To tell or not to tell those around you that you are HIV-positive? This is the question that every person living with HIV (PLHIV) asks themselves at some point and which is not without consequences. A British study looked at the issue of non-disclosure of HIV status (the fact of not talking regarding it) and its impact on adherence to antiretroviral treatment, reports the site Info-VIH. Disclosure of HIV status to family, friends and/or a stable partner may be linked to improved health outcomes for people living with HIV. But what regarding maintaining secrecy? What are the risks incurred or the expected benefits of disclosing one’s HIV status? The Astra (Antiretrovirals Sexual Transmission Risks and Attitudes) study assessed whether non-disclosure is associated with psychological symptoms, non-adherence to antiretroviral therapy and non-suppression of viral load. A total of 3,258 PLHIV in the UK completed the confidential ASTRA study questionnaire (2011-2012). Participants indicated whether they had told anyone else that they were HIV-positive and to whom: friends, family, work colleagues, stable partner. Among participants, the prevalence of not disclosing to anyone was 16.6% among heterosexual men, 15.7% among women, and 5.0% among MSM (men who have sex with men). men). MSM were more likely to disclose to some or all of their friends than to family (85.8% versus 59.9%), while heterosexuals were less likely to disclose to their friends than to their family (44.1% once morest 61.1% for men, 57.5% once morest 67.1% for women). Moreover, among the 1,631 participants with a stable partner, non-disclosure to a stable partner was 4.9% for MSM, 10.9% for heterosexual men and 13.0% for men who have sex with men. women. There was no evidence that non-disclosure overall (vs. disclosure to anyone) was associated with low social support, symptoms of depression or anxiety, non-adherence to treatment or non-suppression of viral load in MSM or heterosexual people. However, compared to MSM who disclosed to ‘none’ or ‘some’ friends and family, MSM who disclosed to ‘most or all’ of those around them were more likely to have symptoms of depression, anxiety and reporting non-adherence to ARV treatment. The study does not say whether the psychological disorders were pre-existing to the disclosure or whether it is possible serophobic reactions that explain the presence of the symptoms. These results are encouraging and may be useful in informing discussions between patients and healthcare professionals regarding the support available to those who choose not to disclose their status.
