title: Age and life course location as interpretive resources for decisions regarding disclosure of HIV to parents and children: Findings from the HIV and later life study.
abstract: Studies of disclosure amongst older people living with HIV (PLWH) are uninformed by critical social-gerontological approaches that can help us to appreciate how older PLWH see and treat age as relevant to disclosure of their HIV status. These approaches include an ethnomethodologically-informed social constructionism that explores how 'the' life course (a cultural framework depicting individuals' movement through predictable developmental stages from birth to death) is used as an interpretive resource for determining self and others' characteristics, capacities, and social circumstances: a process Rosenfeld and Gallagher (2002) termed 'lifecoursing'. Applying this approach to our analysis of 74 life-history interviews and three focus groups with older (aged 50+) people living with HIV in the United Kingdom, we uncover the central role that lifecoursing plays in participants' decision-making surrounding disclosure of their HIV to their children and/or older parents. Analysis of participants' accounts uncovered four criteria for disclosure: the relevance of their HIV to the other, the other's knowledge about HIV, the likelihood of the disclosure causing the other emotional distress, and the other's ability to keep the disclosed confidential. To determine if these criteria were met in relation to specific children and/or elders, participants engaged in lifecoursing, evaluating the other's knowledge of HIV, and capacity to appropriately manage the disclosure, by reference to their age. The use of assumptions about age and life-course location in decision-making regarding disclosure of HIV reflects a more nuanced engagement with age in the disclosure decision-making process than has been captured by previous research into HIV disclosure, including on the part of people aging with HIV.
authors.affiliation: Keele University School of Social Science and Public Policy, Keele, Stafford ST55BG, United Kingdom.
authors.forename: Dana
authors.initials: D
authors.lastname: Rosenfeld
authors.affiliation: University of Westminster Faculty of Science and Technology, 115 New Cavendish Street, London W1W 6UW, United Kingdom.
authors.forename: Damien
authors.initials: D
authors.lastname: Ridge
authors.affiliation: South Kensington and Chelsea Mental Health Centre, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NG, United Kingdom.
authors.forename: Jose
authors.initials: J
authors.lastname: Catalan
authors.affiliation: HIV/STI Department, Public Health England, 61 Colindale Ave, London NW9 5EQ, United Kingdom.
authors.forename: Valerie
authors.initials: V
authors.lastname: Delpech
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D003657:Decision Making; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D012650:Self Disclosure; D013240:Stereotyping
keywords: Disclosure; HIV; Life course; Stigma