NCJ Number
204509
Journal
Maternal and Child Health Journal Volume: 4 Issue: 2 Dated: June 2000 Pages: 111-120
Editor(s)
Milton Kotekchuck Ph.D.
Date Published
June 2000
Length
10 pages
Annotation
This paper examines the effects of a HIV-positive diagnosis on women in relation to their disclosure to others and the violence experienced by women diagnosed with HIV.
Abstract
Notification of a positive HIV test result can profoundly affect and impact a woman’s psychological and physical well-being. The stigma associated with HIV can cause women to experience feelings of isolation and shame, as well as fear, rejection, and abandonment following disclosure of their HIV-positive diagnosis. These concerns keep women from disclosing to others. Disclosure has led to negative consequences, including violence. In a study of the relationship between HIV status and violence in a large urban area, issues of disclosure and violence were addressed. HIV-positive women who had known they were positive for at least 6-months were interviewed using both quantitative and qualitative methodology. The research questions addressed in this paper include: (1) what role do healthcare providers play in the disclosure process; (2) what are women’s concerns and experiences with disclosure; (3) what violence do women living with HIV experience; and (4) how is the violence related to their diagnosis and disclosures? Data were from Project WAVE, a cross-sectional study of the relationship between violence and HIV risk in which 301 HIV-negative and 310 HIV-positive women were interviewed. The women were recruited between May 1997 and April 1999 from an outpatient HIV primary care clinic and an outpatient drug treatment clinic located in Baltimore, MD. Findings indicate high rates of disclosure among the sample of HIV-positive women who had been living with the disease for an average of 5.8 years. Virtually all women, or 95 percent, had disclosed to more than 1 person, and 58 percent had disclosed to more than 10 people. Slightly more than half of the sample or 57 percent remembered being told by a healthcare provider that they should disclose to their sex partners and almost half of the sample, or 46 percent, said their healthcare provider offered to help them disclose their test results. Women afraid of disclosure related violence were significantly more likely to report having received help with disclosure. Data also suggest an individual constellation of factors--drug use, partner status, income, age, and duration of the disease--can be used to heighten a provider’s index of suspicion that a woman may be at risk of abuse. An individualized approach to posttest counseling that assesses women’s unique situations and risk is highly recommended and warranted. References