266168 How do coping strategies affect HIV disclosure?

Monday, October 29, 2012

Parissa Salimian, BA , Department of Psychology, Boston University, Boston, MA
John Bark, BA , Department of Psychology, Boston University, Boston, MA
Jennie David, BA , Department of Psychology, Boston University, Boston, MA
Ruth C. Cruise, MA , Department of Psychology, Boston University, Boston, MA
Sannisha Dale, MA, EdM , Department of Psychology, Boston University, Boston, MA
Gwendolyn Kelso, MA , Department of Psychology, Boston University, Boston, MA
Mardge H. Cohen, MD , Department of Medicine, Rush and Cook County Health and Hospital Systems, Chicago, IL
Leslie Brody, PhD , Department of Psychology, Boston University, Boston, MA
Background: For people living with HIV, the decision to share their status is a perennial stressor. Greater understanding of contributors to this decision among women is needed.

Methods: Participants were women (N=32; ages 25-61; 94% African American) at the Women's Interagency HIV Study Chicago site. Women's qualitative responses to a projective task and autobiographical narratives were reliably coded for coping strategies (4 point scale). Qualitative analyses of instances of HIV disclosure or nondisclosure were guided by principles of grounded theory.

Results: Partial correlations tested relationships between disclosure and coping strategies, controlling for age. Age tended to positively relate to disclosure (p<.08). Significant positive relationships existed between spiritual soothing and disclosure to partners (p<.05) and overall disclosure (p<.05). Inverse relationships existed between altruism and nondisclosure to partners (p<.05) and insight and overall nondisclosure (p<.05). T-tests compared nondisclosure (yes/no) on types of coping strategies. Women who referenced nondisclosure to partners had lower levels of spiritual soothing (p<.01), perspective-taking (p<.01), and altruism (p<.05). Qualitative results revealed that disclosure was driven by moral rightness and prosocial concern, as well as self-interest. Themes co-occurring with disclosure included expressed gratitude to God, increased personal ownership of life, and insight about life's fragility. Motives for nondisclosure and delayed disclosure included self and other-protection and vengefulness, often occurring in the context of not accepting HIV seropositivity.

Conclusions: Programmatic efforts to increase disclosure may be improved by the inclusion of spirituality, the promotion of the idea that life is precious, and the framing of disclosure as prosocial conduct.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Protection of the public in relation to communicable diseases including prevention or control
Public health or related organizational policy, standards, or other guidelines
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the role of coping and contextual variables in facilitating or hindering HIV disclosure.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived the idea for the presentation and conducted quantitative and qualitative data 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.