HIV Disclosure

Disclosure Counseling

Disclosure counseling:

       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