Department of Community Health Services, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA.
AIDS Patient Care STDS. 2013 Mar;27(3):191-200. doi: 10.1089/apc.2012.0441.
Young women with HIV and histories of physical and/or sexual abuse in childhood may be vulnerable to difficulties with disclosure to sexual partners. Abuse in childhood is highly prevalent in HIV-positive women, and has been associated with poorer communication, low assertiveness, low self worth, and increased risk for sexual and other risk behaviors that increase the risk of secondary transmission of HIV. HIV disclosure may be an important link between abuse and sexual risk behaviors. Qualitative interviews with 40 HIV-positive young women with childhood physical and/or sexual abuse were conducted; some women had also experienced adult victimization. Results suggest that HIV-positive women with abuse histories use a host of strategies to deal with disclosure of HIV status, including delaying disclosure, assessing hypothetical responses of partners, and determining appropriate stages in a relationship to disclose. Stigma was an important theme related to disclosure. We discuss how these disclosure processes impact sexual behavior and relationships and discuss intervention opportunities based on our findings.
年轻的 HIV 感染者中，有过童年期身体或性虐待经历的女性可能在向性伴侣披露病情方面存在困难。童年期虐待在 HIV 阳性女性中非常普遍，并且与沟通不良、缺乏自信、低自尊以及性和其他风险行为增加有关，这些行为增加了 HIV 二次传播的风险。HIV 披露可能是虐待和性风险行为之间的重要联系。对 40 名有过童年期身体或性虐待经历的 HIV 阳性年轻女性进行了定性访谈；一些女性还经历过成年期的受害。研究结果表明，有虐待史的 HIV 阳性女性使用了多种策略来处理 HIV 状况的披露，包括延迟披露、评估伴侣的假设反应，以及确定在关系的适当阶段披露。耻辱感是与披露相关的一个重要主题。我们讨论了这些披露过程如何影响性行为和关系，并根据我们的发现讨论了干预机会。
