"You just can't trust everybody": the impact of sexual risk, partner type and perceived partner trustworthiness on HIV-status disclosure decisions among HIV-positive black gay and bisexual men

被引:19
作者
Bird, Jason D. P. [1 ]
Eversman, Michael [1 ]
Voisin, Dexter R. [2 ,3 ]
机构
[1] Rutgers Univ Newark, Coll Arts & Sci, Dept Social Work, Newark, NJ 07102 USA
[2] Univ Chicago, Sch Social Serv Adm, Chicago, IL 60637 USA
[3] STI HIV Intervent Network, Sch Social Serv Adm, Chicago, IL USA
关键词
HIV prevention; communication and disclosure; Black men; gay and bisexual men; HIV-related stigma; USA; SEROSTATUS DISCLOSURE; YOUNG MEN; STIGMA; INFECTION; HOMOPHOBIA; HEALTH; MSM;
D O I
10.1080/13691058.2016.1267408
中图分类号
D669 [社会生活与社会问题]; C913 [社会生活与社会问题];
学科分类号
1204 ;
摘要
HIV remains an intractable public health concern in the USA, with infection rates notably concentrated among Black gay and bisexual men. Status disclosure by HIV-positive individuals can be an important aspect of risk reduction but doing so poses dilemmas concerning privacy, stigma and self-protection, especially among populations subjected to multiple types of stigmatisation. Understanding the factors related to the disclosure process can help to inform prevention efforts. Using exploratory in-depth interviews, this qualitative study examines the disclosure process among a sample of twenty HIV-positive Black gay and bisexual men (mean age=40) recruited through a non-profit health centre in a mid-western city in the USA. Data were analysed using a thematic analysis approach with HIV-disclosure as an a priori sensitising concept. Fears of stigma and secondary disclosure within social networks were critical barriers to talking about HIV with sexual partners and disclosure decisions involved a complex process centred on three primary themes: degree of sexual risk, partner type and perceived partner trustworthiness. The unique combinations of these contextual factors resulted in increased or decreased likelihood of disclosure. A conceptual model explicating a potential process by which these contextual factors influence disclosure decisions is presented.
引用
收藏
页码:829 / 843
页数:15
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