To tell or not to tell: Managing HIV/AIDS disclosure in a low-prevalence context

The aim of the study was to highlight the challenges confronting health service providers and persons living with HIV/AIDS in facilitating serostatus disclosure to partners at risk in a low-prevalence context. Descriptive qualitative research was employed to obtain data through in-depth interviews with a total of 22 service providers and service users in two sexual health clinics in Dublin, Ireland. A thematic analysis of data was undertaken following transcription of interviews. We describe the barriers to HIV/AIDS disclosure from the perspective of service providers and service users. Findings highlight a range of systemic, cultural, gender and personal issues that regulate HIV/AIDS disclosure in a context of socio-cultural and demographic transformation. Several guidelines for managing HIV/AIDS disclosure are currently in use, but these do not reflect the diverse nature of the population of persons using the sexual health service, and the different professional service providers involved in managing the disclosure process. We recommend the development of standardised guidelines that recognise the diversity and peculiarities of persons living with HIV/AIDS, as well as ongoing training of health personnel managing disclosure.