title: Strategies and outcomes of HIV status disclosure in HIV-positive young women with abuse histories.
abstract: Young women with HIV and histories of physical and/or sexual abuse in childhood may be vulnerable to difficulties with disclosure to sexual partners. Abuse in childhood is highly prevalent in HIV-positive women, and has been associated with poorer communication, low assertiveness, low self worth, and increased risk for sexual and other risk behaviors that increase the risk of secondary transmission of HIV. HIV disclosure may be an important link between abuse and sexual risk behaviors. Qualitative interviews with 40 HIV-positive young women with childhood physical and/or sexual abuse were conducted; some women had also experienced adult victimization. Results suggest that HIV-positive women with abuse histories use a host of strategies to deal with disclosure of HIV status, including delaying disclosure, assessing hypothetical responses of partners, and determining appropriate stages in a relationship to disclose. Stigma was an important theme related to disclosure. We discuss how these disclosure processes impact sexual behavior and relationships and discuss intervention opportunities based on our findings.
authors.affiliation: Department of Community Health Services, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA. gclum@tulane.edu
authors.forename: Gretchen A
authors.initials: GA
authors.lastname: Clum
authors.forename: Lauren
authors.initials: L
authors.lastname: Czaplicki
authors.forename: Katherine
authors.initials: K
authors.lastname: Andrinopoulos
authors.forename: Kathryn
authors.initials: K
authors.lastname: Muessig
authors.forename: L
authors.initials: L
authors.lastname: Hamvas
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Ellen
mesh_terms: D000293:Adolescent; D000328:Adult; D002650:Child Abuse, Sexual / Q000523:psychology*; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012747:Sexual Partners; D057545:Social Stigma; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult