Maybe, maybe not: Deciding to disclose HIV to family

也许，也许不是：决定向家人透露艾滋病毒

• 批准号: 8841411
• 负责人: JULIANNE M SEROVICH
• 金额: $ 64.31万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-16 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8841411
• 关键词: Age; Anxiety; Attention; Characteristics; Communication; Conflict (Psychology); Control Groups; Decision Making; Development; Disclosure; Disease Management; Effectiveness; Effectiveness of Interventions; Emotional; Ensure; Evaluation; Evidence based intervention; Family; Family member; Feeling; Gender; Goals; HIV; HIV Seropositivity; Health; Health Services Accessibility; Intervention; Lead; Learning; Life; Link; Loneliness; Mediating; Mental Depression; Mental Health; Nuclear Family; Outcome; Outcome Measure; Participant; Persons; Physical Function; Pilot Projects; Positioning Attribute; Preparation; Problem Solving; Process; Randomized Controlled Trials; Regrets; Relative (related person); Reporting; Research; Rewards; Risk; Self Efficacy; Sex Orientation; Social support; Staging; Stress; Testing; Time; Work; base; cost; demographics; evidence base; expectation; experience; follow-up; group intervention; high risk sexual behavior; improved; innovation; intervention effect; medication compliance; physical conditioning; post intervention; primary outcome; satisfaction; secondary outcome; self esteem; skills; theories; therapy design; tool; transmission process; treatment effect

DESCRIPTION (provided by applicant): The decision to disclose one's serostatus to family members creates considerable emotional strain for people living with HIV (PLWH), regardless of gender and sexual orientation. While disclosure to family members has been linked to positive outcomes including increased social support, improved physical and mental health outcomes, reduced loneliness and stress, and improved HIV disease management, the decision not to disclose can also lead to positive outcomes. To date, most research about serostatus disclosure has focused on the act of disclosing - the who, what, where, and when of disclosing - rather than the decision process involved. Based on lessons learned during the pilot study of this intervention, disclosure decision-making is a lifelong process and PLWH can benefit from an intervention which helps them clarify their disclosure-related goals, weigh the costs and rewards of disclosure and non-disclosure, identify strategies that will minimize potential costs - and even helps them come to terms with the decision not to disclose. Our long-range goal is to further refine and evaluate an intervention designed to enhance HIV disclosure decision-making among PLWH. To reach this goal, we are proposing a course of study with the following specific aims: Specific Aim 1: Conduct a randomized, controlled trial (n=450) of the piloted intervention, and assess the effectiveness of the intervention relative to an attention- control condition on a variety of primary outcomes related to disclosure and health. Specific Aim 2: Examine the effects of the intervention over time. Specific Aim 3: Explore potential moderating effects of participant demographics, relationship characteristics, and contextual variables related to family on intervention effectiveness. Specific Aim 4: Evaluate the effects of treatment engagement, retention, and expectations on outcomes. The central hypothesis of this proposal is based on the Consequences Theory of Disclosure. According to the theory, positive persons weigh the rewards and costs of disclosing their status to family. Whenever the rewards outweigh the costs, disclosure occurs. We have adapted our theory and intervention to incorporate fundamental processes of decision making such as clarifying antecedent goals, decision making, and decision evaluation. This proposal is highly innovative in two very important ways. First, to date, no evidence-based intervention has been developed to assist PLWH in making decisions about disclosure to family. Second, the focus of this intervention is on the disclosure decision-making process and comfort/acceptance with the disclosure decision. As such, skills learned through the intervention can be applied to the lifelong process of serostatus disclosure.

描述（由申请人提供）：决定向家庭成员透露自己的血清状况会给艾滋病毒感染者（PLWH）带来相当大的情绪压力，无论性别和性取向如何。虽然向家庭成员披露与积极的结果有关，包括增加社会支持，改善身心健康结果，减少孤独和压力，改善艾滋病毒疾病管理，但不披露的决定也可能导致积极的结果。迄今为止，大多数关于血清状态披露的研究都集中在披露行为上-披露的人、内容、地点和时间-而不是所涉及的决策过程。根据对这种干预措施的试点研究中所吸取的教训，披露决策是一个终身过程，艾滋病毒/艾滋病感染者可以从干预措施中受益，这些干预措施可以帮助他们澄清与披露有关的目标，权衡披露和不披露的成本和回报，确定将潜在成本最小化的战略，甚至 帮助他们接受不公开的决定我们的长期目标是进一步完善和评估旨在加强艾滋病毒感染者艾滋病毒披露决策的干预措施。为了达到这一目标，我们提出了一个研究过程，具有以下具体目标：具体目标1：进行一项随机对照试验（n=450）的试点干预，并评估干预的有效性相对于注意力控制条件的各种主要成果有关的披露和健康。具体目标2：检查干预措施在一段时间内的效果。具体目标3：探讨参与者的人口统计学，关系特征和背景变量相关的家庭干预效果的潜在调节作用。具体目标4：评价治疗参与、保留和预期对结局的影响。这一建议的核心假设是基于披露的后果理论。根据这一理论，积极的人会权衡向家人透露自己状况的回报和成本。只要回报超过成本，就会进行披露。我们已经调整了我们的理论和干预措施，以纳入决策的基本过程，如澄清先前的目标，决策和决策评估。这项建议在两个非常重要的方面具有高度的创新性。首先，迄今为止， 没有制定基于证据的干预措施来协助艾滋病毒/艾滋病感染者决定是否向家人披露。第二，这种干预的重点是披露决策过程和舒适/接受披露决定。因此，通过干预学到的技能可以应用于血清状况披露的终身过程。