Barriers and enablers of HIV serostatus disclosure among haitian immigrants in New York City

Disclosure of sensitive information such as one's HIV serostatus is an emotionally difficult task for people living with HIV. On the one hand, disclosure can lead to social support, condom use and medication adherence. On the other, disclosure can lead to rejection and stigmatization. Although the recent changes in the 22-year-old travel and immigration ban against people with HIV has led to an increase in the number of HIV-positive people who have traveled to the U.S, few studies have examined how HIV-positive immigrants living in the U.S. manage the disclosure process. In this paper, we employed the Disclosure Processes Model to examine the disclosure experiences of 21 HIV-positive Haitian immigrants in New York City. Data were collected through in depth interviews between May 2012 and January 2013. Analysis of the interviews yielded several enablers relevant to reasons for disclosure including participants being in a close relationship with someone they trusted or felt comfortable with, and the need for support and understanding about the illness. Some of the barriers to HIV serostatus disclosure were fear of being stigmatized, rejected, and not wanting to be perceived as promiscuous. For participants who had disclosed to significant others in the U.S. and in Haiti, they reported that they experienced both positive and negative outcomes including social support, emotional relief, encouragement to take their medication and on some occasions mistreatments, isolation, and stigma. These findings suggest the need for innovative interventions to address HIV stigma in immigrant communities in order to promote HIV serostatus disclosure.