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Disclosing HIV Serostatus to Family Members: Effects on Psychological and Physiological Health in Minority Women Living with HIV

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Abstract

Background

Directly disclosing a positive HIV serostatus to family members can have psychological and physiological health benefits. Perceptions that one is in a supportive family environment may enhance these benefits.

Purpose

We examined a mediated moderation model in which we expected interactions between serostatus disclosure to family members and HIV-specific family support to be associated with women’s perceived stress, which in turn would explain depressive symptoms and 24-h urinary cortisol in women living with HIV (WLWH).

Method

Low-income ethnic minority WLWH (n = 82) reported the percentage of family members they had directly disclosed their serostatus to, perceptions of HIV-related support from family members, perceived stress, and depressive symptoms. Cortisol was measured via 24-h urinary collection.

Results

Disclosure to spouses and children coupled with high levels of family support was associated with higher levels of depressive symptoms in women. For disclosure to spouses, this relationship was explained by higher perceived stress. Direct disclosure to mothers in tandem with high support was associated with lower cortisol, and this relationship was explained through higher levels of perceived stress.

Conclusion

The effects of serostatus disclosure on perceived stress and health in WLWH may depend, in part, on women’s family environment and to whom they disclose to within that environment.

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Notes

  1. Because disclosure to spouses was associated with lower viral load (Table 1), we re-conducted the analysis with viral load as an additional covariate. No appreciable differences emerged in the magnitude or direction of the associations described in the text.

  2. Because disclosure to children was associated with higher viral load (Table 1), we re-conducted the analysis with viral load as an additional covariate. No appreciable differences emerged in the magnitude or direction of the associations described in the text.

  3. Because some of the women in this analysis were married, and could potentially be receiving support from their spouses, we re-conducted the analysis with only women who were married and had disclosed to their children while controlling for spousal support. No appreciable differences emerged in the patterns of findings described in the text.

  4. Because some of the women in these analyses were married, we re-conducted these analyses with only women who were married and had disclosed to their mothers while controlling for spousal support. No appreciable differences emerged in the patterns of findings described in the text.

  5. Because disclosure to children was associated with higher viral load (Table 1), we re-conducted the analysis with viral load as an additional covariate. No appreciable differences emerged in the magnitude or direction of the associations described in the text.

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Author information

Authors and Affiliations

  1. Department of Psychology, University of Miami, 5665 Ponce de Leon Boulevard, Coral Gables, FL, 33146, USA

    Erin M. Fekete, Michael H. Antoni & Neil Schneiderman

  2. California School of Psychology, Alliant International University, Los Angeles, USA

    Ron Durán

  3. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA

    Brenda L. Stoelb

  4. Department of Psychiatry and Behavioral Sciences, University of Miami, Cable Gobles, USA

    Mahendra Kumar

Authors
  1. Erin M. Fekete
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  2. Michael H. Antoni
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  3. Ron Durán
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  4. Brenda L. Stoelb
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  5. Mahendra Kumar
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  6. Neil Schneiderman
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Corresponding author

Correspondence to Erin M. Fekete.

Additional information

This research was supported by National Institute of Mental Health grants PO1 MH49548 and T32 MH18917-17.

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Fekete, E.M., Antoni, M.H., Durán, R. et al. Disclosing HIV Serostatus to Family Members: Effects on Psychological and Physiological Health in Minority Women Living with HIV. Int.J. Behav. Med. 16, 367–376 (2009). https://doi.org/10.1007/s12529-009-9041-9

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  • DOI: https://doi.org/10.1007/s12529-009-9041-9

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