Communication Privacy Management
and HIV Disclosure
People who are HIV positive must confront a series of difficult decisions when they consider disclosing their HIV status. This chapter offers a theoretical map that lays a foundation to understand when people choose to reveal their HIV diagnosis, when they refrain from making that status known to others, and the consequences of these choices. To study how and why people conceal or reveal their HIV status, we apply Petronio's (2002) theory of communication privacy management (CPM) to understand the decisions people with HIV make about disclosing or concealing their illness (e.g., Greene & Faulkner, 2002; Greene & Serovich, 1996; Petronio, 2000a; Petronio, Reeder, Hecht, & Mon't Ros-Mendoza, 1996; Yep, 2000).
Focusing on the CPM theory gives us a heuristic to illustrate the interconnection between opening up and disclosing about the HIV diagnosis or withholding information. People are social beings with needs to connect as well as needs to separate from others. In many ways, this is the paradox of the HIV dilemma. There are conditions that justify withholding information about a person's HIV status from others. Colleagues at work might disengage interpersonally if they know, family members might find it difficult to cope with the knowledge, and friends may not understand how to help. For example, MSM may conceal their HIV status when others do not know their sexual orientation (e.g., Marks et al., 1992). Yet, to obtain the much needed social support or because others may be affected, disclosure is necessary. The key to navigating the markers between private lives and shared ones is people's decisions to open up completely partially, or keep their privacy boundaries closed. However, every decision has a consequence that may complicate future privacy maintenance depending on who is told, when someone is told, how much is told, and what is told about the diagnosis.
CPM is a practical theory that is applied to understand the way that people manage the dialectical tensions of disclosure and privacy of an HIV diagnosis