Disclosure Of Seropositive Status Research Articles

Factors Associated with Outcomes of Status Disclosure among Antiretroviral Therapy (ART) Attendees in Public Health Facilities of Mekelle City, Tigray, Ethiopia

INTRODUCTION: Positive status disclosure is considered a central strategy and a critical gateway in the prevention and treatment of the Human Immunodeficiency Virus. Disclosure of serostatus plays a significant role in preventing transmission and provides early care services for people with the virus. It also improves adherence to treatment and the quality of life in Human Immunodeficiency Virus-positive clients. However, research on the outcome of seropositive status disclosure has been uneven, both in time and geography, and is limited, particularly in the Tigray region. OBJECTIVE: To assess the factors associated with outcomes of status disclosure among antiretroviral therapy attendees in public health facilities of Mekelle City. METHOD: An institution-based cross-sectional study was conducted. A systematic random sampling technique with K=6 was used to select study participants, recruiting a total sample size of 273. The data were collected based on face-to-face interviews using structured questionnaires. Bivariate and multivariable logistic regression analysis with a 95% confidence interval and a cut-off point p-value < 0.25 were used to assess the associated factors. SPSS version 21 was used to analyze the data. RESULT: Of the total respondents in this study, 231 (84.6%) reported that the outcome of discussing their HIV seropositive result was positive. Conversely, 15.4% reported negative outcomes of disclosure. In the multivariable analysis, the outcome of disclosure was significantly associated with gender (AOR=3.5, 95% CI [1.110-11.272]) and the quality of the relationship with a partner before disclosure of status (AOR=0.172, 95% CI [0.045-0.647]). CONCLUSION: Although the majority of the people experienced positive outcomes, a significant proportion of individuals are experiencing negative outcomes from positive status disclosure. Therefore, healthcare providers should be aware of both the benefits and the negative consequences of disclosure. They should also identify women most at risk for negative outcomes and provide counseling and support throughout the entire disclosure process.

Magnitude of Prompt HIV-Seropositive Status Disclosure to Partner and Associated Factors among Adult Clients on ART at Holeta Health Center, Central Ethiopia, 2020

Background. Disclosure of HIV-seropositive status is important for HIV prevention and maintenance of health for people living with HIV and the community at large. Most of the disclosure in our country and elsewhere were after putting the partner at risk of contracting HIV/AIDS. This study aimed to assess prompt HIV-seropositive status disclosure to partner and its associated factors among people living with HIV and attending care and treatment at a health center, in central Ethiopia. Methods. A cross-sectional study was carried out from September 15, 2019, to March 15, 2020, among 438 people living with HIV who were more than 18 years old and had sexual partner attending ART clinic at Holeta Health Center, central Ethiopia. The data were collected through face-to-face interviews using a structured questionnaire. The data were entered into Epi data version 3.1 and exported to SPSS version 21 for analysis. Descriptive analysis was conducted to determine the magnitude of prompt HIV seropositive status disclosure to partner and multivariable logistic regression analysis was computed to identify factors associated with prompt HIV seropositive status disclosure. Results. A total of 434 study participants took part in this study giving a response rate of 99%. Three hundred thirteen (72.1%) respondents disclosed their seropositive status to their partners promptly. Being married (AOR = 2.99, 95% CI = 1.09–8.21), less than 24-months duration on treatment (AOR = 0.185, 95% CI = 0.076–0.454), discouraging response of partner about the test (AOR = 0.34, 95% CI = 0.0149–0.780), knowing serostatus of one’s own partner (AOR = 10.42, 95% CI = 4.19–25.19), and using condom always with a partner (AOR = 11.44, 95% CI = 3.37–38.79) were factors significantly associated with prompt HIV seropositive status disclosure to partner. Conclusion. The proportion of prompt disclosure of HIV seropositive status to partner was low when compared to the overall partner disclosure rate. Being in marriage, less than 24 months duration on treatment, discouraging response of partner about the test, knowing serostatus of one’s partner, and using condom always with a partner were identified as predictors of prompt HIV seropositive status disclosure to partner.

