This flies in the face of the theory that disease progression - how quickly serious symptoms appear - determines when a person discloses his or her disease, said Julie Serovich, an associate professor of human development and family science and director of the Marriage and Family Clinic at Ohio State University. HIV is the virus that causes AIDS.
A report on her research appears in a recent issue of the journal AIDS Education and Prevention.
"Men tend to weigh the benefits and drawbacks of revealing that they have HIV," she said. "Although we only looked at men in this study, we found in a related study that women have a tendency to base their decision to disclose more on their need for social support. This suggests that women may consider different consequences than do men."
Of the 138 HIV-positive gay men in the study, just over half (55 percent) disclosed their disease status to family, while 63 percent told friends. Serovich also found that three out of four men had told their partners.
Disclosure is pivotal in reducing the behaviors that continue the spread of the disease, she said. Most of the men in the study said they had contracted HIV via unsafe sexual practices.
For the men in this study, the top three reasons for disclosing included wanting to keep friends and family safe from HIV; seeking understanding; and feeling that others have a right to know. The top three reasons for keeping HIV status under wraps were avoiding fights, being lectured and being blamed.
The men in the study were interviewed and asked to fill out surveys about their decision to disclose or not to disclose, and to whom.
"If the positive consequences outweighed the negative repercussions, chances were good that a man told friends and family," Serovich said. "But the same doesn't seem to hold true for sexual partners, and we're not sure why.
"The consequences with sexual partners are very different than the consequences with family and friends, so we may not have tapped them in this study," she said. "Individuals with a sexual partner may worry more about whether or not they'll still have a relationship or if they'll be abandoned if they do disclose."
Serovich dispelled the theory that the progression of serious symptoms common to HIV convinces an infected man to disclose.
"When the HIV/AIDS epidemic was in its infancy, the progression of the disease was certain," she said. "A person contracted HIV, which quickly developed into AIDS, and the person usually died. The disease had obvious physical manifestations, such as lesions and extreme weight loss. Hiding the disease was difficult. But advancements in HIV therapies now keep the virus under control in many cases."
Disclosure often has substantial consequences - the infected person may feel threatened when people know. On the other hand, disclosure might mean he would get needed emotional, physical and social support.
"In this study, we were looking to identify the 'right' people to tell," Serovich said. "No one should walk around with a billboard on their back saying 'I'm HIV-positive' unless there's something to be gained."
The research was supported by grants from the National Institutes of Mental Health and the National Institute of Allergy and Infectious Diseases.
Contact: Julie Serovich, 614-292-5685; Serovich.1@osu.edu
Written by Holly Wagner, 614-292-8310;
Wagner.235@osu.edu
Journal
AIDS Education and Prevention