"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
"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
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DOI：
10.1080/13691058.2016.1267408
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发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Voisin, Dexter R.
中科院分区：
文献类型：
--
作者：
Bird, Jason D. P.;Eversman, Michael;Voisin, Dexter R.
在美国，艾滋病毒仍然是一个棘手的公共卫生问题，感染率主要集中在黑人同性恋和双性恋男性中。艾滋病毒抗体阳性者披露其状况可能是减少风险的一个重要方面，但这样做会带来隐私、耻辱和自我保护方面的困境，特别是在遭受多种类型耻辱的人群中。了解与披露过程有关的因素有助于为预防工作提供信息。使用探索性的深入访谈，本定性研究探讨了披露过程中的样本20个艾滋病毒阳性的黑人同性恋和双性恋男子（平均年龄=40），通过一个非营利性的健康中心在美国中西部城市招募。数据进行了分析，使用主题分析方法与艾滋病毒的披露作为一个先验的敏感概念。担心在社交网络内受到羞辱和二次披露是与性伙伴谈论艾滋病毒的关键障碍，而披露决定涉及一个复杂的过程，其核心是三个主要主题：性风险程度、伙伴类型和认为的伙伴可信度。这些背景因素的独特组合导致披露的可能性增加或减少。一个概念模型，阐明了一个潜在的过程，这些背景因素影响披露的决定。
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.