The role of disclosure in coping with HIV infection

Abstract

A qualitative investigation was conducted to explore the role of disclosure in HIV infection. Forty homosexual and bisexual men completed a short demographic questionnaire and participated in a one-to-one, semi-structured interview. The interview was designed to address a variety of personal, interpersonal and organizational issues related to their HIV status and participants were invited to talk about their personal experiences from immediately prior to their diagnosis to the time of the interview. The results from the interviews are presented in three sections: immediately post-diagnosis, asymptomatic phase and symptomatic/AIDS phases. The data revealed that disclosing one's HIV status was an acute and recurrent stressor. Immediately post-diagnosis, individuals were more likely to adopt a policy of non-disclosure and this provided them with an opportunity to come to terms with their diagnosis before having to contend with the reactions of others. After this phase, there was evidence that individuals increasingly used disclosure as a mechanism for coping with the disease. Disclosure of one's status was used to increase both practical and emotional support, share responsibility for sex and to facilitate self-acceptance of one's condition. The results from this investigation revealed that disclosure has a dual role in HIV infection acting as both a stressor and a mechanism by which individuals contend with their infection.

Why do People Disclose their HIV Status? Qualitative Evidence from a Group of Activist Women in Khayelitsha

“…She wanted to be treated as normal when she disclosed, because she was healthy, and therefore aimed to educate others regarding her situation and the biophysical realities of HIV/AIDS. These findings are consistent with other international studies where PLWHA do not want to be a burden on others (Holt et al 1998). They want to remain contributing members to their respective households and society.…”

“…Alonzo and Reynolds (1995) attribute this to the fact that the person is no longer able to hide his or her status as the disease becomes clearly visible, and treatment, care and support become necessary for survival. The biophysical effect on disclosure is evident in other studies where disclosure patterns varied according to psychological conditions, fear of stigma and stage of the disease (Holt et al, 1998).…”

“…For many PLWHA, disclosure is the means to access health-related support and services to manage their illness (Holt et al, 1998). Although there seems to be a fear of discrimination, the data from the current study suggests that this fear is based on perception as none of the participants have experienced traumatic events as a result of being identified as HIV-positive (Almeleh 2004).…”

“…The degree to which people cope with the physical and psychosocial aspects of living with HIV/AIDS is to a large extent affected by disclosure decisions (Greene et al 2003;Schmidt and Goggin 2002;Holt et al, 1998;Petrak et al 2001). Poor emotional well-being, including depression and HIV-related anxiety, has been attributed to lack of satisfaction of social support due to nondisclosure (Petrak et al 2001;Armistead et al, 1999).…”

“…People living with HIV are confronted with many factors that compel, encourage or constrain the decision to disclose their HIV status (Almeleh 2004;Greene et al 2003;Petrak et al 2001;Serovich, 2000;Holt et al 1998).…”