Disclosure not automatically linked to mental well-being
Individuals who choose not to disclose their HIV status are not more likely to suffer from depression or anxiety, have more problems with treatment adherence or worse HIV outcomes, according to a large study presented at the British HIV Association (BHIVA) conference in Brighton last week.
Being able to talk about your HIV status is often considered an essential part of living well with HIV, although data supporting this theory is limited. The Antiretrovirals, Sexual Transmission Risk and Attitudes (ASTRA) study included 3258 people attending 8 different clinics in the United Kingdom. It looked at disclosure of HIV status to stable partners, family, friends and work colleagues, within different groups of people living with HIV between 2011 and 2012.
All participants were asked if they had disclosed their HIV status and to whom. A significant minority had not talked about their HIV status with anyone at all - 5% of gay men, 16% of women and 17% of heterosexual men. Across all groups, individuals who had been recently diagnosed, black people and older people were less likely to disclose their HIV status. Gay men belonging to an organised religion were also less likely to disclose.
The study revealed that mental health issues and adherence problems were not associated with disclosure, as they were common under all respondents regardless their disclosure status. Other factors, including low levels of social support, symptoms of depression or anxiety, adherence problems and a detectable viral load were also not more common among people who had not disclosed their status to anyone. The study suggests that a selective disclosure strategy is associated with better health outcomes and concludes that non-disclosure appears to be a way of coping, which is not necessarily linked to poor mental health or difficulty managing treatment.