Disclosure of HIV status to medical providers: differences by gender, "race," and immune function.

OBJECTIVE The authors used data from a larger study to explore differences by gender, self-reported racial identification, and immune function in disclosure of HIV-positive serostatus to medical providers (dentists, family doctors, and emergency room [ER] and obstetrics-gynecology [ob/gyn] providers). METHOD The authors analyzed interview responses from a convenience sample of African American and white men and women receiving HIV medical care at urban hospitals and clinics in St. Louis. Missouri. RESULTS Of 179 respondents using at least one of three types of providers, 124 (69%) disclosed their HIV status to all applicable types of providers, 39 (22%) disclosed to only one or two types of providers, and 16 (9%) did not disclose to any of these types of providers. "Race" and CD4 count, but not gender, were independently associated with disclosure to dentists, family doctors, and ER providers in multivariate logistic regression analyses. CONCLUSIONS Differences in disclosure rates, especially among patients who may be asymptomatic, suggest a need for public health education of both medical providers and patients with HIV.

[1]  J. Neuhaus,et al.  Dental care access and use among HIV-infected women. , 1999, American journal of public health.

[2]  J. Koval,et al.  Factors associated with refusal to treat HIV-infected patients: the results of a national survey of dentists in Canada. , 1999, American Journal of Public Health.

[3]  B. Maheux,et al.  Do people with HIV/AIDS disclose their HIV-positivity to dentists? , 1999, AIDS care.

[4]  D. Jeffe,et al.  Factors associated with HIV-infected patients' recognition and use of HIV medications. , 1998, Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association.

[5]  L M Sullivan,et al.  Sexual ethics. Disclosure of HIV-positive status to partners. , 1998, Archives of internal medicine.

[6]  M. Winiarski.  HIV Mental Health for the 21st Century , 2020 .

[7]  G. Marks,et al.  Disclosing HIV status and sexual orientation to employers. , 1997, AIDS care.

[8]  V. Fraser,et al.  A survey of women with HIV about their expectations for care. , 1997, AIDS care.

[9]  R L Sowell,et al.  Resources, stigma, and patterns of disclosure in rural women with HIV infection. , 1997, Public health nursing.

[10]  R. Miller,et al.  Women with HIV disease attending a London clinic. , 1997, Genitourinary medicine.

[11]  B. Gerbert,et al.  HIV risk assessment: a video doctor seeks patient disclosure. , 1997, M.D. computing : computers in medical practice.

[12]  D. Karus,et al.  Testing and treatment behaviour of HIV-infected women: white, African-American, Puerto Rican comparisons. , 1997, AIDS care.

[13]  J. Faithfull.  HIV-positive and AIDS-infected women: challenges and difficulties of mothering. , 1997, The American journal of orthopsychiatry.

[14]  A. Gielen,et al.  Women's disclosure of HIV status: experiences of mistreatment and violence in an urban setting. , 1997, Women & health.

[15]  S. Bunting,et al.  Sources of stigma associated with women with HIV. , 1996, ANS. Advances in nursing science.

[16]  J. Bartlett,et al.  Medical Management of HIV Infection , 1996 .

[17]  R. Greenblatt,et al.  Self-disclosure experience of people with HIV infection in dedicated and mainstreamed dental facilities. , 1996, Journal of public health dentistry.

[18]  A. Demi,et al.  Experiences of disclosure in women infected with HIV. , 1996, Health care for women international.

[19]  B. Rapkin,et al.  Social support and barriers to family involvement in caregiving for persons with AIDS: implications for patient education. , 1996, Patient education and counseling.

[20]  G. Marks,et al.  The prevalence of patient disclosure of HIV infection to doctors. , 1995, American journal of public health.

[21]  G. Mansergh,et al.  Self‐disclosure of HIV infection among men who vary in time since seropositive diagnosis and symptomatic status , 1995, AIDS.

[22]  G. Marks,et al.  Women's self-disclosure of HIV infection: rates, reasons, and reactions. , 1995, Journal of consulting and clinical psychology.

[23]  Mossadeq Ar,et al.  Self-disclosure of HIV-1 antibody test results: the San Francisco General Hospital Cohort. , 1995 .

[24]  G. Marks,et al.  Culturally sanctioned secrets? Latino men's nondisclosure of HIV infection to family, friends, and lovers. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[25]  J. Szapocznik.  Research on disclosure of HIV status: cultural evolution finds an ally in science. , 1995, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[26]  S. Perry,et al.  Self-disclosure of HIV infection to sexual partners after repeated counseling. , 1994, AIDS education and prevention : official publication of the International Society for AIDS Education.

[27]  S. Allen,et al.  The social impact of HIV infection on women in Kigali, Rwanda: a prospective study. , 1994, Social science & medicine.

[28]  S. Quinn.  AIDS and the African American Woman: The Triple Burden of Race, Class, and Gender , 1993, Health education quarterly.

[29]  S. Perry,et al.  Self-disclosure of HIV infection to dentists and physicians. , 1993, Journal of the American Dental Association.

[30]  Robert Bor,et al.  HIV/AIDS and the family: a review of research in the first decade , 1993 .

[31]  T. Patterson,et al.  Identification of psychobiological stressors among HIV-positive women. HIV Neurobehavioral Research Center (HNRC) Group. , 1993, Women & health.

[32]  R. Wolitski,et al.  Men's disclosure of HIV test results to male primary sex partners. , 1992, American Journal of Public Health.

[33]  N. Kass,et al.  Homosexual and bisexual men's perceptions of discrimination in health services. , 1992, American journal of public health.

[34]  G. Marks,et al.  Self-disclosure of HIV infection: preliminary results from a sample of Hispanic men. , 1992, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[35]  G. Marks,et al.  Self disclosure of HIV infection to sexual partners. , 1991, Disease markers.

[36]  T. Coates,et al.  Perceptions of AIDS: the continuing saga of AIDS‐related stigma , 1989, AIDS.

[37]  S. Cochran,et al.  Acquired immunodeficiency syndrome and black Americans: special psychosocial issues. , 1987, Public health reports.

[38]  A. Leonard.  Employment discrimination against persons with AIDS. , 1985, University of Dayton law review. University of Dayton. Law School.

[39]  A. Brandt,et al.  Racism and research: the case of the Tuskegee Syphilis Study. , 1978, The Hastings Center report.