HIV serostatus disclosure: development and validation of indicators considering target and modality. Results from a community-based research in 5 countries

Marie Préau (1, 2) , Dominic Beaulieu-Prévost (3) , Emilie Henry (4) , Bernier Adeline (4) , Ludivine Veillette-Bourbeau (4) , Joanne Otis (5)

1 GRePS - Groupe de Recherche en Psychologie Sociale
2 SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale
3 Département de sexologie [Montréal]
4 Coalition PLUS
5 UQAM - Université du Québec à Montréal = University of Québec in Montréal

RATIONALE: HIV serostatus disclosure is a complex challenge for persons living with HIV (PLHIV). Despite its beneficial effects, it can also lead to stigmatization and rejection. The current lack of multi-dimensional measurement tools impede an in-depth understanding of the dynamic of disclosure. OBJECTIVE: To develop and validate complex measures of serostatus disclosure. METHODS: This international community based research study was performed by joint research teams (researchers/community based organizations (CBO)) in five countries (Democratic Republic of the Congo, Ecuador, Mali, Morocco and Romania). A convenience sample of 1500 people living with HIV (PLHIV) in contact with local CBO were recruited in 2011 (300 in each country). Face-to-face interviews were performed using a 125-item questionnaire covering HIV status disclosure to 23 potential disclosure targets and related issues (including personal history with HIV, people's reaction to disclosure, sexuality). A principal component analysis and a hierarchical cluster analysis were performed, in order to identify the main components of HIV disclosure, create measures and classify participants into profiles. RESULTS: Patterns of disclosure were summarized using two main measures: direct and indirect disclosure. Disclosure to sexual partners, whether steady or not, was different from patterns of disclosure to other targets. Among the participants, three profiles emerged - labelled Restricted disclosure, Mainly indirect disclosure and Mainly direct disclosure, respectively representing 61%, 13% and 26% of the total sample. The profiles were associated with different aspects of PLHIV's lives, including self-efficacy, functional limitations and social exclusion. Patterns varied across the five studied countries. CONCLUSION: Results suggest that multi-dimensional constructs should be used to measure disclosure in order to improve understanding of the disclosure process.

Mots clés: Community-based-research; Cultural contexts; Disclosure modalities; Disclosure process; HIV infection

Domaines: Psychologie

Marie Préau, Dominic Beaulieu-Prévost, Emilie Henry, Bernier Adeline, Ludivine Veillette-Bourbeau, et al.. HIV serostatus disclosure: development and validation of indicators considering target and modality. Results from a community-based research in 5 countries. Social Science and Medicine, 2015, 146, pp.137-146. ⟨10.1016/j.socscimed.2015.10.034⟩. ⟨halshs-01429291⟩