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Published in: AIDS and Behavior 1/2016

01-01-2016 | Original Paper

Predictors of HIV Disclosure in Infected Persons Presenting to Establish Care

Authors: Latesha Elopre, Andrew O. Westfall, Michael J. Mugavero, Anne Zinski, Greer Burkholder, Edward W. Hook, Nicholas Van Wagoner

Published in: AIDS and Behavior | Issue 1/2016

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Abstract

Persons receiving effective HIV treatment experience longevity and improvement in quality of life. For those infected, social support is associated with improved medication adherence. Disclosure of infection status is likely a prerequisite for social support. However, little research describes patterns of HIV disclosure by infected persons. We retrospectively evaluated factors associated with disclosure among patients initiating HIV care at a university-based clinic from 2007 to 2012. Of 490 persons initiating care, 13 % had not disclosed their HIV infection to anyone. Black race significantly predicted non-disclosure and persons living with a significant other or friends were more likely to have disclosed their HIV infection versus those living alone. CD4 + T lymphocyte count <200 was associated with nondisclosure and disclosure only to family members. Future research is needed to better understand factors associated with disclosure of HIV infection status, because this could enhance receipt of social support and contribute to improved HIV health outcomes.
Literature
1.
go back to reference Centers for Diease Control and Prevention. HIV/AIDS surveillance report, 2008. vol 20. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2009. Centers for Diease Control and Prevention. HIV/AIDS surveillance report, 2008. vol 20. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.
2.
go back to reference Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, et al. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S123–7.PubMedCrossRef Ammassari A, Trotta MP, Murri R, Castelli F, Narciso P, Noto P, et al. Correlates and predictors of adherence to highly active antiretroviral therapy: overview of published literature. J Acquir Immune Defic Syndr. 2002;31(Suppl 3):S123–7.PubMedCrossRef
3.
go back to reference Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One. 2013;8(12):e81355.PubMedPubMedCentralCrossRef Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One. 2013;8(12):e81355.PubMedPubMedCentralCrossRef
4.
go back to reference DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207–18.PubMedCrossRef DiMatteo MR. Social support and patient adherence to medical treatment: a meta-analysis. Health Psychol. 2004;23(2):207–18.PubMedCrossRef
5.
go back to reference Kalichman SC, DiMarco M, Austin J, Luke W, DiFonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32.PubMedCrossRef Kalichman SC, DiMarco M, Austin J, Luke W, DiFonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32.PubMedCrossRef
6.
go back to reference Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS care. 2008;20(10):1266–75.PubMedCrossRef Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS care. 2008;20(10):1266–75.PubMedCrossRef
8.
go back to reference Siegel K, Lune H, Meyer I. Stigma management among gay/bisexual men with HIV/AIDS. Qual Sociol. 1998;21:3–24.CrossRef Siegel K, Lune H, Meyer I. Stigma management among gay/bisexual men with HIV/AIDS. Qual Sociol. 1998;21:3–24.CrossRef
9.
go back to reference Derlega VJ, Winstead BA, Greene K, Serovich J, Elwood WN. Perceived HIV-related Stigma and HIV disclosure to relationship partners after finding out about the seropositive diagnosis. J Health Psychol. 2002;7(4):415–32.PubMedCrossRef Derlega VJ, Winstead BA, Greene K, Serovich J, Elwood WN. Perceived HIV-related Stigma and HIV disclosure to relationship partners after finding out about the seropositive diagnosis. J Health Psychol. 2002;7(4):415–32.PubMedCrossRef
10.
go back to reference Mugavero MJ, Norton WE, Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system. Clin Infect Dis. 2011;52(Suppl 2):S238–46.PubMedPubMedCentralCrossRef Mugavero MJ, Norton WE, Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system. Clin Infect Dis. 2011;52(Suppl 2):S238–46.PubMedPubMedCentralCrossRef
11.
go back to reference Chen RY, Accortt NA, Westfall AO, Mugavero MJ, Raper JL, Cloud GA, et al. Distribution of health care expenditures for HIV-infected patients. Clin Infect Dis. 2006;42(7):1003–10.PubMedCrossRef Chen RY, Accortt NA, Westfall AO, Mugavero MJ, Raper JL, Cloud GA, et al. Distribution of health care expenditures for HIV-infected patients. Clin Infect Dis. 2006;42(7):1003–10.PubMedCrossRef
12.
