Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention.
ABSTRACT This study investigated the disclosure of HIV-positive serostatus to sexual partners by heterosexual and bisexual men, selected in centers for HIV/AIDS care. In 250 interviews, we investigated disclosure of serostatus to partners, correlating disclosure to characteristics of relationships. The focus group further explored barriers to maintenance/establishment of partnerships and their association with disclosure and condom use. Fear of rejection led to isolation and distress, thus hindering disclosure to current and new partners. Disclosure requires trust and was more frequent to steady partners, to partners who were HIV-positive themselves, to female partners, and by heterosexuals, occurring less frequently with commercial sex workers. Most interviewees reported consistent condom use. Unprotected sex was more frequent with seropositive partners. Suggestions to enhance comprehensive care for HIV-positive men included stigma management, group activities, and human rights-based approaches involving professional education in care for sexual health, disclosure, and care of "persons living with HIV".
Full-textDOI: · Available from: Vera S.F. Paiva, Jun 27, 2014
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ABSTRACT: PurposeThis study utilized Self-Determination Theory's sub-theory Basic Needs Theory (Deci & Ryan, 2000) to understand older youths' perceptions of support for their basic needs of autonomy, relatedness, and competence in the context of disclosing their HIV status.Methods Semi-structured interviews lasting 10–60 min each were conducted with nine youth aged 17–19 (4 women and 5 men) and two adult staff at a one-week residential program in a large southern city. Participant observations of disclosure-related conversations and experiences were conducted and recorded throughout the program. Reliability and validity assurances were met in multiple ways. Analysis of the content of interviews and observations indicated consistent themes that converged on the research questions.ResultsWhen participants perceived more support for their basic psychological needs for autonomy, relatedness, and competence, they reported more self-determined motivation to disclose their status and better satisfaction with their decisions. The results of this study indicate that Basic Needs Theory is useful for understanding how the basic psychological needs of autonomy, relatedness, and competence are satisfied or thwarted in the context of HIV disclosure for older youth.Conclusions Programs and people working with older youth with HIV/AIDS can use BNT to help youth identify, create, and adapt contexts to be supportive of their basic needs for autonomy, relatedness, and competence, and provide guidance and support accordingly. Providers can utilize this information to support youth in strategizing about their disclosure decisions and goals for their well-being.Children and Youth Services Review 01/2013; 35(1):102–111. DOI:10.1016/j.childyouth.2012.10.021 · 1.27 Impact Factor
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ABSTRACT: Understanding partnership dynamics is a crucial step in the process of HIV serostatus disclosure to partners. This study examines the relational characteristics associated with HIV serostatus disclosure and the role of disclosure on sexual behaviours within steady partnerships among people living with HIV (PLHIV) in Rio de Janeiro, Brazil. The overall study surveyed 900 participants from six large public health facilities to investigate psychosocial and structural factors associated with sexual health and well-being. This analysis focuses on 489 individuals reporting being in steady partnerships, 86% of whom reported HIV serostatus disclosure to steady partners. After adjusting for demographic variables, attitudes towards disclosure, having an HIV-positive partner, living with partner and longer relationships were significantly associated with reported disclosure in multivariable logistic regression. Living with partner was negatively associated with partner concurrency. However, having an HIV-positive partner, sex under the influence of drugs or alcohol and experiencing physical aggression by a steady partner were negatively associated with consistent condom use. Interventions supporting PLHIV to safely and voluntarily disclose to partners may be an effective prevention approach between steady partners; however, partner violence and substance use should be addressed in future work.Global Public Health 09/2014; 9(9):1-14. DOI:10.1080/17441692.2014.952655 · 0.92 Impact Factor