Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs’ Strategies for Disclosing HIV Status

Abstract

People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non–face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

Notes

¹The AIDS service organization recruited participants who met criteria that included: HIV+, older than 18 years of age, speak English, with no cognitive impairment. In addition, participants must have disclosed their HIV status to at least one person before the interview and were told that the interview focused on how and when people choose to share their HIV status. Participants expected the interview to be about 45 min, and they were previously acquainted with the AIDS service organization. Participants were told about research compensation, and this could also have affected motivation to participate in the project (many participants were economically distressed).

²Participants’ body mass index ranged from 19.13 to 51.37 (M = 29.45, SD = 7.55). T-cell counts ranged from undetectable to 1,267 (M = 561, SD = 279), viral load from undetectable to 9,730 (M = 555, SD = 1,641), suggesting a reasonably healthy sample with some physically distressed participants.

³The questions focused on disclosure generally, which enabled participants to express overall endorsement of disclosure strategies. By keeping the questions broad, participants had the opportunity to provide specific examples of situations and/or relationships where this strategy may be more or less appropriate.

⁴Additional probes regarding the benefits and drawbacks of each disclosure strategy include what would be the pros/cons, positives/negatives, pluses/minuses, or good consequences/bad consequences.

⁵Two trained coders conducted the inductive coding. Disagreements were resolved through discussion between coders and senior author. Exemplary quotations were selected.