Overcoming barriers to disclosure: Using newly diagnosed, HIV-positive support groups to facilitate serostatus dialogue among MSM

The psychosocial support needs of gay and bisexual men recently diagnosed with HIV appears to be shifting over time. A recent analysis of presenting issues revealed that disclosure of HIV status ranked as the most frequently discussed concern among participants in HIV newly-diagnosed groups at Callen-Lorde Community Health Center, an agency in New York City servicing the LGBT and HIV-affected communities with medical, dental and mental health care. Professionally facilitated, 10-12 session HIV support groups were offered to MSM diagnosed within one year. Participants communally chose topics for discussion. We reviewed presenting concerns for groups initiating between 2005-2011. Demographic and treatment information, such as age, race, previous or concurrent individual psychotherapy, self-reported substance use, current antiretroviral therapy, engagement in intensive HIV-care coordination services, and the presence of other co-morbidities were explored as they related to group attendance. Our review revealed disclosure of HIV status to potential sexual partners and family and friends as the most frequently-chosen topic for discussion. In many group sessions participants also chose to explore barriers related to disclosure. This represents a shift away from medical concerns towards psychosocial concerns among group participants. Review of quantitative data revealed that engagement in other support services or intensive medical treatment was related to group attendance and completion. These data imply that newly-diagnosed support groups provide not only a forum for psychoeducation and emotional adjustment to an HIV diagnosis, but also an important opportunity to address positive prevention issues, such as disclosure of serostatus to potential sexual partners.