Parsons Jeffrey T, Missildine Whitney, Van Ora Jason, Purcell David W, Gómez Cynthia A
Hunter College of the City University of New York, New York, New York 10021, USA.
AIDS Patient Care STDS. 2004 Aug;18(8):457-69. doi: 10.1089/1087291041703683.
Utilizing mixed methods analyses with cross-sectional data from an ethnically diverse sample of HIV-seropositive injection drug users (IDUs), we sought to examine disclosure and sexual behavior based on partner type, partner serostatus, and transmission risk. Results indicated that more participants disclosed to their HIV-positive sex partners than to their HIV-negative or unknown status sex partners. However, unexpectedly, we found that more participants disclosed to casual sex partners than primary partners before first sexual contact. Consistent disclosers reported more unprotected sexual activity compared to nondisclosers, and were more likely to believe they had a responsibility to disclose. Nondisclosers were less likely than consistent disclosers to believe it was important to protect sex partners from HIV and were more resentful of wearing condoms. In terms of the qualitative data, we found that the emotionally upsetting narratives came from those we defined as "eventual disclosers." This category represented those participants who were in relationships and had not disclosed their status to their primary partners until after having had sex with that partner. These narratives indicated that researchers looking at disclosure behavior should be aware of varying disclosure contexts as well as the emotional consequences impacting disclosure decision-making within these contexts.
我们利用混合方法分析，对来自不同种族的HIV血清阳性注射吸毒者（IDU）样本的横断面数据进行研究，旨在根据性伴侣类型、伴侣血清学状态和传播风险来考察信息披露情况和性行为。结果表明，与HIV阴性或血清学状态不明的性伴侣相比，更多参与者向其HIV阳性性伴侣披露了自身情况。然而，出乎意料的是，我们发现，在首次性接触之前，更多参与者向临时性伴侣而非主要伴侣披露了自身情况。与不披露者相比，持续披露者报告的无保护性行为更多，并且更有可能认为自己有责任进行披露。与持续披露者相比，不披露者不太可能认为保护性伴侣免受HIV感染很重要，并且对使用避孕套更加反感。在定性数据方面，我们发现，令人情绪不安的叙述来自我们定义为“最终披露者”的人群。这一类别代表那些处于恋爱关系中、在与主要伴侣发生性行为之后才向其披露自身状况的参与者。这些叙述表明，研究信息披露行为的研究人员应意识到不同的披露背景以及这些背景下影响披露决策的情感后果。
