Advertisement

AIDS and Behavior

, Volume 22, Issue 5, pp 1606–1613 | Cite as

Disclosure and Stigma of a Positive HIV-Serostatus: A Two-Step Cluster Analysis of the HIV Disclosure Scale

  • Arryn A. Guy
  • Kristin Niel
  • R. E. Franco Durán
Original Paper
  • 220 Downloads

Abstract

Despite national efforts to improve the public’s education about an HIV diagnosis, stigma still plays a significant role in how persons living with HIV (PLH) decide to disclose their serostatus to friends, family, or healthcare workers. Disclosure can be related to both positive and negative psychological health outcomes, including rates of depression and perceived social support. Researchers often assess disclosure patterns in PLH due to its association with important health implications; however, to date, there are no empirically validated measures of HIV-serostatus disclosure. The HIV Disclosure Scale (HDS) was created to assess various aspects of the disclosure process and has been utilized in several studies as an adequate measurement of HIV-serostatus disclosure despite no available psychometric data. This study aims to uncover constructs measured by the HDS using exploratory two-step cluster analysis to provide an initial analysis of the psychometric properties of this scale.

Keywords

HIV/AIDS Disclosure Stigma Psychometrics 

Notes

Funding

This study was funded by Lewis College of Human Sciences, Illinois Institute of Technology, student research scholarship awarded to Arryn A. Guy.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    CDC. Diagnoses of HIV infection in the United States and dependent areas. HIV Surveill Rep 2015; 26.Google Scholar
  2. 2.
    Baugher AR, Beer L, Fagan JL, et al. Prevalence of internalized HIV-related stigma among HIV-infected adults in care, United States, 2011–2013. AIDS Behav. 2017;.  https://doi.org/10.1007/s10461-017-1712-y.PubMedGoogle Scholar
  3. 3.
    Bairan A, Taylor GAJ, Blake BJ, Akers T, Sowell R, Mendiola R. A model of HIV disclosure: disclosure and types of social relationships. J Am Assoc Nurse Pract. 2007;19(5):242–50.CrossRefGoogle Scholar
  4. 4.
    Fekete EM, Antoni MH, Durán R, Stoelb BL, Kumar M, Schneiderman N. Disclosing HIV serostatus to family members: effects on psychological and physiological health in minority women living with HIV. Int J Behav Med. 2009;16(4):367–76.CrossRefPubMedGoogle Scholar
  5. 5.
    Fekete EM, Antoni MH, Lopez CR, et al. Men’s serostatus disclosure to parents: associations among social support, ethnicity, and disease status in men living with HIV. Brain Behav Immun. 2009;23(5):693–9.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Whetten K, Reif S, Whetten R, Murphy-McMillan LK. Trauma, mental health, distrust, and stigma among HIV-positive persons: implications for effective care. Psychosom Med. 2008;70(5):531–8.  https://doi.org/10.1097/PSY.0b013e31817749dc.CrossRefPubMedGoogle Scholar
  7. 7.
    Simoni JM, Demas P, Mason HR, Drossman JA, Davis ML. HIV disclosure among women of African descent: associations with coping, social support, and psychological adaptation. AIDS Behav. 2000;4(2):147–58.CrossRefGoogle Scholar
  8. 8.
    Swendeman D, Rotheram-Borus MJ, Comulada S, Weiss R, Ramos ME. Predictors of HIV-related stigma among young people living with HIV. Health Psychol. 2006;25(4):501.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Durán R. Differential consequences of serostatus disclosure in men and women. Paper presented at a symposium entitled “Gender Issues in HIV and AIDS Research—Informing Prevention and Treatment Efforts.” The 1998 American Psychological Association Annual Convention. San Francisco, California. August, 1998.Google Scholar
  10. 10.
    Carter TJ. HIV-positive identity and health behaviors in adolescents living with HIV. (Unpublished Doctoral Dissertation). 2005. University of Miami, Coral Gables, FL.Google Scholar
  11. 11.
    Gore-Felton C, Power R, Durán R, et al. Psychosocial factors associated with disclosure of HIV positive serostatus: understanding the influence of depression and social support. J HIV AIDS Soc Serv. 2008;7(1):83–98.CrossRefGoogle Scholar
  12. 12.
    Mooi E, Sarstedt M. Cluster analysis. In: Mooi E, Sarstedt M, editors. A concise guide to market research. Berlin: Springer; 2010.Google Scholar
  13. 13.
    Reis HT, Patrick BC. Attachment and intimacy: Component processes. 1996.Google Scholar
  14. 14.
    Reis HT, Shaver P. Intimacy as an interpersonal process. Handb Pers Relationsh. 1998;24(3):367–89.Google Scholar
  15. 15.
    Yep GA. Disclosure of HIV infection in interpersonal relationships: A communication boundary management approach. In: Balancing the secrets of private disclosures, 2000; 83–96.Google Scholar
