Frye V., Fortin P., MacKenzie S., Purcell D., Edwards L.V., Mitchell S.G., Valverde E., Garfein R., Metsch L., Latka M.H.
Steinhardt School of Culture, Education, and Human Development, New York University, New York, United States; New York City Department of Health and Mental Hygiene, New York, NY, United States; University of California San Francisco, San Francisco, CA, United States; Sojourner Douglass College, Baltimore, MD, United States; Health and Productivity Research Division, Thomson Medstat, Washington, DC, United States; Friends Social Research Center, Baltimore, MD, United States; Centre for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Division of AIDS Prevention, Atlanta, GA, United States; School of Medicine, University of California San Diego, San Diego, CA, United States; Miller School of Medicine, University of Miami, Miami, FL, United States; Aurum Institute, Johannesburg, South Africa
Frye, V., Steinhardt School of Culture, Education, and Human Development, New York University, New York, United States; Fortin, P., New York City Department of Health and Mental Hygiene, New York, NY, United States; MacKenzie, S., University of California San Francisco, San Francisco, CA, United States; Purcell, D., Sojourner Douglass College, Baltimore, MD, United States; Edwards, L.V., Sojourner Douglass College, Baltimore, MD, United States; Mitchell, S.G., Health and Productivity Research Division, Thomson Medstat, Washington, DC, United States, Friends Social Research Center, Baltimore, MD, United States; Valverde, E., Centre for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Division of AIDS Prevention, Atlanta, GA, United States; Garfein, R., School of Medicine, University of California San Diego, San Diego, CA, United States; Metsch, L., Miller School of Medicine, University of Miami, Miami, FL, United States; Latka, M.H., Aurum Institute, Johannesburg, South Africa
Disclosure of HIV status to potential and current sex partners by HIV-positive people (HIVPP) is a complex issue that has received a significant amount of attention. Research has found that disclosure depends upon the evaluation by HIVPP of potential benefits and risks, especially of the risks stemming from the profound social stigma of HIV and AIDS. Drawing on concepts from Goffman's classic stigma theory and Anderson's more recently developed cultural-identity theory of drug abuse, we analyzed data from in-depth, post-intervention qualitative interviews with 116 heterosexually active, HIV-positive injection drug users enrolled in a randomized trial of a behavioral intervention to prevent HIV transmission. We explored how disclosure experiences lead to identity impacts defined as: (1) identity challenges (i.e. interactions that challenge an individual's self-concept as a normal or non-deviant individual); and (2) identity transformations (i.e. processes whereby an individual comes to embrace a new identity and reject behaviors and values of an old one, resulting in the conscious adoption of a social and/or public identity as an HIV-positive individual). Participants engaged in several strategies to manage the identity impacts associated with disclosure. Implications of these findings for research and prevention programming are discussed.