title: Men's serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV.
abstract: BACKGROUND
  Directly disclosing a positive HIV serostatus to family members can affect psychological and disease status. Perceptions that one is in a supportive family environment may moderate these effects; however, ethnic differences may exist in the support processes of families coping with HIV.
  
  
  METHODS
  We examined the role of serostatus disclosure to parents, HIV-specific family support, and ethnicity (Latino versus non-Hispanic White) in explaining disease status (HIV Viral Load, CD4+ cell count) in a sample of men living with HIV (MLWH). Men (n=120) reported whether they had disclosed their serostatus to their mothers and fathers, rated their perceptions of HIV-specific social support received from family members, and provided morning peripheral venous blood samples to assess immune function. We also collected psychosocial and urinary neuroendocrine indicators of stress/distress as possible mediator variables.
  
  
  RESULTS
  A three-way interaction emerged between serostatus disclosure to mothers, HIV-specific family support, and ethnicity in explaining both viral load and CD4+ cell count. Non-Hispanic White men who had disclosed to mothers and were receiving high family support had a lower viral load and higher CD4+ cell count, but Latino men who had disclosed to mothers and were receiving low family support had a higher viral load. These associations were not accounted for by men's medication adherence, psychological distress, or neuroendocrine hormones. Disclosure to fathers was not related to disease status.
  
  
  CONCLUSIONS
  The effects of serostatus disclosure on disease status may depend, in part, on ethnic differences in the interpersonal processes of men's close family relationships.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL 33146, USA. efekete@psy.miami.edu
authors.forename: Erin M
authors.initials: EM
authors.lastname: Fekete
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
authors.forename: Corina R
authors.initials: CR
authors.lastname: Lopez
authors.forename: Ron E
authors.initials: RE
authors.lastname: Durán
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Penedo
authors.forename: Frank C
authors.initials: FC
authors.lastname: Bandiera
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Fletcher
authors.forename: Nancy
authors.initials: N
authors.lastname: Klimas
authors.forename: Mahendra
authors.initials: M
authors.lastname: Kumar
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
mesh_terms: D000328:Adult; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000276:immunology / Q000378:metabolism; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005431:Florida / Q000453:epidemiology; D006679:HIV Seropositivity / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010287:Parent-Child Relations; D011584:Psychology; D012650:Self Disclosure; D019529:Sexuality; D012944:Social Support; D013315:Stress, Psychological / Q000276:immunology / Q000378:metabolism; D019562:Viral Load; D055815:Young Adult
chemical_list: D015415:Biomarkers; D006854:Hydrocortisone; D009638:Norepinephrine