Sexual+Disease+Disclosures

Sharday Love

=**Sexual Disease Disclosures**=

Many sexually transmitted infections present no symptoms. If gone untreated they can not only lead to harmful long-term effects, but they can also be spread to a larger population. As a result, disclosing to partners when STIs are discovered is an extremely important, yet difficult, step to be taken. This includes past, current, and future partners that may have been/could be affected. **Deciding to Disclose** Conquering feelings of shame and deciding to actually disclose to partners is the first move. There are, of course, many factors that may influence your personal decision to disclose. For example, Rutledge (2009) identified five common elements that impacted HIV positive men and their personal decision to disclose their positive status to partners: (1) Making sense of having been infected. This includes a wide range of actions such as coming to terms with having the disease; understanding how it was transmitted; considering how the infection would impact one’s life; experiencing anger or resentment towards self, situation, or infecting partner; forgiving the person from whom the disease was contracted; and looking on the bright side. (2) Envisioning sex as an HIV positive man. This involves deciding how to represent oneself to others; establishing views about safer sex; and what sexual experiences and practices to seek. (3) Sorting through feelings of responsibility for others. Can non-disclosure be harmful to partners? Would it be irresponsible and dishonest to NOT disclose? (4) Responding to views of friends and the community. Is there a support system – friends, family, community, counselors, etc. – with positive, encouraging ideas about disclosure? And, (5) anticipating reactions and consequences of disclosure. How one partner reacts could affect if and how the person discloses again to another partner. Although this was a very limited study group of homosexual men, we can imagine that similar factors would influence all of our decisions of whether or not to disclose. **Methods of Disclosure** If the verdict is to disclose, Serovich, Oliver, Smith, and Mason (2005) identified several methods people use to disclose: **Point blank**: Direct disclosure or overt expression of one’s sexually transmitted infection. This can be done in-person, over the phone, in email, via letter, etc. Some people prefer to have the in-person disclosure in a public place or among trust friends in an attempt to minimize chances of violence or negative reactions (Serovich et al, 2005). This plan of public disclosure could, however, backfire. **Stage setting**: Use of a variety of hints and symbols that prime the disclosure event and act as cues that you have the infection (Serovich et al, 2005). This includes verbal hinting, symbolic hinting (like leaving pamphlets where partners will come across them), posting it in online dating profiles, asking a partner about their status first, and insisting on condom usage. Such hinting leads to questioning by the partner and eases into direct disclosure. **Indirect**: The overt disclosure never happens. Occurs when it is believed that partners understand the hints and that hinting is enough. **Buffering**: A third party is used to facilitate disclosure. This could be a person, thing, or event (like an awareness event) but is often times a supportive friend. This method is usually implement when perceived cost of disclosure are great. **Seeking similars**: Surrounding oneself with people you think will be accepting. This includes finding others with the infection or those who are sympathetic to people with the infection. If the infection is incurable, like HIV or herpes, this could mean finding partners who are already infected to help ease disclosure and reduce disclosure related anxieties. **Getting Help** Disclosing can be tough so know that you don’t have to go it alone. Many states offer disclosure assistance programs which help you to notify sexual or needle sharing partners. The Virginia Department of Health (2009) outlined several options that offered by such programs. The first prepares you for **self-disclosure**. A counselor helps you practice what you want to say, you tell your partner that you have the infection, and then the partner is brought in for counseling and treatment. The second is **dual disclosure**. Here, a counselor is present when partners are told and he/she assists with the conversation, answering all questions that the partner may have. Finally, the last is **anonymous third party notification**. This is a popular method because your identity is not disclosed to partners, ensuring anonymity. You simply provide the name and location of partners and a professional health counselor notifies them for you. **Benefits of Disclosure** Disclosing to partners is not only good for them and their partners, but it’s also good for you! Research has found correlations between disclosing and positive psychological well being. Newton and McCabe (2008) found that having herpes or HPV had significant negative impacts on aspects of sexual self-concept. Disclosing seems to restore those views of self-concept to some extent. Those who did disclose reported significantly more positive feelings of sexual self-concept than those who had not disclosed. Disclosers have also been found to be significantly less anxious than non-disclosers (Scrivener, Green, Hetherton, & Brook, 2008). Although fear of rejection and damage to relationships are among the biggest concerns of disclosing, often times it can bring people closer. According to Scrivener et al (2008), partner response was significantly more supportive than was expected. In fact, disclosers reported that their relationships lasted longer and were closer than those who had not disclosed. Indeed, it seems that, for many, the positive benefits of disclosing to others about their STIs are worth it. Disclosers in the Scrivener et al. (2008) study were a lot less likely to report regret about their decision to disclose. However, non-disclosers were a lot more likely to report regret of their decision NOT to disclose. In Serovich, Mason, Bautista, and Toviessi’s (2006) study, HIV positive, homosexual men, overall, did not regret disclosing their status to, not only partners, but also various social network members like family and friends. When there was regret reported, it was more likely to be when disclosing to immediate family, coworkers, and casual sex partners. Even so, the regret was minimum and it was not seen with committed sex partners.

References Newton, D. C., & McCabe, M. (2008). Effects of Sexually Transmitted Infection Status, Relationship Status, and Disclosure Status on Sexual Self-Concept. //Journal of Sex// //Research//, 45(2), 187-192. doi:10.1080/00224490802012909 Rutledge, S. (2009). Formation of Personal HIV Disclosure Policies among HIV-Positive Men Who Have Sex with Men. //AIDS Patient Care & STDs//, 23(7), 531-543. doi:10.1089/apc.2008.0179 Scrivener, L. L., Green, J. J., Hetherton, J. J., & Brook, G. G. (2008). Disclosure of anogenital warts to sexual partners. //Sexually Transmitted Infections//, 84(3), 179- 182. doi:10.11 36/sti.2007.029116 Serovich, J. M., Mason, T. L., Bautista, D., & Toviessi, P. (2006). Gay Men’s Report of Regret of HIV Disclosure to Family, Friends, and Sex Partners. //AIDS Education// //& Prevention//, 18(2), 132-138. Retrieved from EBSCO//host//. Serovich, J. M., Oliver, D. G., Smith, S. A., & Mason, T. L. (2005). Methods of HIV Disclosure by Men Who Have Sex with Men to Casual Sexual Partners. //AIDS// //Patient Care & STDs//, 19(12), 823-832. doi:10.1089/apc.2005.19.823 Virginia Department of Health. (2009, July 27). Disclosure assistance services. Retrieved from http://www.vdh.state.va.us/epidemiology/DiseasePrevention/DAS.htm