the interpersonal relationships of those with HIV (see Derlega & Barbee, 1998a; Greene & Serovich, 1998).
One key feature that needs to be understood to address HIV issues is the process of disclosing about an HIV diagnosis. People report great stress around disclosure decisions (e.g., Holt et al., 1998), and the actual revelation itself can become an added trauma (Limandri, 1989). Vazquez-Pacheco (2000) described the dilemma:
So when exactly do you bring it up? When do you talk about serostatus? Is there ever a good time to talk about it?… When to have that disclosure discussion remains one of the most difficult decisions for an individual to make in this epidemic, (p. 22)
Not all people with HIV disclose their infection (see chap. 3), but failure to disclose has potential to harm the self, others, and close relationships. Disclosure of HIV status is crucial for both the individual's health and broader health prevention efforts. The goal of this book is to bring together a wide spectrum of information from research literature and organize it into a cohesive framework to generate new questions and identify critical issues about HIV disclosure. One way to provide an organizational structure is to use a theoretical formulation to synthesize research findings in a systematic fashion. We depend on the theory of communication privacy management (CPM) in this book to give us a way to understand the choices that people diagnosed with HIV make about disclosing this information to others (Petronio, 2002). Using a theoretical foundation gives us a way to organize existing information in a more meaningful way to establish additional paths for new research endeavors and more fully understand the existing information. By doing this, we can help those with HIV and those who try to help people with HIV come to some understanding of practical approaches they might take to cope with this disease. This introduction reviews HIV and AIDS statistics, addresses what constitutes disclosure, describes the importance of disclosure, overviews the chapters in the book, and finally reviews the interviews used for the book. First, we turn to a profile of the epidemic worldwide and in the United States.
The United Nations Program on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) reported that through the end of 2001 there were an estimated 40 million people living with HIV around the world (UNAIDS/WHO, 2001). The majority of these HIV cases are in developing countries (95%). There were nearly 3 million AIDS-related deaths estimated in 2001, with nearly 22 million people worldwide who have died from AIDS (Sepkowitz, 2001). Despite earlier estimates predicting the HIV epidemic would peak by 2000, the latest calculations announced at the XIV annual Conference on AIDS in Barcelona, Spain in July of 2002 indicated AIDS will cause an additional 65 million deaths by 2020.