title: Helping patients talk about HIV: inclusion of messages on disclosure in prevention with positives interventions in clinical settings.
abstract: Disclosure of HIV serostatus by HIV-infected individuals is considered a prevention strategy, under the assumption that disclosure will prompt risk reduction practices among sex partners. We examined patients' self-reports regarding disclosure messages they found relevant as part of prevention with positives (PwP) interventions in clinical settings. We conducted 52 in-depth interviews with patients participating in 13 PwP interventions. We found that the opportunity to reflect about living with HIV, explore fears of stigma and rejection, develop communication skills and strategies to disclose, and explore a sense of responsibility influenced patients' intention to disclose and their disclosure practices. PwP interventions need to include a combination of messages about disclosure strategies, stigma, and communication, as well as helping patients frame disclosure as a process that includes situations and interactions to consider post-disclosure. PwP disclosure counseling can help influence a shift in patients' risk towards safer sex practices.
authors.affiliation: Center for AIDS Prevention Studies, AIDS PolicyResearch Center, University of California, San Francisco 50 Beale St, Suite 1300, San Francisco, CA 94105, USA. andres.maiorana@ucsf.edu
authors.forename: Andre
authors.initials: A
authors.lastname: Maiorana
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Koester
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Myers
authors.forename: Karen C
authors.initials: KC
authors.lastname: Lloyd
authors.forename: Starley B
authors.initials: SB
authors.lastname: Shade
authors.forename: Carol
authors.initials: C
authors.lastname: Dawson-Rose
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Morin
mesh_terms: D003376:Counseling / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology*; D006801:Humans; D008297:Male; D036301:Qualitative Research; D040242:Risk Reduction Behavior; D012650:Self Disclosure; D057566:Self Report; D014481:United States