To tell or not to tell? - Disclosure and you

Disclosure of one’s positive status is difficult; often a shock and no two people react in the same way to the news. Responses can range from involvement, caring and support on the one hand, to abandonment, indifference, and antagonism on the other.

1. Should I disclose my HIV-positive status
Whether or not to disclose your HIV-positive status is a difficult decision to make because disclosure (or non-disclosure) is often followed by major and life-changing consequences.

Consider the benefits as well as the negative consequences that disclosure may have for you as individual. Trained counsellors can really assist in helping you weigh these possible consequences up against each other. Because disclosure is a very personal and individual decision, all relevant personal circumstances should be taken into account.

You should also decide if you want full disclosure (i.e. publicly revealing your HIV status) or partial disclosure (i.e. telling only certain people such as, for example, a spouse, relative or friend). Disclosure can be accompanied by the following benefits:

• Disclosure can help you to accept your HIV-positive status and reduce the stress of coping on your own.
• Disclosure can help you to access the medical services, care and support that they need.
• Disclosure can help you to protect yourself and others. Openness about your HIV-positive status may help to negotiate safer sex practices.
• Disclosure may help to reduce the stigma, discrimination and denial that surround HIV/Aids.
• Disclosure promotes responsibility. It may encourage the person’s loved ones to plan for the future.

Disclosure can also be accompanied by negative consequences such as: problems in relationships (e.g. with sexual partners, family, friends, community members, employer or colleagues), rejection, and the conviction that people are constantly judging one.

You should think through all the pros and cons very carefully and plan ahead before disclosing your HIV-positive status.

2. Guidelines to disclose your HIV positive status

The following guidelines may help a person who wants to disclose their HIV positive status.

• Take time to think things through. Disclosure is a process, not an event. Try to think of the implications of disclosure. Consider in advance what the reaction of family, friends, colleagues and others might be. Make sure it is what you want to do. Plan how you are going to do it.
• Be practical. Develop a “plan” before disclosure – who you will inform first, how and where the disclosure will take place, and what the level of disclosure will be.
• It may be a better idea to disclose gradually rather than to everyone at once.
• Choose the person/people you want to disclose to carefully: It must be someone who is accepting, mature, empathic and supportive.
• Make sure that the time and place are right for disclosure
• Identify sources of support, such as support groups for people living with HIV and counselling organisations.
• Counsellors can help you to role play to help you prepare for disclosure.
• Accept yourself just as you are.
• Be prepared for a shocked and even hostile reaction from some people. The people close to you will probably learn to accept your HIV status over a period of time – if not immediately.
• Once a decision to disclose has been made, it may be easier to begin with those nearest to you: relatives, family, friends, or someone to whom you are very close and whom you trust.
• Think about the likely response of the person you decided to disclose to. Assess how much the person you plan to disclose to know and understand about HIV and Aids. This will help you to decide what you need to tell the person and how to tell them. Such preparation will make disclosure less traumatic for both of you.
• Be strong enough to allow others to express their feelings and concerns after your disclosure.
• Get information and support to “live positively”, and make sure that you know how to practise safer sex to protect your sex partner/s.
• If you do not want to disclose your status to somebody, don’t feel unduly pressurised to disclose.
• Ask a counsellor’s help if you need him or her to mediate the disclosure process if the need arises (e.g. to be present when you disclose your HIV-positive status to a partner).
• Keep in mind that disclosure can be very empowering.

Disclosure can be particularly difficult for MSM (men who have sex with men). You might find it difficult to discuss your sexuality with a support group of heterosexuals – who may be prejudiced or who may simply not understand the issues involved. Ask your counsellor to refer you to a support group that is sensitive to the needs of gay men and MSM. Otherwise ask Health4Men if they can point you in the right direction.