Impact of AIDS Disclosure on Rural African American Men.

描述(由申请人提供)：艾滋病病毒感染对农村非裔美国男性的影响。非裔美国人，特别是男性，在艾滋病毒/艾滋病患者中所占比例不成比例，占疾病患者的49%，但只占人口的13%。在南部农村，AAS占所有艾滋病病例的56%。再生障碍性贫血男性的艾滋病毒感染率是全国最高的。生活在农村地区加剧了与艾滋病毒/艾滋病有关的问题，因为服务和资源的减少或缺乏、交通的缺乏以及导致回避和污名化的保守文化规范。这些因素创造了一种环境，使艾滋病毒携带者不愿向他人透露自己的疾病。没有披露艾滋病毒/艾滋病的人被报告为：1)缺乏管理疾病的知识和技能，2)较少使用卫生保健服务，3)可能感染他人，4)缺乏社会支持。披露有潜在的负面后果，如拒绝和羞耻，但披露对于获得积极健康结果所需的支持性资源和服务至关重要。披露被认为是一个复杂的过程，会随着时间的推移而变化。这项定性研究的目的是探索再生障碍性贫血男子向伴侣和家人披露艾滋病毒的过程和背景，以及披露的预期健康结果、好处和后果。这项拟议的研究将解决以下研究问题：1)艾滋病病毒携带者和再生障碍性贫血患者如何向他们的性伴侣和家人描述他们的披露经历？2)哪些因素促进或阻碍了对他人的披露？3)艾滋病毒携带者再生障碍性贫血患者描述了他们自己、他们的伴侣和他们的家人披露的后果？以及，4)什么将有助于帮助农村艾滋病毒+再生障碍性贫血男性做出披露决定？将使用扎根的理论方法来审查披露过程，通信隐私管理理论(一种共享私人信息的决策理论)将为数据收集提供信息。样本将包括从农村艾滋病服务组织和诊所招募的40名HIV+AA男性。被诊断至少六个月的参与者将就他们的披露决定和披露他们的艾滋病毒状况的过程接受采访。他们将被问及他们的披露决定，关于他们向谁披露了他们的艾滋病毒诊断，他们披露的动机，披露信息的内容，以及披露的后果和好处。采访将被录音和转录，以供分析。本文将采用常量比较法进行分析。这项研究的结果将为制定与文化相关的干预措施提供必要的信息，以指导有助于农村艾滋病毒+免疫缺陷病毒携带者健康和生活质量的披露决定。公共卫生相关性：该项目的调查结果将阐明农村非裔美国人男子感染艾滋病毒的披露决定和经验的关键方面。这些数据对于制定与文化相关的干预措施至关重要，以增加艾滋病毒+非裔美国人男子做出披露决定的可能性，从而加强他们的疾病管理和生活质量，并减少向其他人的传播。

DESCRIPTION (provided by applicant): Impact of AIDS Disclosure on Rural African American Men. African Americans (AAs), especially men, are disproportionately represented among people with HIV/AIDS, accounting for 49% of the people with the disease, but only 13% of the population. In the rural south AAs account for 56% of all AIDS cases. AA men have the highest rate of HIV infection in the country. Living in rural areas compounds the problems associated with living with HIV/AIDS because of decreased or lack of services and resources, lack of transportation, and conservative cultural norms which result in shunning and stigmatization. These factors create an environment that makes HIV+ men reluctant to disclose their disease to others. People who do not disclose their HIV/AIDS have been reported to: 1) lack the knowledge and skills to manage their disease, 2) use health care services less, 3) potentially infect others, and 4) lack social support. There are potential negative consequences to disclosure, such as rejection and shame, but disclosure is critical to accessing supportive resources and services necessary for positive health outcomes. Disclosure is recognized as a complex process that changes over time. The purpose of this qualitative study is to explore the process and context of HIV disclosure by AA men to partners and family, and the perceived health outcomes, benefits and consequences of the disclosures. The proposed study will address the following research questions: 1) How do HIV+ AA men describe their disclosure experiences to their sexual partners and family members? 2) What factors facilitate or inhibit disclosure to others? 3) What consequences of disclosure do HIV+ AA men describe for themselves, their partners, and their families? And, 4) What would be helpful to assist rural HIV+ AA men in making disclosure decisions? Grounded theory methodology will be used to examine the disclosure process, with Communication Privacy Management Theory (a decision making theory for sharing private information) informing data collection. The sample will consist of 40 HIV+ AA men recruited from rural AIDS Service Organizations and clinics. Participants who have been diagnosed for at least six months will be interviewed about their disclosure decisions and the process of disclosing their HIV status. They will be questioned about their disclosure decisions about to whom they have disclosed their HIV diagnosis, what motivated them to disclose, the content of the disclosure message, and consequences and benefits of disclosure. The interviews will be audio taped and transcribed for analysis. The constant comparative method will be used for analysis. The findings of this study will provide essential information for developing culturally relevant interventions to guide disclosure decisions which will be supportive of the health and quality of life of rural HIV+ AAs. PUBLIC HEALTH RELEVANCE: Findings from this project will elucidate key aspects of disclosure decisions and experiences for rural African Americans men with HIV Disease. These data are critical in developing culturally relevant interventions to increase the likelihood of HIV+ African American men making disclosure decisions that enhance their disease management and quality of life and decrease transmission to others.