go back to reference Hart TA, Wolitski RJ, Purcell DW, Parsons JT, Gomez CA, Seropositive Urban Men’s Study Team. Partner awareness of the serostatus of HIV-seropositive men who have sex with men: impact on unprotected sexual behavior. AIDS Behav. 2005;9(2):155–66.PubMedCrossRef Hart TA, Wolitski RJ, Purcell DW, Parsons JT, Gomez CA, Seropositive Urban Men’s Study Team. Partner awareness of the serostatus of HIV-seropositive men who have sex with men: impact on unprotected sexual behavior. AIDS Behav. 2005;9(2):155–66.PubMedCrossRef
13.
go back to reference Parsons JT, Schrimshaw EW, Bimbi DS, Wolitski RJ, Gomez CA, Halkitis PN. Consistent, inconsistent, and non-disclosure to casual sexual partners among HIV-seropositive gay and bisexual men. Aids. 2005;19(Suppl 1):S87–97.PubMedCrossRef Parsons JT, Schrimshaw EW, Bimbi DS, Wolitski RJ, Gomez CA, Halkitis PN. Consistent, inconsistent, and non-disclosure to casual sexual partners among HIV-seropositive gay and bisexual men. Aids. 2005;19(Suppl 1):S87–97.PubMedCrossRef
14.
go back to reference Rosser BR, Horvath KJ. Predictors of success in implementing HIV prevention in rural America: a state-level structural factor analysis of HIV prevention targeting men who have sex with men. AIDS Behav. 2008;12(2):159–68.PubMedPubMedCentralCrossRef Rosser BR, Horvath KJ. Predictors of success in implementing HIV prevention in rural America: a state-level structural factor analysis of HIV prevention targeting men who have sex with men. AIDS Behav. 2008;12(2):159–68.PubMedPubMedCentralCrossRef
15.
go back to reference Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005;16(6):33–47.PubMedCrossRef Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005;16(6):33–47.PubMedCrossRef
16.
go back to reference Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: National Academies Press, US: 2011. http://www.ncbi.nlm.nih.gov/books/NBK64806/. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: National Academies Press, US: 2011. http://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK64806/​.
17.
go back to reference Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013;13:482.PubMedPubMedCentralCrossRef Baral S, Logie CH, Grosso A, Wirtz AL, Beyrer C. Modified social ecological model: a tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health. 2013;13:482.PubMedPubMedCentralCrossRef
18.
go back to reference Van Wagoner N, Mugavero M, Westfall A, Hollimon J, Slater LZ, Burkholder G, et al. Church attendance in men who have sex with men diagnosed with HIV is associated with later presentation for HIV care. Clin Infect Dis. 2014;58(2):295–9.PubMedPubMedCentralCrossRef Van Wagoner N, Mugavero M, Westfall A, Hollimon J, Slater LZ, Burkholder G, et al. Church attendance in men who have sex with men diagnosed with HIV is associated with later presentation for HIV care. Clin Infect Dis. 2014;58(2):295–9.PubMedPubMedCentralCrossRef
19.
go back to reference Organization WH. Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. 2013. Organization WH. Consolidated Guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. 2013.
20.
go back to reference Catz SL, Kelly JA, Bogart LM, Benotsch EG, McAuliffe TL. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000;19(2):124–33.PubMedCrossRef Catz SL, Kelly JA, Bogart LM, Benotsch EG, McAuliffe TL. Patterns, correlates, and barriers to medication adherence among persons prescribed new treatments for HIV disease. Health Psychol. 2000;19(2):124–33.PubMedCrossRef
21.
go back to reference Gonzalez JS, Penedo FJ, Antoni MH, Duran RE, McPherson-Baker S, Ironson G, et al. Social support, positive states of mind, and HIV treatment adherence in men and women living with HIV/AIDS. Health Psychol. 2004;23(4):413–8.PubMedCrossRef Gonzalez JS, Penedo FJ, Antoni MH, Duran RE, McPherson-Baker S, Ironson G, et al. Social support, positive states of mind, and HIV treatment adherence in men and women living with HIV/AIDS. Health Psychol. 2004;23(4):413–8.PubMedCrossRef
22.
go back to reference Stirratt MJ, Remien RH, Smith A, Copeland OQ, Dolezal C, Krieger D, et al. The role of HIV serostatus disclosure in antiretroviral medication adherence. AIDS Behav. 2006;10(5):483–93.PubMedCrossRef Stirratt MJ, Remien RH, Smith A, Copeland OQ, Dolezal C, Krieger D, et al. The role of HIV serostatus disclosure in antiretroviral medication adherence. AIDS Behav. 2006;10(5):483–93.PubMedCrossRef
23.
go back to reference Centers for Disease Control and Prevention. Disparities in diagnoses of HIV infection between blacks/African Americans and other racial/ethnic populations–37 states, 2005-2008. MMWR Morb Mortal Wkly Rep. 2011;60(4):93–8. Centers for Disease Control and Prevention. Disparities in diagnoses of HIV infection between blacks/African Americans and other racial/ethnic populations–37 states, 2005-2008. MMWR Morb Mortal Wkly Rep. 2011;60(4):93–8.