Determinants of Human Immunodeficiency Virus Seropositive Status Disclosure in Kenya

The purpose of the study was to determine whether socio-demographic characteristics of People Living with HIV and AIDS (PLWHA) predicted self-disclosure of HIV seropositivity status in Kenya. A survey was conducted among a random sample of 232 respondents in Nairobi County. Data was gathered through interviews and focus group discussions. The findings indicated that 28.0% of the respondents were male and 72.0% were female. The respondents were aware of their HIV seropositive status for at least one year prior to the study. About half of the respondents (50.9%) had disclosed their HIV seropositive status, while 49.1% had not disclosed. The binary logistic regression established that the socio-demographic predictors of HIV seropositive status disclosure were educational attainment (AOR =1.266; p = 0.001), regular employment status (AOR = 1.691; p = 0.001) perceptions of financial security (AOR = 2.440; p = 0.020) and knowledge of management of HIV (AOR = 3.505; p = 0.001). However, respondents’ sex (p = 0.162), age (p = 0.921) and marital status p = 0.621) were not statistically significant predictors of HIV seropositivity disclosure to sexual partners. This implies that public health programmes should focus on educational interventions, financial security, and training on the management protocols for People Living with HIV and AIDS in order to promote HIV seropositivity status disclosure to sexual partners.

Attitudes Toward HIV-Positive Status Disclosure Among U=U-Aware Sexual and Gender Minority Individuals in the USA: a Consensual Qualitative Research Approach.

IntroductionThe U=U (i.e., undetectable equals untransmittable) campaign is founded upon biomedical advancements that have positioned HIV as a manageable condition with effectively zero risk of transmission. In spite of these developments, attitudes of sexual and gender minority populations regarding the necessity of seropositive status disclosure remain unexamined.MethodsThe current study analyzed qualitative data regarding the necessity of seropositive status disclosure from 62 sexual minority men as well as transgender and gender non-conforming individuals who have sex with men from 2020 to 2021.ResultsThe majority of participants believed disclosure to be necessary and invoked several social and structural factors that informed their attitudes. Participants cited HIV criminalization laws, the ethics of non-disclosure, and disclosure as a means of educating sex partners when appraising the necessity of disclosure. Participants also presented concerns regarding U=U efficacy and HIV stigma.ConclusionsFindings indicate that the disclosure of seropositive status to sex partners is still important to U=U-aware sexual and gender minority individuals. The majority of the study sample, irrespective of HIV status, believed seropositive status disclosure was necessary in advance of sex.Policy ImplicationsFindings suggest opportunities for public health messaging to remediate concerns about U=U efficacy, combat misinformation, and clarify out-of-date information on HIV criminalization.

Living With a Stigmatized Identity; Perceptions of Disclosure, Coping, and Medication Adherence Among Adolescent Boys and Young Men in Chiredzi-Zimbabwe.

There is limited research on adolescent boys and young men (ABYM)'s initial and onward HIV seropositive status disclosure, coping strategies and treatment adherence journeys especially in Zimbabwe. This qualitative exploratory study employed in-depth individual interviews at Chiredzi General Hospital in Zimbabwe to explore the dynamics of disclosure, coping and treatment adherence among ABYM. Twenty-one HIV positive ABYM with ages ranging from 14 to 21 were recruited from their scheduled visit to collect medication at the hospital. Findings indicate that ABYM disclosure journeys began with shock, confusion or misunderstanding and ended in a positive life outlook. Treatment adherence among ABYM was very poor due to poverty, erratic food supply, feeling sick after taking medication, forgetfulness and the public nature of medication collection centers. The study concluded that ABYM maintained secrecy in order to be accepted by their peers but also to protect themselves from stigma and isolation.

