Taking into Account the Quality of the Relationship in HIV Disclosure


Despite growing interest in HIV disclosure, most theoretical frameworks and empirical studies focus on individual and social factors affecting the process, leaving the contribution of interpersonal factors relatively unexplored. HIV transmission and disclosure often occur within a couple however, and this is where disclosure has the most scope as a HIV transmission intervention. With this in mind, this study explores whether perceived relationship quality influences HIV disclosure outcomes. Ninety-five UK individuals with HIV participated in a cross-sectional survey. Retrospective data were collected on their perceived relationship quality prior to disclosing their HIV positive status, and on disclosure outcomes. Perceived relationship quality was found to significantly affect disclosure outcomes. Positive qualities in the relationship were associated with positive outcomes, whereas negative qualities were associated with negative outcomes. Results further confirmed that this association was not merely correlational, but demonstrated predictive power. Relationship quality might act as either a risk or a resilience factor in the disclosure process, and thus warrants greater attention in future research.

This is a preview of subscription content, log in to check access.


  1. 1.

    Chaudoir SR, Fisher JD, Simoni JM. Understanding HIV disclosure: a review and application of the disclosure processes model. Soc Sci Med. 2011;72(10):1618–29.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Flowers P, Davis MDM. Understanding the biopsychosocial aspects of HIV disclosure among HIV-positive gay men in Scotland. J Health Psychol. 2012;18(5):711–24.

    Article  PubMed  Google Scholar 

  3. 3.

    Kelly JA, Kalichman SC. Behavioral research in HIV/AIDS primary and secondary prevention: recent advances and future directions. J Consult Clin Psychol. 2002;70(3):626.

    Article  PubMed  Google Scholar 

  4. 4.

    National AIDS Trust. HIV partner notification: a missed opportunity. London: Author; 2012.

    Google Scholar 

  5. 5.

    Rodkjaer L, Sodemann M, Ostergaard L, Lomborg K. Disclosure decisions: HIV positive persons coping with disease-related stressors. Qual Health Res. 2011;21(9):1249–59.

    Article  PubMed  Google Scholar 

  6. 6.

    Hosek S, Brothers J, Lemos D, the Adolescent Medicine Trials Network for HIV/AIDS Interventions. What HIV-positive young women want from behavioral interventions: a qualitative approach. AIDS Patient Care STDs. 2012;26(5):291–7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Black BP, Miles MS. Calculating the risks and benefits of disclosure in African women who have HIV. J Obstet Gynecol Neonatal Nurs. 2002;31(6):688–97.

    Article  PubMed  Google Scholar 

  8. 8.

    Mburu G, Hodgson I, Kalibala S, et al. Adolscent HIV disclosure in Zambia: barriers, facilitators and outcomes. J Int AIDS Soc. 2014;17:1–9.

    Article  Google Scholar 

  9. 9.

    Vyavaharkar M, Moneyham L, Corwin S, Tavakoli A, Saunders R, Annang L. HIV-disclosure, social support, and depression among HIV-infected women living in the rural southeastern united states. AIDS Educ Prev. 2011;23(1):78–90.

    Article  PubMed  Google Scholar 

  10. 10.

    Okareh OT, Akpa OM, Okunlola JO, Okoror TA. Management of conflicts arising from disclosure of HIV status among married women in southwest Nigeria. Health Care Women Int. 2013;36(2):149–60.

    Article  PubMed  Google Scholar 

  11. 11.

    Valle M, Levy J. Weighing the consequences: self-disclosure of HIV-positive status among African American injection drug users. Health Educ Behav. 2008;36(1):155–66.

    Article  PubMed  Google Scholar 

  12. 12.

    Gielen AC, O’Campo P, Faden RR, Eke A. Women’s disclosure of HIV status: experiences of mistreatment and violence in an urban setting. Women Health. 1997;25(3):19–31.

    CAS  Article  PubMed  Google Scholar 

  13. 13.

    Gielen AC, McDonnell KA, Burke JG, O’Campo P. Women’s lives after an HIV-positive diagnosis: disclosure and violence. Matern Child Health J. 2000;4(2):111–20.

    CAS  Article  PubMed  Google Scholar 

  14. 14.

    Arnold EM, Rice E, Flannery D, Rotheram-Borus MJ. HIV disclosure among adults living with HIV. AIDS Care. 2008;20(1):80–92.

    Article  Google Scholar 

  15. 15.

    Bairan A, Taylor GAJ, Blake BJ, et al. A model of HIV disclosure: disclosure and types of social relationships. J Am Acad Nurse Pract. 2007;19:242–50.

    Article  PubMed  Google Scholar 

  16. 16.

    Chaudoir SR, Fisher JD. The disclosure processes model: understanding disclosure decision-making and post-disclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull. 2010;136(2):236–56.

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Amoran OE. Predictors of disclosure of sero-status to sexual partners among people living with HIV/AIDS in ogun state, Nigeria. Niger J Clin Pract. 2012;15(4):385–90.

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Osinde MO, Kakaire O, Kaye DK. Factors associated with disclosure of HIV serostatus to sexual partners of patients receiving HIV care in kabala, Uganda. Int J Gynaecol Obstet. 2012;118:61–4.

    Article  PubMed  Google Scholar 

  19. 19.

    Vu L, Andrinopoulos K, Mathews C, et al. Disclosure of HIV status to sex partners among HIV-infected men and women in cape town, south Africa. AIDS Behav. 2012;16:132–8.

