Women living with HIV: Disclosure, violence, and social support

This paper describes the frequency of women's disclosure of their HIV statu s, examines the extent to which they experience adverse social and physical consequences when others learn they are infected, and analyzes correlates of these negative outcomes. There were 257 HIV-positive women between the a ges of 18 and 44, recruited from HIV/AIDS primary care clinics and from com munity sites, who completed a face-to-face interview. Women in the sample w ere 33 years old on average; 92% were African-American; 54% had less than 1 2 years of education; 56% had used intravenous drugs; and 30% knew they wer e HN positive for 5 or more years. There were 97% who disclosed their HIV s tatus; 64% told more than 5 people. Negative consequences associated with o thers knowing they were HN-positive were reported by 44%, most commonly the loss of friends (24%), being insulted or sworn at (23%), and being rejecte d by family (21%). There were 10 women (4%) who reported being physically o r sexually assaulted as a result of their being HIV positive, and 16% repor ted having no one they could count on for money or a place to stay. Violenc e was widespread in this sample, with 62% having experienced physical or se xual violence, including sexual abuse or rape (27%), being beaten up (34%), and weapon-related violence (26%). Logistic regression analysis indicated that women with a history of physical and sexual violence were significantl y more likely to experience negative social and physical consequences when their infection became known to others, adjusting for age and the number of people women had disclosed to, both of which were only marginally signific ant. Farmer notification policies and support programs must be responsive t o the potential negative consequences associated with others learning that a woman is HIV positive. The high rates of historical violence in the lives of women living with HIV underscore the need for routine screening and int ervention for domestic violence in all settings that provide health care to HIV-positive women.