Sexual Practices and HIV Seropositivity Disclosure among Adults in Nairobi, Kenya

The purpose of the study was to assess the relationship between sexual practices and HIV seropositive status disclosure to sexual partners by People Living with Human Immune-Deficiency Virus (PLWHIV) in Nairobi, Kenya. A survey was conducted among 232 PLWHIV who were registered members of HIV support groups in an informal settlement. Results showed that half (50.5%) of the respondents had disclosed their HIV seropositive status to their sexual partners. Chi-square results revealed statistically significant relationships between HIV seropositive disclosure and the following sexual behaviours: condom use in the last sexual encounter (χ2 = 12.144; df = 1; p = 0.001); regular sexual partner (χ2 = 5.124; df = 1; p = 0.024); agreement on HIV testing with sexual partner (χ2 = 3.873; df = 1; p = 0.039) and knowledge of sexual partners’ HIV serostatus (χ2 = 6.536; df = 1; p = 0.011). The binary logistic regression results established four positive predictors of self-disclosure to sexual partners as regular sexual partner (AOR = 2.506; p = 0.012), knowledge of sexual partners’ HIV serostatus (AOR = 3.949; p = 0.015), condom use during the last sexual encounter (AOR = 3.507; p = 0.035) and agreement on HIV testing with sexual partner (AOR = 2.560; p = 0.020). However, the desire to conceive (AOR = 3.050; p = 0.094) and the method of testing HIV serostatus (AOR = 0.853; p = 0.530) were not significant predictors of HIV seropositivity disclosure. It was concluded that respondents who knew their partners HIV serostatus and also used a condom during their last sexual encounter were four times more likely to disclose than those who were not aware of partners’ serostatus or those who did not use a condom in their last sexual encounter. Furthermore, those who were in regular sexual relationships and also agreed on HIV testing with sexual partners were twice more likely to disclose than those in casual sexual relationships. An analysis of sexual practices of PLWHIV can therefore enhance the formulation of targeted strategies aimed at enhancing HIV prevention and reduction of risky sexual behaviour among PLWHIV.

Factors Responsible for Disclosure of HIV Seropositivity among Residents of Cross River State, Nigeria.

Context:Disclosure of HIV-positive status to sex partners is viewed as a preventive measure and as a social and legal responsibility for HIV-infected individuals.Aims:The aim of this study is to determine the proportions and factors responsible for disclosure of HIV seropositivity among residents of Cross River State, Nigeria.Settings and Design:This was a cross-sectional comparative study.Subjects and Methods:It involved 320 HIV-positive individuals equally selected from the urban and rural settings of Cross River State and use questionnaires.Statistical Analysis Used:Data analysis used SPSS version 20.0. Chi-square test and logistic regression were used to identify determinants of HIV status disclosure.Results:Among urban respondents, 93.8% had disclosed compared with 79.4% among rural respondents, the difference was statistically significant (P < 0.001). There was a statistically significant association between HIV status disclosure and age (P = 0.008), marital status (P = 0.027), number of nonspousal sexual partner (P = 0.006), and area of residence (P < 0.001). There was no statistically significant association between HIV status disclosure and gender (P = 0.622), between occupation (P = 0.495) or income (P = 0.351 and head of household (P = 0.241). There was statistically significant association between HIV status disclosure and level of education (P = 0.015), house ownership (P = 0.008), time from diagnosis (P = 0.003), and duration of treatment (P = 0.002).Conclusions:This study has shown that HIV seropositive status disclosure was higher when compared with other local studies, and age, marital status, and area of residence were factors associated with HIV seropositive status disclosure.

Criminalization of HIV Exposure: A Review of Empirical Studies in the United States.

