HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands

The disclosure of HIV status presents a dilemma; it can promote health, social support, and psychological well-being but it can also lead to negative social consequences such as stigmatisation and rejection. To understand disclosure it is necessary to understand the reasoning employed by people living with HIV (PLWH). This study explored disclosure through interviews with 42 people of African and Afro-Caribbean origin living in the Netherlands; a population disproportionately affected by HIV. Reasons for nondisclosure included: fear of stigmatisation, previous negative experiences with disclosure; having observed the stigmatisation of others; shame; the desire to protect others (particularly family or children) from stigmatisation by association or worry; and the belief that HIV status is a private matter. Among the motives for disclosure were: being in a close and supportive relationship; emotional release; access to emotional or financial support; a perceived duty to inform; and a desire to educate others about sexual risk-taking. The authors conclude that stigma plays an important role in disclosure decisions among these populations. They point to a need for HIV-related stigma reduction interventions in African and Afro-Caribbean communities and culturally sensitive counselling for PLWH