    Article  PubMed  Google Scholar 

  20. 20.

    Katz DA, Kiarie JN, John-Stewart GC, Richardson BA, John FN, Farquhar C. HIV testing men in the antenatal setting: understanding male non-disclosure. Int J STD AIDS. 2009;20(11):765–7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Ehrhardt AA, Exner TM, Hoffman S, et al. A gender-specific HIV/STD risk reduction intervention for women in a health care setting: short- and long-term results of a randomized clinical trial. AIDS Care. 2002;14:147–61.

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Field A. Discovering statistics using IBM SPSS statistics. London: Sage; 2009.

    Google Scholar 

  23. 23.

    Mayers A. Introduction to statistics and SPSS in psychology. London: Pearson; 2013.

    Google Scholar 

  24. 24.

    APA. Reporting standards for research in psychology. Why do we need them? What might they be? Am Psychol. 2008;63(9):839–51.

    Article  Google Scholar 

  25. 25.

    Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60.

    Article  PubMed  Google Scholar 

  26. 26.

    Clark-Carter D. Quantitative psychological research: a student’s handbook. East Sussex: Psychology Press; 2004.

    Google Scholar 

  27. 27.

    Gaskins SW, Payne PF, Sowell RL, Lewis TL, Gardner A, Parton JM. Making decisions: the process of HIV disclosure for rural African American men. Am J Mens Health. 2012;6(6):442–52.

    Article  PubMed  Google Scholar 

  28. 28.

    Nacius LA, Levison J, Minard CG, Fasser C, Davila JA. Serodiscordance and disclosure among HIV-positive pregnant women in the southwestern united states. AIDS Patient Care STDs. 2013;27(4):242–7.

    Article  PubMed  Google Scholar 

  29. 29.

    Stutterheim SE, Shiripinda I, Bos AER, et al. HIV status disclosure among HIV-positive African and afro-caribbean people in the Netherlands. AIDS Care. 2011;23(2):195–205.

    Article  PubMed  Google Scholar 

  30. 30.

    Malaju MT, Alene GD. Women’s expectation of partner’s violence on HIV disclosure for prevention of mother to child transmission of HIV in north west Ethiopia. BMC Res Notes. 2013;6(96):2–6.

    Google Scholar 

  31. 31.

    Seid M, Wasie B, Admassu M. Disclosure of HIV positive result to a sexual partner among adult clinical service users in kemissie district, northeast Ethiopia. Afr J Reprod Health. 2012;16(1):97–105.

    PubMed  Google Scholar 

  32. 32.

    Sendo EG, Cherie A, Erku TA. Disclosure experience to partner and its effect on intention to utilize prevention of mother to child transmission service among HIV positive pregnant women attending antenatal care in addis ababa, Ethiopia. BMC Public Health. 2013;13:765–71.

    Article  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Sarnquist C, Kang J, Moyo P et al. Intimate partner violence and HIV-infection among women in Zimbabwe: a complex interplay. Oral presentation delivered at the American Public Health Association. 2014; Retrieved from https://apha.confex.com/apha/142am/webprogram/Paper312666.html.

  34. 34.

    Loukid M, Abadie A, Henry E, et al. Factors associated with HIV status disclosure to one’s steady sexual partner in PLHIV in Morocco. J Community Health. 2014;39:50–9.

    Article  PubMed  Google Scholar 

  35. 35.

    Lyimo RA, Stutterheim SE, Hospers HJ, de Glee T, van der Ven A, de Bruin M. Stigma, disclosure, coping and medication adherence among people living with HIV/AIDS in northern Tanzania. AIDS Patient Care STDs. 2014;28(2):98–105.

    Article  PubMed  Google Scholar 

  36. 36.

    Edelman EJ, Cole CA, Richardson W, Boshnack N, Jenkins H, Rosenthal MS. Opportunities for improving partner notification for HIV: results from a community-based research study. AIDS Behav. 2014;10:1888–97.

    Article  Google Scholar 

  37. 37.

    Villar-Loubet OM, Bruscantini L, Shikwane M, Weiss S, Peltzer K, Jones DL. HIV disclosure, sexual negotiation and male involvement in prevention-of-mother-to-child-transmission in south Africa. Cult Health Sex. 2013;15(3):253–68.

    Article  PubMed  Google Scholar 

  38. 38.

    Korner H. Negotiating cultures: disclosure of HIV-positive status among people from minority ethnic communities in Sydney. Cult Health Sex. 2007;9(2):137–52.

    Article  PubMed  Google Scholar 

  39. 39.

    Dima AL, Stutterheim SE, Lyimo R, de Bruin M. Advancing methodology in the study of HIV status disclosure: the importance of considering disclosure target and intent. Soc Sci Med. 2014;108:166–74.

    Article  PubMed  Google Scholar 

  40. 40.

    World Health Organization. Gender dimensions of HIV status disclosure to sexual partners: rates, barriers and outcomes. A review paper. Geneva: World Health Organization; 2004.

    Google Scholar 

  41. 41.

    Finkenauer C, Engles RCME, Branje SJT, Meeus W. Disclosure and relationship satisfaction in families. J Marriage Fam. 2004;66(1):195–209.

    Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Charlotte Smith.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Smith, C., Cook, R. & Rohleder, P. Taking into Account the Quality of the Relationship in HIV Disclosure. AIDS Behav 21, 106–117 (2017). https://doi.org/10.1007/s10461-016-1323-z

Download citation


  • Disclosure
  • HIV transmission
  • Relationship quality