  16. 16.
    Zea MC, Reisen CA, Poppen PJ, Echeverry JJ, Bianchi FT. Disclosure of HIV-positive status to Latino gay men’s social networks. Am J Community Psychol. 2004;33(1–2):107–16.CrossRefPubMedGoogle Scholar
  17. 17.
    Hawk ST. Disclosures of maternal HIV infection to seronegative children: a literature review. J Soc Pers Relat. 2007;24(5):657–73.CrossRefGoogle Scholar
  18. 18.
    Serovich JM. A test of two HIV disclosure theories. AIDS Educ Prev. 2001;13(4):355.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Mason HR, Marks G, Simoni JM, Ruiz MS, Richardson JL. Culturally sanctioned secrets? Latino men’s nondisclosure of HIV infection to family, friends, and lovers. J Health Psychol. 1995;14(1):6.CrossRefGoogle Scholar
  20. 20.
    Zea MC, Reisen CA, Poppen PJ, Díaz RM. Asking and telling: communication about HIV status among Latino HIV-positive gay men. AIDS Behav. 2003;7(2):143–52.CrossRefPubMedGoogle Scholar
  21. 21.
    Zea MC, Reisen CA, Poppen PJ, Bianchi FT, Echeverry JJ. Predictors of disclosure of human immunovirus-positive serostatus among Latino gay men. Cult Divers Ethnic Minor Psychol. 2007;13(4):304.CrossRefGoogle Scholar
  22. 22.
    Kalichman SC, DiMarco M, Austin J, Luke W, DiFonzo K. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32.CrossRefPubMedGoogle Scholar
  23. 23.
    Comer LK, Henker B, Kemeny M, Wyatt G. Illness disclosure and mental health among women with HIV/AIDS. J Community Appl Soc Psychol. 2000;10(6):449–64.CrossRefGoogle Scholar
  24. 24.
    Cederfjäll C, Langius-Eklöf A, Lidman K, Wredling R. Gender differences in perceived health-related quality of life among patients with HIV infection. AIDS Patient Care STDS. 2001;15(1):31–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Clark HJ, Lindner G, Armistead L, Austin BJ. Stigma, disclosure, and psychological functioning among HIV-infected and non-infected African-American women. Women Health. 2004;38(4):57–71.CrossRefGoogle Scholar
  26. 26.
    Derlega VJ, Winstead BA, Oldfield EC III, Barbee AP. Close relationships and social support in coping with HIV: a test of sensitive interaction systems theory. AIDS Behav. 2003;7(2):119–29.CrossRefPubMedGoogle Scholar
  27. 27.
    Ingram KM, Jones DA, Fass RJ, Neidig JL, Song YS. Social support and unsupportive social interactions: their association with depression among people living with HIV. AIDS Care. 1999;11(3):313–29.CrossRefPubMedGoogle Scholar
  28. 28.
    Zea MC, Reisen CA, Poppen PJ, Bianchi FT, Echeverry JJ. Disclosure of HIV status and psychological well-being among Latino gay and bisexual men. AIDS Behav. 2005;9(1):15–26.CrossRefPubMedGoogle Scholar
  29. 29.
    Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310.CrossRefPubMedGoogle Scholar
  30. 30.
    Niel KA. Posttraumatic growth among HIV-seropositive adolescents and young adults. (Unpublished doctoral dissertation). 2016. Illinois Institute of Technology, Chicago, IL.Google Scholar
  31. 31.
    Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson; 2013.Google Scholar
  32. 32.
    Schwarz G. Estimating the dimension of a model. Ann Stat. 1978;6(2):461–4.CrossRefGoogle Scholar
  33. 33.
    Lichtenstein B, Laska MK, Clair JM. Chronic sorrow in the HIV-positive patient: issues of race, gender, and social support. AIDS Patient Care STDS. 2002;16(1):27–38.CrossRefPubMedGoogle Scholar
  34. 34.
    Surlis S, Hyde A. HIV-positive patients’ experiences of stigma during hospitalization. J Assoc Nurses AIDS Care. 2001;12(6):68–77.CrossRefPubMedGoogle Scholar
  35. 35.
    Khakha DC. Discrimination in health care to patients living with HIV/AIDS. Nurs J India. 2003;94(12):273.PubMedGoogle Scholar
  36. 36.
    Green G, Platt S. Fear and loathing in health care settings reported by people with HIV. Sociol Health Illn. 1997;19(1):70–92.CrossRefGoogle Scholar
  37. 37.
    Nyblade L, Stangl A, Weiss E, Ashburn K. Combating HIV stigma in health care settings:what works? J Int AIDS Soc. 2009;12(1):1.CrossRefGoogle Scholar
  38. 38.
    Wohl AR, Galvan FH, Myers HF, Garland W, George S, Witt M, LEE ML. Do social support, stress, disclosure and stigma influence retention in HIV care for Latino and African American men who have sex with men and women? AIDS Behav. 2011;15(6):1098–110.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Arryn A. Guy
    • 1
  • Kristin Niel
    • 2
  • R. E. Franco Durán
    • 3
  1. 1.Clinical Psychology, Department of PsychologyIllinois Institute of TechnologyChicagoUSA
  2. 2.St. Jude Children’s Research HospitalMemphisUSA
  3. 3.California School of Professional PsychologyAlliant International UniversityAlhambraUSA

Personalised recommendations