesizes and interprets how 15 HIV-positive men who have sex with men (MSM) formed personal HIV disclosure policies for sexual situations. Participants described five elements influencing development of their personal policies, including: (1) making sense of having been infected, (2) envisioning sex as an HIV-positive man, (3) sorting through feelings of responsibility for others, (4) responding to views of friends and the gay community, and (5) anticipating reactions and consequences of disclosure. The article concludes with implications for current initiatives for prevention with positives.

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

“…This ''normalizing'' of serostatus discussion could remove the burden completely from people living with HIV and hence reduce the barriers to sexual communication, including disclosure. Given the disproportionate expectation for and obligation of disclosure assigned to PLHIV rather than uninfected persons, 19 future research and practice directions may consider the need for an improved understanding of mutual serostatus disclosure between partners regardless of HIV serostatus. By positioning the responsibility of serostatus disclosure exclusively on PLHIV, the risks of marginalization and stigmatization of this population, with their many negative consequences, is likely to continue.…”

“…18,32,34,35 Specifically, HIV-positive MSM are typically less likely to disclose to sexual partners relative to MSW and WSM, citing fears of rejection, issues of confidentiality, and concerns of stigmatization as barriers to HIV disclosure. 19,36 These findings, combined with the disclosure processes model, suggest that disclosure goals and effects on behavior may vary for different sexual behavior groups. Additional empirical attention may help us more fully understand the role of disclosure, not merely the likelihood that disclosure will occur, in facilitating safer sex as a behavioral outcome.…”

“…[16][17][18] Accordingly, disclosure decisions are postulated to occur most often when HIV has advanced to symptomatic AIDS, making it challenging to hide one's illness. 19,20 However, empirical research has not demonstrated consistent associations between disease stage and disclosure to sexual partners. 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.…”

Prevalência e fatores associados à violência entre parceiros íntimos após a revelação do diagnóstico de doenças sexualmente transmissíveis ao parceiro

“…Essa estratégia tem um impacto significantemente positivo no encaminhamento para o tratamento de parceiros sexuais de pessoas com DST 28 . Apesar de mais ênfase ser dada ao HIV 29 , a comunicação ao parceiro é fundamental, independentemente da DST, pois proporciona aos parceiros expostos a oportunidade de avaliação e tratamento médico, limitando a propagação da infecção.…”

Helping Patients Talk About HIV: Inclusion of Messages on Disclosure in Prevention with Positives Interventions in Clinical Settings

“…HIV serostatus disclosure to sexual partners may vary by race or ethnicity (Mansergh, Marks, & Simoni, 1995;Marks et al, 1992;Mayfield Arnold, Rice, Flannery, & Rotheram-Borus, 2008), gender (Ciccarone et al, 2003;Duru et al, 2006;Mayfield Arnold et al, 2008;Weinhardt et al, 2004), sexual orientation (Ciccarone et al, 2003;Duru et al, 2006;Weinhardt et al, 2004), partner type (Buchanan, Poppen, & Reisen, 1996;Carballo-Dieguez, Remien, Dolezal, & Wagner, 1997;Crepaz & Marks, 2003;Duru et al, 2006;Mansergh et al, 1995;Perry et al, 1994;Stein et al, 1998;Wolitski, Rietmeijer, Goldbaum, & Wilson, 1998), partner serostatus (Bachmann et al, 2009;Crepaz & Marks, 2003;De Rosa & Marks, 1998;Marks et al, 1992;, psychological well-being (Armistead, Morse, Forehand, Morse, & Clark, 1993;Bennetts et al, 1999;Kalichman & Nachimson, 1999), and substance use (Latkin et al, 2001;Marks & Crepaz, 2001;Reback, Larkins, & Shoptaw, 2003). Personal guidelines may inform the approach of PLWHA (People living with HIV/ AIDS) to disclosing to sex partners (Rutledge, 2009). HIV disclosure may be motivated by a variety of factors, such as relief (Derlega, Winstead, Greene, Serovich, & Elwood, 2004), a duty to inform others (Derlega et al, 2004;Serovich & Mosack, 2003), a supportive relationship or sense of similarity with the disclosee, a need for honesty, health concerns (Derlega et al, 2004),...…”