This review of literature identifies and describes US empirical studies on the criminalization of HIV exposure, examines findings on key questions about these laws, highlights knowledge gaps, and sets a course for future research. Studies published between 1990 and 2014 were identified through key word searches of relevant electronic databases and discussions with experts. Twenty-five empirical studies were identified. Sixteen of these studies used quantitative methods with more than half of these being cross-sectional survey studies. Study samples included male and female HIV-positive persons, HIV-positive and -negative men who have sex with men, public health personnel, and medical providers. Research questions addressed awareness of and attitudes toward HIV exposure laws, potential influences of these laws on seropositive status disclosure for persons living with HIV, HIV testing for HIV-negative persons, safer sex practices for both groups, and associations between HIV exposure laws and HIV-related stigma. Surveys of the laws and studies of enforcement practices were also conducted. Attention should be shifted from examining attitudes about these laws to exploring their potential influence on public health practices and behaviors related to the HIV continuum of care. Studies examining enforcement and prosecution practices are also needed. Adapting a theoretical framework in future research may be useful in better understanding the influence of HIV exposure laws on HIV risk behaviors.

Opening up the HIV epidemic: a review of HIV seropositive status disclosure among people who inject drugs

ABSTRACTHIV status disclosure plays a crucial role in reducing risk behaviors of drug and sexual partners and thereby limiting HIV transmission. As people who inject drugs (PWID) bear a significant HIV burden and disclosure research among PWID is relatively few, we reviewed the literature to highlight what is known about disclosure among HIV-positive PWID. Searches of articles published from 2000 to 2015 yielded 17 studies addressing different aspects of disclosure, and results are presented by major themes. Our results suggest that despite the difficulties, most PWID (64–86%) disclose their HIV-positive status to trusted individuals (family members and intimate sexual partners) and to those who are known to be HIV-positive. Disclosure to non-intimate sexual partners and fellow drug users is relatively lower. Disclosure decision-making is primarily driven by the perceived positive and negative consequences of disclosure. Subsequent risk reduction practices following disclosure are influenced by the feeling of responsibility, as well as partners’ willingness to accept risk. Cultural family values, ethnicity, and different localities were several contextual factors that affect patterns of disclosure and risk behaviors of PWID. Areas for future research are recommended.

HIV Serostatus Disclosure to Sexual Partners Among Sexually Active People Living with HIV in South Africa: Results from the 2012 National Population-Based Household Survey

This paper explores the prevalence and correlates of HIV seropositive status disclosure to sexual partners by people living with HIV (PLHIV) in South Africa. Secondary analysis of the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey was conducted on data obtained from 934 sexually active PLHIV aged 15years and older who responded to the question about HIV seropositive status disclosure. Overall, a large majority of respondents (77.1%) reported disclosing their HIV-positive status to all their current sex partners. Multiple regression analysis, after adjustments for sex, marital status and locality type, revealed that those who were living together, going steady, and those who were single were all 60% [adjusted odds ratio (AOR)=0.4, 95% CIs 0.20-0.78; AOR=0.4, 95% CIs 0.24-0.77; and AOR=0.4, 95% CIs 0.19-1.00, all ps<0.05] less likely to disclose their HIV positive status to their partners compared to those who were married. Those who lived in rural formal areas were 70% less likely to disclose their HIV status to their partners compared to those who stayed in urban formal areas (AOR=0.3, 95% CI 0.17-0.69, p<0.001). Those who had correct HIV knowledge and rejection of myths were 2.0 times more likely to disclose their HIV status to their partners compared to those who did not have correct HIV knowledge and rejection of myths (AOR=2.0, 95% CI 1.04-3.68, p<0.05). In conclusion, intervention programmes which help improve HIV seropositive status disclosure are needed by PLHIV who are not married, live in rural formal areas, and have incorrect HIV knowledge and rejection of myths.

