The course of HIV infection includes a parallel pathway of
disclosure (Asudani, Corser, & Patel, 2004). Multiple types
of HIV disclosure have been identified across a wide spectrum of HIV prevention
and treatment cascade (Arnold, 2008; Arun, Singh,
Lodha, & Kabra, 2009; Ateka, 2006; Bairan et al., 2007). They all need
to be under the spotlight of academic research. HIV testing, often seen as an
entry point to diagnosis and disease management, involves disclosure of risk
behaviors and disclosure of partners on the part of the individual being tested
and disclosure of test results on the part of the healthcare providers
(Atuyambe et al., 2014; Bachanas et
al., 2013; Bedell, van
Lettow, & Landes, 2014). Onward
disclosure of serostatus is then the complex behavior under consideration in
most HIV disclosure research (Afifi & Afili,2009).
Disclosure, or self-disclosure, is a process in
which personal (often private or confidential) information is verbally
communicated from one person (i.e., the discloser) to another person (i.e., the
target; Chelune,1979). HIV disclosure includes an array of
behaviors associated with the practice in which HIV-infected persons disclose
their HIV serostatus to their partners, family members, or friends; or when a
child is informed of her/his own HIV status (Qiao, Li, & Stanton, 2013b). Essentially,
it is the process of moving from unawareness to knowledge, invariably a
unidirectional, irrevocable act (Li, de Wit, Qiao, & Sherr,2015). Disclosure has
been viewed as an integral component in the public health effort to reduce
incident HIV infections and improve HIV treatment and care (Remis, 2013). In detail,
much research has also been done in terms of factors enabling or hindering
disclosure, correlates and predictors of disclosure, preparation for disclosure
and consequences of disclosure (Jorjoran Shushtari, Sajjadi, Forouzan, Salimi,
& Dejman,2014; Kumar,
Waterman, Kumari, & Carter, 2006; Latkin et al., 2012; Lee, Bastos,
Bertoni, Malta, & Kerrigan, 2014; Liamputtong
& Haritavorn, 2014; Linda, 2013; Lyimo et al., 2014).
Existing research and theorizing suggest that HIV
disclosure is not a single event but a process of gradual and selective
delivery of information embedded in the context of a social relationship (Lesch
et al., 2007; Moses &
Tomlinson, 2013). A growing
number of empirical studies have focused on the process of HIV disclosure,
including decision-making, disclosure patterns, and post-disclosure adjustment.
These elements are shaped by various social, psychological and clinical factors
(Bott & Obermeyer, 2013; Letteney,
Krauss, & Kaplan, 2012; Li et al., 2007). Studies have
elaborated a cycle of how HIV disclosure has had complex, often reciprocal
influences on behavioral, psychosocial, and clinical aspects of the lives of
HIV-infected individuals (Butler et al., 2009;
Carballo-Dieguez, Miner, Dolezal, Rosser, & Jacoby, 2006; Dageid,
Govender, & Gordon, 2012; De Baets,
Sifovo, Parsons, & Pazvakavambwa, 2008). Disclosure has
also been found to be layered with different needs, demands, and ramifications
of various forms of disclosure ranging from sexual partners, to close family
members, to friends and social acquaintances, to children, to employers, and to
employees (Eustace & Ilagan, 2010; Fesko, 2001). Conceptual
frameworks need to provide understanding of the drivers and inhibitors of
disclosure, on variations in the disclosure process and how these may (or may
not) affect various physical or psychosocial outcomes (Chaudoir & Fisher, 2010; Chaudoir,
Fisher, & Simoni, 2011; Qiao et al., 2013b). Both intended
and unintended consequences of disclosure need to be considered (Serovich,
McDowell, & Grafsky, 2008; Shamu,
Zarowsky, Shefer, Temmerman, & Abrahams, 2014). Active,
coerced, and accidental disclosure may all have different effects on the behavior
and mental health of all individuals concerned (Feigin, Sapir, Patinkin, &
Turner, 2013)...
Full article at: http://goo.gl/fTNxQ6
By:
aDepartment of Health Promotion, Education,
and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University
of South Carolina Arnold School of Public Health, Columbia, SC, USA
bCenter for Social Research in Health, University
of New South Wales, Sydney, New South Wales, Australia
cResearch Department of Infection &
Population Health, University College London, London, UK
Contact Xiaoming Li ; Email: ude.cs.xobliam@gnimoaix
More at: https://twitter.com/hiv
insight
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