Yoshioka M R, Schustack A
Columbia University School of Social Work, New York, New York 10025-4600, USA.
AIDS Patient Care STDS. 2001 Feb;15(2):77-82. doi: 10.1089/108729101300003672.
Disclosure of human immunodeficiency virus (HIV) status is a difficult emotional task creating opportunities for both support and rejection. For Asian patients there may be additional self-imposed barriers to disclosure that are rooted in cultural values. The purpose of this article is to describe how Asian cultural values of harmony and avoidance of conflict affect the disclosure experiences of HIV-positive Asian American and immigrants. Effective practice guidelines have been developed based on this information. Based on in-depth interviews with 16 HIV-positive Asian men, three focal issues were identified that serve as barriers to disclosure to family members: protection of family from shame, protection of family from obligation to help, and avoidance of communication regarding highly personal information. Additionally, patients felt disclosure was inhibited by the lack of HIV education to which families living overseas may have access. This is compounded by their lack of access to translated materials that they could send to family members. Similar to past disclosure research with non-Asian samples, the findings suggest that gay Asian men seek emotional support from gay friends. They would consider disclosing to relatives only when health reasons necessitated it. It is essential that helping professionals be attentive to the dishonor that patients may experience through disclosure and the stigma associated with being gay. Patients who are considering making a disclosure may need assistance with thinking through ways to provide HIV/acquired immune deficiency syndrome (AIDS) education to those family members that have little knowledge in this area. This may include translating or locating informational brochures translated into the family's language.
披露人类免疫缺陷病毒（HIV）感染状况是一项艰难的情感任务，既带来了获得支持的机会，也可能遭遇拒绝。对于亚洲患者而言，可能还存在源于文化价值观的自我强加的披露障碍。本文旨在描述亚洲人和谐与避免冲突的文化价值观如何影响亚裔美国人和移民HIV阳性者的披露经历。基于这些信息制定了有效的实践指南。通过对16名HIV阳性亚洲男性的深入访谈，确定了三个阻碍向家庭成员披露的核心问题：保护家人免受耻辱、保护家人不承担帮助义务以及避免交流高度个人化的信息。此外，患者感到由于海外家庭无法获得HIV教育，披露受到了抑制。他们无法获取可寄给家庭成员的翻译材料，这使情况更加复杂。与过去对非亚洲样本的披露研究类似，研究结果表明，亚裔男同性恋者会向男同性恋朋友寻求情感支持。只有在健康原因必要时，他们才会考虑向亲属披露。帮助专业人员必须注意患者披露可能会经历的耻辱以及与同性恋相关的污名。考虑披露的患者可能需要帮助，思考如何向对此领域知之甚少的家庭成员提供HIV/获得性免疫缺陷综合征（AIDS）教育。这可能包括翻译或查找翻译成家人语言的信息手册。
