A qualitative investigation into the HIV disclosure process within an intimate partnership: ‘the moment I realized that our relationship was developing into something serious, I just had to tell him’

Objectives. This study sought to elucidate the process through which people living with HIV (PLWH) in the United Kingdom disclose their status to an intimate partner (IP).
Design. A qualitative cross-sectional survey design was used.
Method. A total of 95 PLWH took part. They were presented with a series of open-ended questions enquiring into their last experience of disclosing to an IP. The data was analyzed using thematic analysis.
Results. Disclosure became a salient issue when the discloser acknowledged their relationship as meaningful. A decision to tell was mostly made in order to build a foundation for the evolving relationship. Once the decision was made, it was enacted via one of two mechanisms (self-initiated or opportunistic) and partners’ reported reactions fell within one of four main reaction types. In the long-term for couples that remained together, disclosure was understood to have brought them closer. However, for both those whose relationships remained intact, and for those whose relationship had since broken down, sexual difficulties associated with being in a sero-discordant partnership pervaded. At a personal level, the experience resulted in increased confidence in living the diagnosis, and an increased sense of disclosure mastery.
Conclusions: Disclosure is a highly nuanced process. In particular, it was found to be largely characterized by the IP relational context in which it was occurring. The clinical and theoretical implications of these findings are discussed. In particular, these findings highlight a need for the provision of long-term support to PLWH in negotiating their relationships throughout the process.