Abstract
Background: Disclosing one’s HIV status can have a substantial impact on the well-being of people
living with HIV, and on preventing HIV transmission. Previous studies have reported beneficial effects
such as increased social support, less stigmatization, and improved treatment adherence, but also negative
influences such as associations with increased stigmatization. To better understand the complex role of
disclosure, we need to rethink how disclosure is considered in research and clinical practice: is it one
event, one process consisting of multiple events, or a collection of distinct processes? Most studies have
assumed that disclosure is a single event or process, but evidence has started to gather in support of the
fact that HIV disclosure may have different occurrence rates and different causes and consequences
depending on disclosure target and intent. Therefore it is important to examine the structure of disclosure
events before studying its role in HIV treatment and prevention.
Methods: We present a 3-step procedure for studying disclosure quantitatively that takes into account
disclosure target and intent and their possible influences on the structure of disclosure. This procedure
consists of developing a list of relevant actor-categories for the study population, examining the structure
of voluntary and involuntary disclosure via Mokken Scaling, and examined the relationships between the
resulting disclosure dimensions and stigma and social support.
Results: Reports of voluntary and involuntary disclosure from 158 people living with HIV in Kilimanjaro,
Tanzania, were collected via interviews in the spring of 2010. For voluntary disclosure, we identified two
multi-actor clusters, family and community, and two single-category dimensions, partner and children.
Involuntary disclosure consisted of several unrelated single- or two-category dimensions. Correlation
analyses revealed distinct relationships for each disclosure dimension.
Conclusions: Assessing HIV disclosure as a single process may lead to incorrect conclusions about
causes and consequences of disclosure. We therefore recommend using this methodology to investigate
disclosure processes in HIV research. Understanding the process of disclosure itself prior to examining its
relationships with other constructs would increase the quality of our evidence base regarding the process
(es) of sharing this information
living with HIV, and on preventing HIV transmission. Previous studies have reported beneficial effects
such as increased social support, less stigmatization, and improved treatment adherence, but also negative
influences such as associations with increased stigmatization. To better understand the complex role of
disclosure, we need to rethink how disclosure is considered in research and clinical practice: is it one
event, one process consisting of multiple events, or a collection of distinct processes? Most studies have
assumed that disclosure is a single event or process, but evidence has started to gather in support of the
fact that HIV disclosure may have different occurrence rates and different causes and consequences
depending on disclosure target and intent. Therefore it is important to examine the structure of disclosure
events before studying its role in HIV treatment and prevention.
Methods: We present a 3-step procedure for studying disclosure quantitatively that takes into account
disclosure target and intent and their possible influences on the structure of disclosure. This procedure
consists of developing a list of relevant actor-categories for the study population, examining the structure
of voluntary and involuntary disclosure via Mokken Scaling, and examined the relationships between the
resulting disclosure dimensions and stigma and social support.
Results: Reports of voluntary and involuntary disclosure from 158 people living with HIV in Kilimanjaro,
Tanzania, were collected via interviews in the spring of 2010. For voluntary disclosure, we identified two
multi-actor clusters, family and community, and two single-category dimensions, partner and children.
Involuntary disclosure consisted of several unrelated single- or two-category dimensions. Correlation
analyses revealed distinct relationships for each disclosure dimension.
Conclusions: Assessing HIV disclosure as a single process may lead to incorrect conclusions about
causes and consequences of disclosure. We therefore recommend using this methodology to investigate
disclosure processes in HIV research. Understanding the process of disclosure itself prior to examining its
relationships with other constructs would increase the quality of our evidence base regarding the process
(es) of sharing this information
| Original language | English |
|---|---|
| Title of host publication | 16th BIPAI Network Meeting |
| Subtitle of host publication | Abstract Book |
| Chapter | Issues in adherence and disclosure |
| Pages | 17 |
| Number of pages | 1 |
| Publication status | Published - 2014 |