Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship betwe en illness disclosure and mental health among an ethnically-diverse group o f women with HIV/AIDS. In the first, and commonly accepted model, illness d isclosure predicts enhanced mental health status. In the second or alternat e model, based on the stigmatization that accompanies HIV/AIDS infection, i llness disclosure predicts poorer mental health. We also explore an alterna te interpretation for this second model, namely that the mental health stat us of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed duri ng the baseline visit for a comprehensive longitudinal study. Results showe d that these women constituted a highly-disclosed population; over one-thir d of them had disclosed their HIV status to their entire social networks. C ontrary to expectation, disclosure was unrelated to mental hearth among the African-American (n = 72) and European-American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher le vels of depression, psychological distress, and reported pain. Regression a nalyses controlling for age, education, and illness severity showed that di sclosure makes a small but independent contribution to the prediction of me ntal health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wid er disclosure. General patterns of disclosure are described and possible ex planations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright (C) 2 000 John Wiley & Sons, Ltd.