Deciding to disclose HIV/AIDS in long-term committed relationships.

摘要

Advances in medical knowledge and treatment allow people living with HIV/AIDS (PLWHA) to live asymptomatic long after their diagnosis, resulting in a reorientation from preparation for death to life with HIV/AIDS and its impact on daily life. In 2003, prevention efforts of the World Health Organization emphasized disclosure of HIV/AIDS status in response to increasing transmission rates among sexual partners. This was done despite the known challenges of such disclosure in an intimate relationship. Accordingly, the research question of this study was to identify and define a disclosure process based on the successful experiences of PLWHA in long-term relationships established after their diagnosis of HIV/AIDS. Both attachment and self-disclosure theories were used to design in-depth interviews and focus group protocols aligned to predict the dynamics that were associated with successful disclosure. The grounded theory design drew data from interviews with 10 participants in serostatus discordant relationships and data collected from 3 focus groups consisting of 18 PLWHA who were 2 years post diagnosis. The combined data were analyzed using a sequential process of open, axial and selective coding to synthesize the core themes of a theoretical understanding of disclosure in PLWHA relationships. This model predicted that successful outcomes began with self-acceptance and education with regards to one's HIV/AIDS status. From that foundation, the individual was able to consider the risks of disclosure and devised a disclosure plan that considered personal risks, risks to the partner, and risks to the relationship formation process. These findings are significant and can lead to positive social change in that they can be used to design effective treatment and interventions to improve the probability that disclosure will occur between PLWHA and their intimate partners.