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. Author manuscript; available in PMC: 2024 Dec 1.
Published in final edited form as: AIDS Care. 2023 Mar 13;35(12):1982–1997. doi: 10.1080/09540121.2023.2188159

Table 4.

Summaries of the outcome measure and impact of HIV disclosure (qualitative studies)

First Author Outcome variable(s) HIV disclosure measure Associations
Disclosure recipient1 Response Theoretical framework
1. Liu Y, et al. 2016 The barriers to and facilitators of linkage to and engagement in HIV care Potential embarrassment of meeting non-gay acquaintance, such as colleagues, friends, and family members in the hospital and the concern that their records of seeking HIV care and their records of seeking HIV care and their gay identity would be documented and reported to the government or linked to future healthcare plans, influenced decisions to avoid the available HIV care services. N/A None Fear of disclosing one’s HIV and homosexuality status in the hospital setting was one of the major barriers of linkage to/engagement in HIV care.
2. Graham SM, et al. 2018 Barriers to and facilitators of HIV care engagement and ART adherence Family members (e.g., sister) and friends last year Provide valuable social support Access-Information, Motivation, and Behavioral Skills (IBM) model Disclosure of HIV status is one of the behavioral skills in the conceptual model of HIV care engagement (i.e., entry in care, ART initiation, ART adherence, retention in care).
3. Chakrapani Venkatesan, et al. 2011 Barriers to ART access (no specific definition) Family members N/A Multilevel framework analysis (family/social level, healthcare system level, individual level) Lack of HIV disclosure to family members precludes family support to initiate ART.
MSM who disclosed their HIV status were motivated to take ART in order to support their families. Some MSM declined follow-up or treatment because of fear of HIV disclosure and subsequent serious adverse consequences if their HIV-positive status were revealed to others. Strong motivations to keep one’s HIV-positive status and same-sex attraction secret were interconnected with sexual prejudice against MSM and transgender. Consequences of disclosure, including rejection by family, eviction from home, social isolation, loss of subsistence income, and maltreatment within the healthcare system, presented powerful disincentives to accessing ART.
4. Bui H, et al. 2017 Barriers to access and uptake of ART

  1. sex partner

  2. female spouse

  3. Police

  1. fear of starting treatment would lead to HIV disclosure to sex partner

  2. Men felt more responsibility to disclose HIV status to spouse

  3. Not disclose to police discontinued ART during incarceration

 Multi-level factors: individual barriers, societal barriers, and health system barriers Not comfortable to disclose HIV status to police resulting in discontinued ART during incarceration. Fear of being stigmatized or discriminated against after HIV disclosure limited their opportunities to connect with HIV testing and care services.
6. Wei CY, et al. 2014 Barriers and facilitators to HIV testing and treatment

  1. partners and close friends

  2. parents or family members

 1. Would only disclose HIV status to a few people, such as partners and close friends; 2. Would not disclose to parents or family members because it will bring shame to the family Ecological model and Health Belief Model to guide the interview HIV non-disclosure to families was one of the interpersonal barriers to ART treatment.
7. Arnold E.A., et al. 2017 Seeking regular care and treatment (no specific definition) General friends, family or sexual partners Some participants disclosed HIV status, but roughly a third were more secretive about their status, and therefore receiving little to no social support for remaining in care None HIV disclosure helped to stay on treatment and in care by eliciting support from family or friends.
8. Hoffman M, et al., 2016 Access to HIV diagnosis, linkage to care, retention in care, ARV provision, or continued treatment to achieve viral suppression (no specific definition). Did not specify the target, just a general disclosure N/A None All MSM feared the disclosure of HIV and reported common experiences with HIV-related stigma, discrimination, violence, and homophobia. Fear of disclosure limited access to all care stages. Quote: “I saw someone I knew, and I left. I didn’t want to pick up the [test] result.”
9.Lazuadi E, et al., 2020 Treatment uptake Disclose to family members, sexual partners, and friends

  1. Seeking support from the family;

  2. End of relationships after disclosing to sexual partners

  3. Difficulty to re-connect with main social network after disclose to friends

 Socio-ecological model Fears relating to unwanted disclosure of HIV status also inhibited and impeded treatment initiation. This fear of disclosing HIV status was magnified by concerns about having to tell other people about their sexual practices.
10. Carnes, et al. 2020 Engagement in medical care (engaged, delayed, inconsistent, and detached) Disclosure to any person

  1. Seeking support from the family

  2. Taking care of them

  3. Assist with medical care engagement

 Social network resources assist PLWH with care engagement The findings suggest that disclosure did not uniformly facilitate or impede linking to or sustaining engagement in care. It observed no patterns. Disclosure and social support’s role in improving care is complex.
11. Nakiganda, L.J., et al., 2022 Engagement with HIV care and treatment services Disclosure to health care providers Repeated disclosures were required due to high staff turnover Socio-ecological model Fears relating to the risk of disclosure of HIV status spreading from health services to communities undermined uptake of treatment services.
1

All the studies did not report HIV disclosure process.