2. To Tell or Not To Tell: HIV Disclosure to Family, Friends and Sex Partners Julie Serovich, PhD Dean and Professor College of Behavioral and Community Sciences The University of South Florida

3. Disclosures of Financial Relationships This speaker has no significant financial relationships with commercial entities to disclose. This speaker will not discuss any off-label use or investigational product during the program. This slide set has been peer-reviewed to ensure that there are no conflicts of interest represented in the presentation.

4. Identify how men and women are similar and different in their rates of disclosure to various targets (e.g., family, sex partners) and appropriately advise them. List reasons for disclosure to sex partner and associated reactions. Describe the magnitude of regret associated with disclosure by men and women.

6.  Five year longitudinal study of HIV+ person’s disclosure practices. The men’s study was conducted from 1997-2002 and the women’s from 2001-2006.  Variables of interest included disclosure, mental health, physical health, social support, disease progression, and sexual risk-taking behaviors.  Participants were recruited primarily from the AIDS Clinical Trials Unit and through Columbus AIDS Task Force, and were interviewed every 6 months for 3 years.

11. A. Mothers B. Fathers C. Sisters D. Brothers

12. 60% of all mothers (n = 94) disclosed to within the first month, 74% within 12 months 60-70% of brothers (n = 117) and sisters (n = 148) disclosed to in 12 months 47% of fathers (n = 74) disclosed to in the first 12 months Serovich, J. M., Craft, S. M., & Yoon, H. (2007).Women’s HIV disclosure to immediate family. AIDS Patient Care and STD’s, 21(12), 970-980.

13. A. Family of origin B. Children C. Extended family D. Partners

14. Partners (n = 173) Children (n = 169) Family of Origin (n=369) Extended Family (n=126) Friends (n=389) Serovich, J. M., Craft, S. M., & Reed, S. (2012). Women’s HIV disclosure to immediate family and friends. AIDS Patient Care and STDs, 26(4), 241-249.

15. Women tell more family members and partners in the first month after diagnosis Rate of increase in disclosure during the first year is highest among friends Serovich, J. M., Craft, S. M., & Reed, S. (2012). Women’s HIV disclosure to immediate family and friends. AIDS Patient Care and STDs, 26(4), 241-249.

16. A. Mothers B. Fathers C. Sisters D. Brothers

17. Only 42% of mothers (n = 116)disclosed to within one month, 52% within 12 months Only 40-44% of brothers (n = 188) and sisters (n = 193) disclosed to within 12 months Only 40% of fathers (n = 100) disclosed to within 12 months Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). HIV disclosure to immediate family over time. AIDS Patient Care & STD’s, 19, 506-517.

18. A. Family B. Long-term friends C. Random friends

19. Rate of disclosure to random friends was 20% higher than to family Difference in the rates was not significant Shape of disclosure to long term friends was significantly different Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). HIV disclosure to immediate family over time. AIDS Patient Care & STD’s, 19, 506-517.

20. Men disclosed to more friends than family in the first month Rate of increase in disclosure to family and friends were similar Serovich, J. M., Esbensen, A. J., & Mason, T. L. (2005). Disclosure of positive HIV serostatus by men who have sex with men to family and friends over time. AIDS Patient Care & STD’s, 21 (7), 492-500.

21. A. Women B. Men

24. A. Afraid they will find out on their own B. Obligation C. To just get it over with

25. Women: Obligation Sense of duty to tell Wanted this person to know what they were getting into Men: Obligation Sense of duty to tell He had a right to know

26. Women: Offered his/her assistance. Perhaps said, “what can I do to help?” Reassured or comforted me Was optimistic-hoped for a cure Men: Hugged me Confirmed our relationship Reassured or comforted me

27. Women: Didn’t think they would be supportive Concerned how he would feel about me Worried they would no longer like me Men: My diagnosis is private information I have a right to privacy I don’t have to tell if I don’t want to

28. Women: Sense of duty to tell Obligation Wanted the person to know the seriousness of the disease Men: I trusted him Obligation We have a close relationship

29. Women: Offered his/her assistance. Perhaps said, “what can I do to help?” Confirmed our relationship saying, “This won’t change the way I feel about you.” Reassured or comforted me Men: - Data not available

30. Women: Relationship wasn’t serious I felt ashamed about being HIV-positive We weren’t very close to each other Men: My diagnosis is private information I have a right to privacy I don’t have to tell if I don’t want to

31. Women: Wanted to educate I trusted him Wanted others to know the seriousness of the disease Men: Obligation I have a duty to tell Don’t want to risk more health problems for either of us

32. Women: Reassured or comforted me Felt sorry for me Was worried for me or my family Men: - Data not available

33. Women: All women disclosed Men: We didn’t know each other well Our relationship wasn’t serious I have a right to privacy

35. A. Men B. Women

37. A. HIV status B. Sexual orientation

39. More likely to regret disclosing sexual orientation (SO) to males More likely to regret second- hand disclosure of serostatus (HIV) More likely to regret both in relationships where satisfaction is low