Should not include pressure for someone to disclose
Is a confidential conversation that assists clients to work through the issues related to telling others about their HIV-status
Is important to reduce stigma, enhance adherence to care and treatment, and reduce the spread of HIV
Is intended to promote informed decisions about whether or not to disclose HIV-status and, if so, to whom
Assists and supports people who have decided to disclose their status
Enhances coping strategies following disclosure
Is an ongoing process that requires preparation, practice and follow-up support
General approach to disclosure counseling:
Use good communication and counseling skills (e.g., good body language, ask open ended questions, summarize and reflect, etc.).
Discuss the advantages and disadvantages of disclosure specific to the person’s life.
Help the person to identify barriers and fears about disclosure.
Explore possible options to overcome barriers.
Encourage the client to take the time needed to think things through.
Talk about sexual partners who need protection from HIV infection.
Identify sources of support.
Support clients to make their own decisions about disclosure.
Peer Educators can help prepare clients who choose to disclose by:
Helping to decide whom to disclose to, when and where (using the disclosure circles discussed before)
For parents or caretakers, deciding what type of information is most understandable for a child, given the child’s age and development
Planning for a good place and time to have the conversation (for example, when the children are asleep and when no one else can hear)
Helping people weigh the advantages and disadvantages to disclosure to different people in their lives
Assisting the client to anticipate likely responses
Practicing disclosure through role-plays with clients, including how they will start the conversation. For example,
- “I wanted to talk to you about something because I know you can help and support me.”
- “I went to the clinic today for a check-up and they talked to me about how it is important for everyone to get an HIV test because you can’t tell if someone has it by looking at them.”
- “I want to talk with you about something very important right now. I am talking to you about it because I love you and I trust you.”
- “I need to talk to you about something difficult right now. It is important for our family that I be able tell you even the hard things. We need to support each other.”
Providing practical suggestions, ongoing support and reassurance
Planning the next steps and scheduling a time for follow-up counseling