Factors Affecting HIV Positive Status Disclosure among People Living with HIV in West Showa Zone, Oromia, Ethiopia; 2013

Background: Disclosure of HIV positive status to at least one family members or relative is paramount important for adherence to highly active anti retroviral therapy (HAART) which enters increase survival and quality life of the people living with HIV (PLHIV). Despite the importance of HIV sero positive status disclosure most PLHIV concealed their sero status from their family/relatives even from their sexual partner. The aim of this study was to assess factors that affect PLHIV to disclose their HIV positive status to their sexual partner. Methods: A cross-sectional study using quantitative research approach supplemented by qualitative methods was conducted from October to March 2013 among 360 people living with HIV (PLHIV) attending ART clinic in Ambo Hospital. Simple random sampling technique was used to select the study participants. Data were collected through face to face interview and focus group discussion using pre-tested structured questionnaire and semi structured interview guides, respectively. Crude and adjusted odds ratios using logistic regression analysis were used to explore associations between different variables and HIV status disclosure. Results: The study revealed that the prevalence of HIV status disclosure to at least one person was 86.2% (95% CI: 82.5-89.3); whereas 84.9% study subjects were disclose their HIV positive sero status to their sexual partner. Marital status (AOR = 0.12, 95% CI: 0.036-0.39), knowledge of partner HIV status (AOR = 5.7, 95% CI: 1.89-17.4), prior discussion about HIV/AIDs (AOR = 6.3, 95% CI: 1.05-38.12), length since HIV test done (AOR = 0.05, 95% CI: 0.01-0.32), and being on HAART (AOR = 0.11, 95% CI = 0.03-0.46) were significant predictors of HIV status disclosure to sexual partners. Conclusion: Knowledge of partner HIV status, prior discussion about HIV/AIDS before test, length since tested for HIV and ART initiation were significantly associated with HIV positive status disclosure to sexual partner. Hence the health workers should address the issue of open discussion among couples to enhance HIV status disclosure to sexual partner and decrease HIV status transmission by hiding once HIV positive status due to fear of divorce, stigma and discrimination.

Seropositive status disclosure to partners and safer sexual behaviours among people living with HIV: An issue in prevention and treatment

The objective of this study was to determine the rate of disclosure to sexual partners and consequent safer sexual practices among people living with HIV (PLHIV). This was a cross-sectional study. A semi-structured interviewer administered questionnaire was used to collect demographic data of age, gender, marital status as well as HIV status disclosureand consistent condom use. This information was collected from consenting consecutive antiretroviral-therapynaive PLHIV accessing care at the Lagos State University Teaching Hospital (LASUTH), southwest Nigeria. Collected data were analysed using statistical package for social sciences (version 10.0, spss) and group comparisons were done with chi square tests. A total of 443 respondents were interviewed. The age of the respondents ranged from 18 to 75 years with a mean of 46.5±9. Majority 268 (60.5%) of respondents were females while 175 (39.5%) were males. The disclosure rate to sexual partners was 43 (9.7%) among studied PLHIV. Consistent condom use was highest (12.7%) among PLHIV who had disclosed to sexual partners while inconsistent use was highest (93.3%) among the undisclosed.p=0.26 CONCLUSION: This study reveals that there is a low sexual partner disclosure rate among studied PLHIV. Seropositive status disclosure to sexual partners was associated with consistent condom use.

New Jersey’s HIV Exposure Law and the HIV-Related Attitudes, Beliefs, and Sexual and Seropositive Status Disclosure Behaviors of Persons Living With HIV

We explored associations between awareness of New Jersey's HIV exposure law and the HIV-related attitudes, beliefs, and sexual and seropositive status disclosure behaviors of HIV-positive persons. A statewide convenience sample (n = 479) completed anonymous written surveys during 2010. We recruited participants through networks of community-based organizations in the state's 9 health sectors. The survey assessed participants' awareness of New Jersey's HIV exposure law, their sexual and serostatus disclosure behavior in the past year, and their HIV-related attitudes and beliefs. We compared responses of participants who were and were not aware of the law through univariate analyses. Fifty-one percent of participants knew about the HIV exposure law. This awareness was not associated with increased sexual abstinence, condom use with most recent partner, or seropositive status disclosure. Contrary to hypotheses, persons who were unaware of the law experienced greater stigma and were less comfortable with positive serostatus disclosure. Criminializing nondisclosure of HIV serostatus does not reduce sexual risk behavior. Although the laws do not appear to increase stigma, they are also not likely to reduce HIV transmission.

