Privacy and Disclosure of HIV in Interpersonal Relationships: A Sourcebook for Researchers and Practitioners

By Kathryn Greene; Valerian J. Derlega et al. | Go to book overview

CHAPTER ONE
Introduction

The HIV epidemic has now enteredits third decade. Being diagnosed with HIV in 2003 is not the same as in 1983 or even 1993 (e.g., Vazquez-Pacheco, 2000). There have been many changes in the medical management of HIV since the outbreak of the epidemic (e.g., Catz & Kelly, 2001; Sepkowitz, 2001), including the introduction of new combination therapies with promising effects (Bartlett & Gallant, 2001; Hammer, 2002). Yet there is still no vaccine available in the immediate future (Haney 2002). Individuals infected with HIV with access to combination drug therapies have increased life-span estimates when compared with early epidemic figures, but these drugs may have serious side effects, do not work for all patients, and are not widely available in many countries (Epstein & Chen, 2002). This bookis particularly relevant in describing what occurs in countries where the combination therapies (including protease inhibitors) became widely available in the mid to late 1990s and as a consequence where there has been a significant decline in AIDS deaths and reduction in physical symptoms associated with HIV disease. Despite these encouraging medical advances, an HIV diagnosis creates significant anxiety and distress about one's health, self-identity and close relationships (e.g., Chesney & Smith, 1999; Holt et al., 1998; Winstead et al., 2002).

The profile of persons with HIV has changed, but stigma linking HIV to groups such as men who have sex with men (MSM) and injection drug users (IDUs) continues to persist despite changes in the profile of the epidemic and extensive educational campaigns addressing transmission (Herek & Capitanio, 1999; Herek, Capitanio, & Widaman, 2002). Today, most HIV infections in the world derive from heterosexual transmission, “a fact that is still overlooked by many” (Sepkowitz, 2001, p. 1765). Academic research and health outreach efforts have turned to the personal relationships of people with HIV and to their social interactions with others (see Derlega & Barbee, 1998a; Derlega, Greene, & Frey 2002; Greene, Frey, & Derlega, 2002). This research and outreach work certainly connects with existing educational campaigns, for example, those targeting transmission routes and stigma, but it differs importantly in its focus on the quality of

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