HIV Status Disclosure among Older African American Men Who Have Sex with Men and Women

Thesis (Ph.D.)--University of Washington, 2016-06

University of Washington Abstract HIV Status Disclosure among Older African American Men Who Have Sex with Men and Women Steven C. Simpkins Chair of the Supervisory Committee: Sarah Shannon School of Nursing HIV has become a chronic illness rather than a terminal diagnosis over the past three decades. Increasing numbers of HIV infected adults are growing old while continuing to enjoy active sex lives. Older African American men who are HIV infected and have sex with men and women are an important group to focus on around prevention of HIV infections through disclosure because of their interactions with both genders. Existing theoretical models provide sparse guidance around how older African American (AA) men who have sex with men and women (MSMW) may experience the process of disclosing their HIV status; specifically, they offer little information about the cultural or community-based experiences that might mediate the disclosure experience for AA MSMW. This study used a directed content analysis approach based on an existing model and the experiences of nine AA MSMW over the age of fifty from a local HIV clinic. It is grounded in the Disclosure Processes Model of HIV status disclosure. Chapter 2 examines the current literature as it applies to HIV status disclosure for older adults, African Americans, and men who have sex solely with men as well as those who have sex with men and women. Chapter 3 explores four models of HIV-status disclosure that sequentially describe the theoretical processes of disclosure that lead up to the Disclosure Processes model. Finally, Chapter 4 presents the experiences of HIV status disclosure of the participants of an online focus group and draws conclusions about these experiences enhance the current theoretical model as it applies to this unique population.