24.
go back to reference Dennis AM, Napravnik S, Sena AC, Eron JJ. Late entry to HIV care among Latinos compared with non-Latinos in a southeastern US cohort. Clin Infect Dis. 2011;53(5):480–7.PubMedPubMedCentralCrossRef Dennis AM, Napravnik S, Sena AC, Eron JJ. Late entry to HIV care among Latinos compared with non-Latinos in a southeastern US cohort. Clin Infect Dis. 2011;53(5):480–7.PubMedPubMedCentralCrossRef
25.
go back to reference Mugavero MJ, Lin HY, Allison JJ, Giordano TP, Willig JH, Raper JL, et al. Racial disparities in HIV virologic failure: do missed visits matter? J Acquir Immune Defic Syndr. 2009;50(1):100–8.PubMedPubMedCentralCrossRef Mugavero MJ, Lin HY, Allison JJ, Giordano TP, Willig JH, Raper JL, et al. Racial disparities in HIV virologic failure: do missed visits matter? J Acquir Immune Defic Syndr. 2009;50(1):100–8.PubMedPubMedCentralCrossRef
26.
go back to reference Howe CJ, Napravnik S, Cole SR, Kaufman JS, Adimora AA, Elston B, et al. African American race and HIV virological suppression: beyond disparities in clinic attendance. Am J Epidemiol. 2014;179(12):1484–92.PubMedPubMedCentralCrossRef Howe CJ, Napravnik S, Cole SR, Kaufman JS, Adimora AA, Elston B, et al. African American race and HIV virological suppression: beyond disparities in clinic attendance. Am J Epidemiol. 2014;179(12):1484–92.PubMedPubMedCentralCrossRef
28.
go back to reference Clark H, Lindner G, Armistead L, Austin B. Stigma, disclosure, and psychological functioning among HIV-infeced and non-infected African American women. Women Health. 2008;38(4):57–71.CrossRef Clark H, Lindner G, Armistead L, Austin B. Stigma, disclosure, and psychological functioning among HIV-infeced and non-infected African American women. Women Health. 2008;38(4):57–71.CrossRef
29.
go back to reference Smth R, Rossetto K, Peterson B. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75.CrossRef Smth R, Rossetto K, Peterson B. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75.CrossRef
30.
go back to reference Greysen SR, Horwitz LI, Covinsky KE, Gordon K, Ohl ME, Justice AC. Does social isolation predict hospitalization and mortality among HIV+ and uninfected older veterans? J Am Geriatr Soc. 2013;61(9):1456–63.PubMedPubMedCentralCrossRef Greysen SR, Horwitz LI, Covinsky KE, Gordon K, Ohl ME, Justice AC. Does social isolation predict hospitalization and mortality among HIV+ and uninfected older veterans? J Am Geriatr Soc. 2013;61(9):1456–63.PubMedPubMedCentralCrossRef
31.
go back to reference Chadborn TR, Delpech VC, Sabin CA, Sinka K, Evans BG. The late diagnosis and consequent short-term mortality of HIV-infected heterosexuals (England and Wales, 2000-2004). AIDS. 2006;20:237–2379.CrossRef Chadborn TR, Delpech VC, Sabin CA, Sinka K, Evans BG. The late diagnosis and consequent short-term mortality of HIV-infected heterosexuals (England and Wales, 2000-2004). AIDS. 2006;20:237–2379.CrossRef
32.
go back to reference Lanoy D, May-Krause M, Tattevin P, et al. Frequency, determinant and consequences of delayed access to care for HIV infection in France. Antivir Ther. 2007;12:89–96.PubMed Lanoy D, May-Krause M, Tattevin P, et al. Frequency, determinant and consequences of delayed access to care for HIV infection in France. Antivir Ther. 2007;12:89–96.PubMed
33.
go back to reference Kelly CF, Kitchen CM, Hunt PW, et al. Incomplete peripheral CD4+T-cell count restoration in HIV-infecred patients receiving long-term antiretroviral treatment. Clin Infect Dis. 2009;48:787–94.CrossRef Kelly CF, Kitchen CM, Hunt PW, et al. Incomplete peripheral CD4+T-cell count restoration in HIV-infecred patients receiving long-term antiretroviral treatment. Clin Infect Dis. 2009;48:787–94.CrossRef
34.
go back to reference Egger M, May M, Chene G, et al. Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy in high-income countries: a collaborative analysis of prospective studies. Lancet. 2002;360:119–29.PubMedCrossRef Egger M, May M, Chene G, et al. Prognosis of HIV-1-infected patients starting highly active antiretroviral therapy in high-income countries: a collaborative analysis of prospective studies. Lancet. 2002;360:119–29.PubMedCrossRef
Metadata
Title
Predictors of HIV Disclosure in Infected Persons Presenting to Establish Care
Authors
Latesha Elopre
Andrew O. Westfall
Michael J. Mugavero
Anne Zinski
Greer Burkholder
Edward W. Hook
Nicholas Van Wagoner
Publication date
01-01-2016
Publisher
Springer US
Published in
AIDS and Behavior / Issue 1/2016
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-015-1060-8

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