Mayfield Arnold E, Rice E, Flannery D, Rotheram-Borus M J
Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1087, USA.
AIDS Care. 2008 Jan;20(1):80-92. doi: 10.1080/09540120701449138.
Research on disclosure among heterosexual adult person(s) living with HIV (PLH) was reviewed, omitting disclosure of parental HIV to children. Disclosure has been studied within five additional relational contexts: with partners, family members, friends, healthcare professionals and in work settings. Disclosure is higher among women than men, among Latino and white compared to African-American families, and among younger compared to older HIV-positive adults. Most PLH disclose to their sexual partners and family members, yet there is a significant minority who do not disclose. Similarly, rates of disclosure to employers range from 27-68%, suggesting broad variability in perceived consequences of employment disclosures. Of concern, 40% of PLH do not consistently disclose to their healthcare professionals. Rather than examine HIV disclosures in the context of relationships, it is possible to understand disclosures around personal identity. Disclosure decisions are often made to tell everyone (making HIV status a central attribute of one's identity), no one (requiring strategies for securing social support while remaining anonymous) or some people (requiring strategic decisions based on context). Given that disclosure decisions are central to personal identity, future data on disclosure and interventions designed to increase disclosure or comfort with disclosure must focus on communication strategies adopted by PLH to present a coherent identity.
对成年异性恋艾滋病毒感染者（PLH）之间信息披露情况的研究进行了综述，不包括向儿童披露父母感染艾滋病毒的情况。信息披露还在另外五种关系背景下进行了研究：与伴侣、家庭成员、朋友、医疗保健专业人员以及工作场所中的情况。女性的信息披露率高于男性，拉丁裔和白人家庭高于非裔美国家庭，年轻的艾滋病毒阳性成年人高于年长的。大多数PLH会向他们的性伴侣和家庭成员披露信息，但仍有相当一部分人不披露。同样，向雇主披露信息的比例在27%至68%之间，这表明人们对就业信息披露后果的认知存在很大差异。令人担忧的是，40%的PLH不会始终如一地向他们的医疗保健专业人员披露信息。与其在人际关系背景下研究艾滋病毒信息披露，不如从个人身份的角度来理解信息披露。信息披露的决定通常是告诉所有人（使艾滋病毒感染状况成为个人身份的核心属性）、不告诉任何人（需要在保持匿名的同时确保获得社会支持的策略）或告诉一些人（需要根据具体情况做出策略性决定）。鉴于信息披露的决定对个人身份至关重要，未来关于信息披露以及旨在增加信息披露或提高对信息披露舒适度的干预措施的数据，必须关注PLH为展现连贯身份而采用的沟通策略。