Predictors of HIV status disclosure to sexual partners among People living with HIV/AIDS in Ethiopia

Disclosure of HIV positive sero-status to sexual partners, friends or relatives is useful for prevention and care. Identifying factors associated with disclosure is a research priority as a high proportion of people living with HIV/AIDS never disclose in Ethiopia. This study was carried out to assess the magnitude and factors associated of HIV seropositive status disclosure to sexual partners among peoples living with HIV/AIDS. A hospital based cross-sectional study was conducted April-June, 2010, among systematically selected 334 HIV patients attending at Woldia hospital, Ethiopia. Data were collected through pre-tested questionnaire, using exit interview. Bivariate and multivariable logistic regression models were fitted to identify associated factors for disclosing their HIV seropostive status to sexual partner. One hundred nineteen nine (59.6%) was females, 218(65%) was from urban area, 297(85.8%) are on antiretroviral therapy. The study found a significant association between higher educational status of the respondents (AOR:0.4; 95%CI (0.17-0.92)) and sexual partners (AOR: 9.0; 95% CI(2.8-29.3)), knowing HIV status of sexual partner (AOR:8.1; 95%CI(3.4 -19.2)), being on antiretroviral therapy (AOR:7.9; 95%CI(3.42-18.5)), having follow up counseling (AOR:5.26; 95%CI(2.2-12.5)), and being tested for HIV in ante natal care clinic (AOR:0.21; 95%CI(1.14- 6.46)) with disclosure of HIV status to sexual partner. The study concluded the need for giving more emphasis for the patients who are not on antiretroviral therapy and the need for giving emphasis on techniques how to disclose status to sexual partner.

A quantitative study of Michigan's criminal HIV exposure law

The objectives of the project were (1) to determine the extent to which HIV-positive persons living in Michigan were aware of and understood Michigan's criminal HIV exposure law, (2) to examine whether awareness of the law was associated with seropositive status disclosure to prospective sex partners, and, (3) to examine whether awareness of the law was associated with potential negative effects of the law on persons living with HIV (PLWH) including heightened HIV-related stigma, perceived societal hostility toward PLWH, and perceived need to conceal one's HIV infection. The study design was cross-sectional. A statewide sample of 384 PLWH in Michigan completed anonymous pen and paper surveys in 1 of 25 data collection sessions. A majority of participants were aware of Michigan's HIV exposure law. Awareness of the law was not associated with increased seropositive status disclosure to all prospective sex partners, decreased HIV transmission risk behavior, or increased perceived responsibility for HIV transmission prevention. However, awareness of the law was significantly associated with disclosure to a greater proportion of sex partners prior to respondents’ first sexual interaction with that partner. Awareness of the law was not associated with increased HIV-related stigma, perceived societal hostility toward PLWH, or decreased comfort with seropositive status disclosure. Evidence of an effect of Michigan's HIV exposure law on seropositive status disclosure was mixed. Further research is needed to examine the various forms of HIV exposure laws among diverse groups of persons living with or at increased risk of acquiring HIV.

Spousal disclosure of HIV serostatus among women attending antenatal care in urban Nigeria

About 80% of HIV-positive pregnant women in our unit have a seronegative spouse. The prevalence, pattern and determinants of spousal disclosure of HIV serostatus was evaluated among 166 HIV-positive pregnant women receiving antiretroviral treatment. Although 146 women (88%) disclosed their HIV serostatus, 20 women (12%) did not disclose their status to their spouse. Non-disclosure was significantly associated with nulliparous (p = 0.024) and unmarried women (p = 0.026). Fear, regarding spread of the information (57.8%), stigmatisation (53%) and deterioration in the relationship with the spouse (47%) were the three commonest reasons for non-disclosure. Disclosure of HIV-positive status remains a sensitive issue among infected pregnant women. Strategies to reduce the stigma associated with HIV infection, appropriate management of the information following disclosure of seropositive status by HIV-infected persons are necessary to encourage disclosure to sexual partners and ultimately prevent new HIV infections.

