Serostatus Disclosure as a Predictor of Metal Health and Physical Health Among HIV-Seropositive Adults

As estimated 1,200,000 people in the United States were living with HIV in 2009 (UNAIDS, 2010). African Americans have an incidence rate seven times that of Caucasians. Research has shown that HIV-positive people have high levels of psychological distress (Cook et al., 2006); depression is the most frequently diagnosed disorder (Treisman, Angelino, & Hutton, 2001). Distress negatively impacts physical health (Comer, Henker, Kemeny, & Wyatt, 2000; Cruess et al., 2005) and medication adherence (Cook, et al., 2006; Mellins et al., 2002) in HIV-positive patients. Although disclosure of HIV-seropositivity can lead to increased social support (Armistead, Morse, Forehand, Morse, & Clark, 1999), it may also lead to social rejection, prejudice and increased distress (Cederfjall, Langius-Eklof, Lidman, & Wredling, 2001; Kalichman, DiMarco, Austin, Luke, & DiFonzo, 2003). This study examined 110 HIV-positive patients at an urban medical clinic. Patients completed self-report measures as part of a larger study investigating posttraumatic growth in HIV/AIDS. It was hypothesized that (a) more participants would disclose to friends and partners than to family; (b) participants who disclosed to more people would endorse fewer symptoms of distress; and (c) participants who disclosed to fewer people would be less likely to adhere to medical regimens and routinely attend medical appointments, and have poorer health outcomes. Distress was measured by Psychiatric Symptom Index (PSI), Beck Depression Inventory (BDI), and the Impact of Event Scale (IES). Viral load and CD4 cell counts were found in medical charts, and the AIDS Clinical Trails Group Adherence Follow-up Questionnaire measured adherence. Analyses reveal that 67.3% of participants disclosed to family, 55.5% to at least one partner, and 45.5% to friends. A negative association existed between full disclosure and IES Avoidance scale (r = -.20, p< .05). There were positive associations between disclosure to family and the PSI Depression Scale (r = .22, p < .05), Cognitive Disturbance Scale (r = .21, p < .05), and PSI Total Score (r = .22, p < .05), implying that disclosure to more groups of people may be associated with increases in psychological distress ratings. Implications of these findings are discussed.M.S. in Psychology, May 201