Serostatus Disclosure and Identity Management Among HIV-positive gay men in Ireland

Abstract

Background: HIV serostatus disclosure is most often construed as a transmission reduction strategy by health professionals. We explored the lived experience of disclosure to sex partners among HIV-positive gay men. Methods: 15 in-depth interviews were conducted with HIV-positive gay men, and were analysed using grounded theory. Findings: The following themes were elaborated: (1) Protective non-disclosure: Discourses portrayed seropositivity as a moral failure rather than the result of viral exposure, and non-disclosure protected a discreditable identity. (2) Rejective non-disclosure: Interviewees refused association with other HIV-positive gay men, characterised as damaged and dysfunctional, and rejected disclosure as allowing oneself to be defined by an illness. (3) Moral non-disclosure: Personal infection was presented as a temporary moral lapse, which when contrasted with a renewed morality and responsibility, made non-disclosure to partners ethical. Discussion: The findings highlight the role of disclosure in identity management, in contrast with usual conceptions of disclosure, and the need for a more nuanced approach in the design of transmission reduction interventions.