HIV seropositive status disclosure to prospective sex partners and criminal laws that require it: perspectives of persons living with HIV

Thirty-one HIV-positive persons living in Michigan took part in focus group discussions about Michigan's HIV disclosure law. Discussion themes included perceived responsibility to prevent infection, concern about unwanted secondary disclosure of HIV-positive status, fear of being falsely accused of violating Michigan's HIV disclosure law and perceived vulnerability of HIV-positive persons within the US legal system. Although participants strongly agreed with the ostensible purpose of Michigan's criminal HIV disclosure law, there was considerable concern about the negative impact of the law on persons living with HIV.

To disclose or not to disclose: The moral complexities of HIV status disclosure in Southern Africa

Residual mass ignorance and various degrees of denial that still surround HIV/AIDS and the associated stigma make it difficult for people, either suffering or suspected to be suffering from the opportunistic infections related with HIV, to go for testing and when they do to accept and disclose their status and seek the necessary psychosocial and medical support. Consequently, there are people, some of whom are in lifelong marital relationship, who have (either due to lack of testing or disclosure of their seropositivity) passed on the virus to their partners and unwittingly to some of their children and thereby contributed to the geometric progression in the onward march of HIV pandemic. As a result, there has been close to a tenfold increase in the rate of infection in Swaziland, within the most productive segment of population, from 3.9 percent in 1992 to 38.6 percent in 2003, predominantly due to lack of testing and disclosure of one's HIV-status, which factor (in combination with other variables) has exacerbated the problem of HIV/AIDS. This paper examines the moral complexities of HIV seropositive status disclosure and argues that personal voluntary disclosure is essential in the fight against the spread of HIV infections. LWATI: A Journal of Contemporary Research Vol.3 () 2006: pp.283-299

Critical Delays in HIV Testing and Care

When learning of a positive HIV test, individuals face a host of psychological and social stresses. HIV-related stigma is associated with psychological distress and can interfere with coping, adjustment, and management of HIV disease. Effective management of HIV disease requires timely testing for HIV infection so that persons who are infected can learn of their serostatus and gain access to care, therefore benefiting from available treatment options. This article discusses the impact that HIV-related stigma has on HIV testing and care. Specifically, problems associated with delays in testing, disclosure of seropositive status, and implications for health care are presented.

Disclosure, stress, and psychological adjustment among mothers affected by HIV.

This study examined patterns of disclosure and psychological adjustment among mothers infected or affected by HIV. All participants were followed through a family AIDS clinic at a midwestern children's hospital. With respect to disclosure, results indicated that high perceived stress (r = 0.50, p = 0.001) and low efficacy related to managing parenting demands (r = -0.42, p = 0.01) were significantly associated with disclosure of seropositive status. Neither time since diagnosis, psychological adjustment, AIDS knowledge, nor health status as indicated by CD4 count were related to disclosure. Results also indicated that 51% of the mothers met DSM-IV diagnostic criteria for a psychological disorder in the preceding year. The most common diagnoses included posttraumatic stress disorder and major depression. Analyses suggested that perceived stress accounted for a significant 43% of the variance in psychological adjustment. Neither disclosure, time since diagnosis, nor CD4 count were related to adjustment. Findings are discussed in terms of mothers' mental health needs and provision of services to families affected by HIV/AIDS. Although the results of this study must be considered preliminary due to a limited number of participants and correlational analyses, they point to several avenues for future research.