Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention.

Instituto de Psicologia, Universidade de São Paulo, Brasil.
Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública (Impact Factor: 0.83). 09/2011; 27(9):1699-710. DOI: 10.1590/S0102-311X2011000900004
Source: PubMed

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".

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    ABSTRACT: To examine HIV-positive patients' reports of whether HIV care providers ever talked with them about practicing safer sex and disclosing seropositive status to sex partners. Cross-sectional survey (1998-1999) of HIV-positive men and women sampled randomly at six public HIV clinics in California. Participants were interviewed and asked whether applicable clinic providers (physician, physician assistant, nurse practitioner, nurse, social worker, health educator, psychologist, psychiatrist) ever talked with them about safer sex or disclosure. Responses were analyzed by clinic site, HIV medical status (viral load), demographic, and behavioral variables (unprotected intercourse, non-disclosure). The sample (n = 839) included heterosexual men (n = 127), men who have sex with men (MSM; n = 607), and women (n = 105). Thirty-nine percent were white, 36% Hispanic, 17% black, and 8% other/mixed ethnicity. Overall, 71% reported that an applicable provider had talked with them at least once about safer sex (range across clinics, 52-94%); 50% reported discussion of disclosure (range across clinics, 31-78%). Discussion of safer sex was more prevalent with physicians than with other clinic staff. In multivariate analyses, in addition to significant clinic differences, MSM (versus heterosexual men) and whites (versus blacks or Hispanics) were less likely to receive prevention messages on these topics. Patients' behaviors (unsafe sex, non-disclosure) and HIV medical status were not independently associated with provider communication. HIV clinics differed substantially in the percentage of patients who reported that they received prevention messages from clinic staff. Care providers should assess and overcome barriers to providing prevention messages to patients.
    AIDS 10/2002; 16(14):1953-7. · 6.41 Impact Factor
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    ABSTRACT: This study examined disclosure of HIV-positive serostatus by 301 Latino gay and bisexual men to members of their social networks and the mental health consequences of such disclosure. The sample was recruited from clinics, hospitals, and community agencies in New York City, Washington, DC, and Boston. Proportions disclosing differed depending on the target, with 85% having disclosed to closest friend, 78% to male main partner, 37% to mother, and 23% to father. Although there were differences depending on the target, disclosure was related to greater quality of social support, greater self-esteem, and lower levels of depression. Moreover, findings indicated that social support mediated the relationship between disclosure of serostatus and both self-esteem and depression. Thus, disclosure resulted in greater social support, which in turn had positive effects on psychological well-being. Findings demonstrate that generally Latino gay men are selective in choosing people to whom they disclose their serostatus and that disclosure tends to be associated with positive outcomes.
    AIDS and Behavior 04/2005; 9(1):15-26. · 3.49 Impact Factor
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    Revista De Saude Publica - REV SAUDE PUBL. 01/2005; 39(2).

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