Abstract
Latinos in the USA have lower levels of disclosure and higher levels of HIV-related stigma when compared to non-Hispanic whites. However, the nature of the stigma-disclosure relation has not been fully explored. We hypothesize that the path between HIV-related stigma and disclosure may be through a mediating attitude toward disclosure. As a secondary hypothesis, we predicted differences in the strength of association that cognitive attitudes and affective attitudes share with disclosure. We interviewed 241 HIV-positive individuals on HAART at an outpatient clinic in El Paso, Texas, a large city that borders Mexico. The significant association between HIV-related stigma and HIV disclosure was fully mediated by attitudes toward disclosure. In addition, the differences between correlations (i.e., both affective and cognitive attitudes with disclosure behaviors) were statistically significant for family members and casual sex partners (Steiger’s Z-test, Z = 5.15 and 2.54, ps < .01). Our model of disclosure-related attitudes suggests that as stigma becomes more salient, negative evaluations about disclosing may become more important during the disclosure decision-making process. Also, despite evidence from the literature that disclosure to certain targets (e.g., intimate partners) may occur for emotional reasons related to catharsis or emotional relief, our data suggest that cognitive appraisals (e.g., responsibility to educate) are more strongly related to disclosure rates to family members and casual sex partners.
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Acknowledgments
This research was based on data collected for the M.A. thesis of the first author. It was supported by grant 1R34 MH08674 and MH084674-S from the National Institute of Mental Health. We are grateful to the patients and staff of Centro de Salud Familiar La Fe CARE Center, Inc., for their participation and facilitation of this study. Jessica Armendariz, Teresa Frias, Carolina Lara, Chrisie Lemon, Virginia Longoria, Elsa Martin, Antonio Martinez, Miriam Pando, Tatiana Rodriguez, Giselle Sanchez, and Cesar Villareal Ramos assisted with data collection, entry, and analysis.
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Sauceda, J.A., Wiebe, J.S., Rao, D., Pearson, C.R., Simoni, J.M. (2013). HIV-Related Stigma and HIV Disclosure Among Latinos on the US-Mexico Border. In: Liamputtong, P. (eds) Stigma, Discrimination and Living with HIV/AIDS. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6324-1_11
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