182239 Understanding HIV disclosure among African-Americans and Latinos in the rural southeast to increase access to needed services and support

Tuesday, October 28, 2008: 8:48 AM

Bahby Banks, MPH , Cecil B. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, Chapel Hill, NC
Malika Roman Isler, MPH , Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC
Margaret Miles, RN, PhD, FAAN , School of Nursing, UNC Chapel Hill, Chapel Hill, NC
Giselle Corbie-Smith, MD, MSc , TraCS Community Engagement Core, University of North Carolina-Chapel Hill, Chapel Hill, NC
Minorities in southeast rural communities experience a significant burden of HIV/AIDS. Lack of disclosure by persons living with HIV/AIDS (PLWHA) may limit access to support and needed clinical services. As part of a larger study we sought to identify patterns of disclosure about HIV status among rural African-American and Latinos, as well as barriers and facilitators to disclosure.

We conducted 35 individual interviews (30 English, 5 Spanish) with PLWHA. The interviews were audio-taped, transcribed and entered into Altas.ti for thematic coding and analysis. Transcripts were independently analyzed by six research team members in a back/forth approach between discovery and verification of findings.

Participants identified key people with whom they shared their status and with whom they did not disclose their status. A majority reported very limited to only moderate disclosure. Many did not disclose their status to other PLWHAs in their communities. Barriers to disclosure included concerns related to confidentiality, negative responses of others, possible physical and social isolation, potential stigma from the community, loss of employment status, and denial of HIV status. Additional barriers for Latino participants included: fears related to loss of medical care due to deportation and loss of employment. Facilitators related to disclosure included access to social support and medical care.

Understanding patterns of disclosure, including key people with whom PLWHAs have shared their status, facilitators and barriers to disclosure and cultural differences among rural minorities can inform strategies to provide medical and social support services that are tailored to the needs of PLWHA.

Learning Objectives:
To identify facilitators and barriers to HIV disclosure among rural PLWHAs To discuss cultural differences related to HIV disclosure To discuss strategies to provide services to PLWHA living in the rural southeast

Keywords: HIV/AIDS, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the development of research tools, assisted with data collection, and conducted analyses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.