The purpose of the proposed project is to test a theoretical model of HIV/AIDS disclosure that simultaneously examines multiple factors hypothesized to predict and inhibit disclosure and tests the relationships between disclosure events and psychological and behavioral outcomes. To date, there exists no known model that simulates the hypothesized complexity of disclosure processes or relates disclosure events to post-disclosure psychological (e.g., negative affect) or behavioral (e.g., sexual risk) outcomes for people living with HIV/AIDS (PLWHA). The proposed model of HIV/AIDS disclosure will provide a parsimonious theoretical framework through which to understand how PLWHA make decisions about whom to disclose their positive serostatus and how they are affected by these decisions. The proposed study will employ a disclosure recipient-specific, longitudinal design in order to assess how these disclosure processes vary across disclosure recipients and time.
Specific Aim 1 will examine the relative predictive utility of factors hypothesized to facilitate (i.e., negative coping, negative psychological effects of concealment, significance of relationship with disclosure recipient, and eco-concerns for well-being of others) and inhibit (i.e., anticipated negative reactions from disclosure recipient, ego-concerns for well-being of self, social norms against disclosure, and perceived positive serostatus of disclosure recipient) disclosure that are conceptually related with either the discloser or the disclosure recipient.
Specific Aim 2 will examine how disclosure (or nondisclosure) decisions affect psychological and behavioral outcomes. It is hypothesized that the effect of disclosure on behavioral outcomes will be mediated by the effect of disclosure on psychological outcomes such that, to the extent that people experience positive psychological outcomes due to disclosure, they will also experience concomitant decreases in sexual risk and increases in adherence behaviors. This project has important conceptual and applied implications. The proposed model of HIV/AIDS disclosure will provide a framework for theorists and researchers to understand the complexity of disclosure processes and allow them to use this knowledge to inform interventions that assist PLWHA in identifying the optimal conditions and recipients for disclosure. Additionally, this framework has the potential to enhance the understanding of general disclosure processes across other types of concealed stigmatized identities (e.g., mental illness) and to emphasize both the potential psychological and behavioral effects of disclosure. ? ? ?
Chaudoir, Stephenie R; Fisher, Jeffrey D (2010) The disclosure processes model: understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull 136:236-56 |
Chaudoir, Stephenie R; Quinn, Diane M (2010) Revealing concealable stigmatized identities: The impact of disclosure motivations and positive first disclosure experiences on fear of disclosure and well-being. J Soc Issues 66:570-584 |
Earnshaw, Valerie A; Chaudoir, Stephenie R (2009) From conceptualizing to measuring HIV stigma: a review of HIV stigma mechanism measures. AIDS Behav 13:1160-77 |
Quinn, Diane M; Chaudoir, Stephenie R (2009) Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. J Pers Soc Psychol 97:634-51 |