Disclosure and stigma: A cultural perspective

Abstract

Disclosure or nondisclosure as a phenomenon is complex, with many variants that impact on the process of disclosure, as well as the experiences of the person living with HIV (PLWHA) who discloses his or her HIV status. This complexity lies in the close link between disclosure, stigma, and culture. High stigma levels prevent disclosure, and disclosure practices vary greatly according to cultural practices and beliefs. The choice of disclosure should always be a well informed and responsible decision involving both the PLWHA and health-care workers. Even if the PLWHA is well informed, the results following disclosure are always mixed. However, disclosure by others without the consent of the PLWHA is also a reality that the PLWHA has to face. Most health literature seems to favour disclosure by persons living with HIV. This is not necessarily always to the advantage of the person disclosing his/her status and there could be some normalcy in not disclosing. In this chapter, a comprehensive framework for the HIV disclosure process is provided, focusing on categories of disclosure, factors before disclosure, as well as factors during and after the process of disclosure. Responsible disclosure management is a shared experience between the PLWHA and the health-care workers involved in their care. To conclude this chapter, a practical approach to responsible disclosure management is offered.