Impact of AIDS Disclosure on Rural African American Men.

描述（由申请人提供）：艾滋病信息披露对非洲裔美国农村男性的影响。非裔美国人，尤其是男性，在艾滋病毒/艾滋病患者中所占比例不成比例，占该疾病患者的49%，但仅占人口的13%。在南部农村，艾滋病患者占所有艾滋病病例的56%。AA男性的HIV感染率是全国最高的。由于服务和资源减少或缺乏、交通工具缺乏以及保守的文化规范导致回避和污名化，生活在农村地区使与艾滋病毒/艾滋病患者有关的问题复杂化。这些因素创造了一种环境，使艾滋病毒阳性男子不愿向他人透露自己的疾病。据报告，不披露其艾滋病毒/艾滋病情况的人：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，例如拒绝和羞耻，但披露对于获得获得积极健康结果所必需的支持性资源和服务至关重要。披露被认为是一个随时间变化的复杂过程。本质性研究的目的是探讨嗜酒者男性向伴侣和家人披露HIV的过程和背景，以及披露的感知健康结果、益处和后果。拟进行的研究将解决以下研究问题：1)HIV+ AA男性如何描述他们向性伴侣和家庭成员披露的经历？2)哪些因素有利于或抑制向他人披露信息？3) HIV+ AA男性描述了自己、伴侣和家人的后果是什么？4)如何帮助农村HIV+ AA男性做出信息披露的决定？将使用扎根理论方法来检查披露过程，并使用通信隐私管理理论（一种共享私人信息的决策理论）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。已确诊至少6个月的参与者将接受采访，了解他们的披露决定和披露其艾滋病毒状况的过程。他们将被问及是否决定向谁披露他们的艾滋病毒诊断，是什么促使他们披露，披露信息的内容，以及披露的后果和好处。访谈将被录音并记录下来以供分析。我们将采用常数比较法进行分析。这项研究的结果将为制定与文化相关的干预措施提供重要信息，以指导披露决策，这将有助于农村艾滋病毒阳性艾滋病患者的健康和生活质量。公共卫生相关性：该项目的研究结果将阐明非洲裔美国农村男性艾滋病毒感染者披露决定和经历的关键方面。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+非洲裔美国男性做出披露决定的可能性，从而提高他们的疾病管理和生活质量，并减少向他人传播。

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.