title: Facilitating HIV disclosure across diverse settings: a review.
abstract: HIV status disclosure is central to debates about HIV because of its potential for HIV prevention and its links to privacy and confidentiality as human-rights issues. Our review of the HIV-disclosure literature found that few people keep their status completely secret; disclosure tends to be iterative and to be higher in high-income countries; gender shapes disclosure motivations and reactions; involuntary disclosure and low levels of partner disclosure highlight the difficulties faced by health workers; the meaning and process of disclosure differ across settings; stigmatization increases fears of disclosure; and the ethical dilemmas resulting from competing values concerning confidentiality influence the extent to which disclosure can be facilitated. Our results suggest that structural changes, including making more services available, could facilitate HIV disclosure as much as individual approaches and counseling do.
authors.affiliation: Department of HIV/AIDS, World Health Organization, 20 Ave Appia, 1211 Geneva, Switzerland. obermeyerc@who.int
authors.forename: Carla Makhlouf
authors.initials: CM
authors.lastname: Obermeyer
authors.forename: Parijat
authors.initials: P
authors.lastname: Baijal
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pegurri
mesh_terms: D003219:Confidentiality; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D011369:Professional-Patient Relations; D012959:Socioeconomic Factors; D014342:Truth Disclosure