Impact of First Disclosure Experience and Internalized Stigma on Disclosure Patterns in the HIV+ Community

The present study examined possible antecedent factors that contribute to the type of discloser (HIV status) one becomes as well as the relation between discloser type, social support, and CD4 count. This study builds off previous research by Stutterheim et al. (2011) that examined differences between disclosure groups on a variety of variables, but the study did not examine variables that may contribute to the type of discloser a person becomes. The present study examined two variables that previous research suggests may influence the type of discloser (relative non-discloser, selective discloser, full discloser) a person becomes, first-disclosure experience, and internalized stigma. It was predicted that more positive first disclosure experiences would be related to more disclosures; full disclosers would report more positive first disclosure experiences than selective disclosers and relative non-disclosers, respectively. It was hypothesized that higher internalized stigma would be related to fewer disclosures; full disclosers would have the lowest internalized stigma scores and relative non-disclosers would report the highest level of internalized stigma. In addition, social support was predicted to fully mediate the relation between the type of discloser and CD4 count. Specifically, full and selective disclosers would report more social support than relative non-disclosers and, as a result, have higher CD4 counts than relative non-disclosers. SEM Path Analysis was employed to examine the relation between the aforementioned variables. Results revealed that internalized stigma was negatively related to the type of discloser one becomes, as predicted. However, first disclosure experience was not significantly related to the type of discloser one becomes. Social support did mediate the relation between type of discloser and CD4 count, but not in the way originally hypothesized. Disclosure type was positively related to social support as hypothesized, but contrary to the prediction higher levels of social support were negatively related to CD4 count. Possible explanations for results and directions for future research are discussed in the final section