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To Tell or Not To Tell: HIV Disclosure to Family, Friends and Sex Partners

To Tell or Not To Tell: HIV Disclosure to Family, Friends and Sex Partners. Julie Serovich , PhD Dean and Professor College of Behavioral and Community Sciences The University of South Florida. Disclosures of Financial Relationships.

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To Tell or Not To Tell: HIV Disclosure to Family, Friends and Sex Partners

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  1. To Tell or Not To Tell:HIV Disclosure to Family, Friends and Sex Partners Julie Serovich, PhD Dean and Professor College of Behavioral and Community Sciences The University of South Florida

  2. Disclosures of Financial Relationships This speaker has no significant financial relationships with commercial entities to disclose. This speaker will not discuss any off-label use or investigational product during the program. This slide set has been peer-reviewed to ensure that there are no conflicts of interest represented in the presentation.

  3. Learning Objectives • Identify how men and women are similar and different in their rates of disclosure to various targets (e.g., family, sex partners) and appropriately advise them. • List reasons for disclosure to sex partner and associated reactions. • Describe the magnitude of regret associated with disclosure by men and women.

  4. The Studies

  5. Kiss and Tell Projects • Five year longitudinal study of HIV+ person’s disclosure practices. The men’s study was conducted from 1997-2002 and the women’s from 2001-2006. • Variables of interest included disclosure, mental health, physical health, social support, disease progression, and sexual risk-taking behaviors . • Participants were recruited primarily from the AIDS Clinical Trials Unit and through Columbus AIDS Task Force, and were interviewed every 6 months for 3 years.

  6. Demographics

  7. Demographics for women(N = 125)

  8. Demographics for men (N = 139)

  9. Rates of Disclosure

  10. Who are women more like tell their diagnosis to first? • Mothers • Fathers • Sisters • Brothers

  11. Women’s Disclosure to Family • 60% of all mothers (n = 94) disclosed to within the first month, 74% within 12 months • 60-70% of brothers (n = 117) and sisters (n = 148) disclosed to in 12 months • 47% of fathers (n = 74) disclosed to in the first 12 months Serovich, J. M., Craft, S. M., & Yoon, H. (2007).Women’s HIV disclosure to immediate family. AIDS Patient Care and STD’s, 21(12), 970-980.

  12. Who are women more like tell their diagnosis to first? • Family of origin • Children • Extended family • Partners

  13. Women’s Disclosure to Partners , Children , FOO, Extended Family and Friends • Partners (n = 173) • Children (n = 169) • Family of Origin (n=369) • Extended Family (n=126) • Friends(n=389) Serovich, J. M., Craft, S. M., & Reed, S. (2012). Women’s HIV disclosure to immediate family and friends. AIDS Patient Care and STDs, 26(4), 241-249.

  14. Women’s Rate of Disclosure to Family • Women tell more family members and partners in the first month after diagnosis • Rate of increase in disclosure during the first year is highest among friends Serovich, J. M., Craft, S. M., & Reed, S. (2012). Women’s HIV disclosure to immediate family and friends. AIDS Patient Care and STDs, 26(4), 241-249.

  15. Who are men more like tell their diagnosis to first? • Mothers • Fathers • Sisters • Brothers

  16. Men’s Disclosure to Family of Origin • Only 42% of mothers (n = 116)disclosed to within one month, 52% within 12 months • Only 40-44% of brothers (n = 188) and sisters (n = 193) disclosed to within 12 months • Only 40% of fathers (n = 100) disclosed to within 12 months Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). HIV disclosure to immediate family over time. AIDS Patient Care & STD’s, 19, 506-517.

  17. Who are men more like tell their diagnosis to first? • Family • Long-term friends • Random friends

  18. Men’s Disclosure to Family and Friends • Rate of disclosure to random friends was 20% higher than to family • Difference in the rates was not significant • Shape of disclosure to long term friends was significantly different Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). HIV disclosure to immediate family over time. AIDS Patient Care & STD’s, 19, 506-517.

  19. Men’s Rate of Disclosure • Men disclosed to more friends than family in the first month • Rate of increase in disclosure to family and friends were similar Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). Disclosure of positive HIV serostatus by men who have sex with men to family and friends over time. AIDS Patient Care & STD’s, 21 (7), 492-500.

  20. Are women or men more likely to tell sex partners? • Women • Men

  21. Rates of Disclosure to Sexual Partners

  22. Reasons and Reactions

  23. What is the top reason men and women disclose to current sex partner? • Afraid they will find out on their own • Obligation • To just get it over with

  24. Women: Obligation Sense of duty to tell Wanted this person to know what they were getting into Men: Obligation Sense of duty to tell He had a right to know Top 3 reasons to tell Current Partners

  25. Women: Offered his/her assistance. Perhaps said, “what can I do to help?” Reassured or comforted me Was optimistic-hoped for a cure Men: Hugged me Confirmed our relationship Reassured or comforted me Top 3 Reactions from Current Partners

  26. Women: Didn’t think they would be supportive Concerned how he would feel about me Worried they would no longer like me Men: My diagnosis is private information I have a right to privacy I don’t have to tell if I don’t want to Top 3 reasons to NOT tell Current Partners

  27. Women: Sense of duty to tell Obligation Wanted the person to know the seriousness of the disease Men: I trusted him Obligation We have a close relationship Top 3 reasons to tell Ex-Partners

  28. Women: Offered his/her assistance. Perhaps said, “what can I do to help?” Confirmed our relationship saying, “This won’t change the way I feel about you.” Reassured or comforted me Men: - Data not available Top 3 reactions from Ex-Partners

  29. Women: Relationship wasn’t serious I felt ashamed about being HIV-positive We weren’t very close to each other Men: My diagnosis is private information I have a right to privacy I don’t have to tell if I don’t want to Top 3 reasons to NOT tell Ex-Partners

  30. Women: Wanted to educate I trusted him Wanted others to know the seriousness of the disease Men: Obligation I have a duty to tell Don’t want to risk more health problems for either of us Top 3 reasons to tell Casual Partners

  31. Women: Reassured or comforted me Felt sorry for me Was worried for me or my family Men: - Data not available Top 3 reactions from Casual Partners

  32. Women: All women disclosed Men: We didn’t know each other well Our relationship wasn’t serious I have a right to privacy Top 3 reasons NOT to tell Casual Partners

  33. Regret

  34. Who experiences more regret for disclosing to family? • Men • Women

  35. Does disclosure result in regret?

  36. Overall, do men experience more regret for disclosing their HIV status or their sexual orientation to family? • HIV status • Sexual orientation

  37. Regret of HIV disclosure compared to coming out (for men)

  38. Predictors of Disclosure Regret • More likely to regret disclosing sexual orientation (SO) to males • More likely to regret second-hand disclosure of serostatus (HIV) • More likely to regret both in relationships where satisfaction is low

  39. Questions?

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