Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention

This study investigated the disclosure of HIV-positive serostatus to sexual partners by heterosexual and bisexual men, selected in centers for HIV/AIDS care. In 250 interviews, we investigated disclosure of serostatus to partners, correlating disclosure to characteristics of relationships. The focus group further explored barriers to maintenance/establishment of partnerships and their association with disclosure and condom use. Fear of rejection led to isolation and distress, thus hindering disclosure to current and new partners. Disclosure requires trust and was more frequent to steady partners, to partners who were HIV-positive themselves, to female partners, and by heterosexuals, occurring less frequently with commercial sex workers. Most interviewees reported consistent condom use. Unprotected sex was more frequent with seropositive partners. Suggestions to enhance comprehensive care for HIV-positive men included stigma management, group activities, and human rights-based approaches involving professional education in care for sexual health, disclosure, and care of "persons living with HIV".

The Hidden Truths of Self-Presentation, Self-Disclosure, and Deception on Online Dating Profiles: A Call for Change

The way in which individuals seek romantic partners has changed considerably in the past decades, most notably through online dating sites (ODSs). Despite the possibility of misrepresentation amongst client users, such sites continue to grow in popularity because ODSs provide a large pool from which individuals can select and attract potential partners. While much research has been undertaken on ODSs, little empirical research has examined postsecondary students’ use of ODSs. Therefore, this study sought to investigate why postsecondary students have become involved with and how they present themselves on ODSs. The researcher surveyed 20 postsecondary students and conducted in-depth interviews with 2 participants who use ODSs. Although the limited sample prevented results from being generalized, quantitative and qualitative analyses suggest that participants became involved with ODSs for various purposes, such as seeking long-term relationships and/or marriage partners, or simply exploring or visiting ODSs out of curiosity. Findings indicate that ODS users’ physical appearance and/or “attractiveness” is considered the strongest predictor of relationship success. The study discusses how participants’ self-presentation affects outcomes of ODS usage, particularly when negative self-identification and presentation corresponding to factors such as individuals’ weight and age are taken into account.

Self-disclosure and privacy calculus on social networking sites: the role of culture

Social Networking Sites (SNSs) have become extremely popular around the world. They rely on user-generated content to offer engaging experience to its members. Cultural differences may influence the motivation of users to create and share content on SNS. This study adopts the privacy calculus perspective to examine the role of culture in individual self-disclosure decisions. The authors use structural equation modeling and multi-group analysis to investigate this dynamics. The findings reveal the importance of cultural dimensions of individualism and uncertainty avoidance in the cognitive processes of SNS users.

"It won't happen to me!": self-disclosure in online social networks

Despite the considerable amount of self-disclosure in Online Social Networks (OSN), the motivation behind this phenomenon is still little understood. Building on the Privacy Calculus theory, this study fills this gap by taking a closer look at the factors behind individual self-disclosure decisions. In a Structural Equation Model with 237 subjects we find Perceived Enjoyment and Privacy Concerns to be significant determinants of information revelation. We confirm that the privacy concerns of OSN users are primarily determined by the perceived likelihood of a privacy violation and much less by the expected damage. These insights provide a solid basis for OSN providers and policy-makers in their effort to ensure healthy disclosure levels that are based on objective rationale rather than subjective misconceptions.

De Relatie tussen Angst- en Stemmingsklachten en Self-disclosure: het Effect van Emotie-inhibitie en Mindfulness

Angst- en stemmingsklachten worden geassocieerd met verminderde self-disclosure. Met self-disclosure wordt zelfonthulling van ervaren emoties bedoeld. Dit speelt een rol bij zelfacceptatie en zelfinzicht, en is belangrijk bij gesprekstherapie. Deze studie onderzocht of emotie-inhibitie de negatieve relatie tussen angst- en stemmingsklachten en self-diclosure verklaart, en of de relatie gunstig te beïnvloeden is door mindfulness. Het effect van mindfulness op deze relatie was nog niet eerder onderzocht. Deelnemers waren 99 vrouwen van 24 t/m 74 jaar (M = 44.60, SD = 10.55) en 26 mannen van 26 t/m 77 jaar (M = 48.27, SD = 12.68), afkomstig uit de normale Nederlands populatie. Het onderzoeksontwerp betrof een cross-sectioneel online vragenlijstonderzoek, waarbij gebruik gemaakt werd van de Symptom Checklist (Arrindel & Ettema, 1986), Emotional Self-Disclosure Scale (Snell, Miller, & Belk, 1988), Emotion Regulation Questionnaire (Gross & John, 2003) en Five Factor Mindfulness Questionnaire – Short Form (Bohlmeijer, Ten Klooster, Fledderus, Veehof, & Baer, 2011). Resultaten tonen, conform bestaande literatuur, dat angst- en stemmingsklachten negatief samenhangen met self-disclosure. Emotie-inhibitie heeft echter géén mediatie-effect en mindfulness heeft géén moderatie-effect op de negatieve relatie tussen angst- en stemmingsklachten en self-disclosure. Mindfulness heeft wel mediatie-effect op deze relatie. Mindfulness hangt hierbij positief samen met self-disclosure. De relevantie van de bevindingen is vooral praktisch: om mensen met angst- en stemmingsklachten te stimuleren over hun emoties te praten zou mindfulness aangewend kunnen worden.

Changing the servicescape : The influence of music, self-disclosure and eye gaze on service encounter experience and approach-avoidance behavior

The purpose of this thesis is to investigate and understand the effect of a servicescape’s ambient and social conditions on consumers’ service encounter experience and their approach/avoidance behavior in a retail context. In three papers, with a total sample of over 1600 participants (including 550 actual consumers) and seven experiments, the author investigates the effect of music (ambient stimuli), employees’ self-disclosure (verbal social stimuli) and employees’ gazing behavior (nonverbal social stimuli) on consumers’ service encounter experience and approach/avoidance behavior in a retail store. Paper I comprised two experiments, and the aim was to investigate the influence of music on emotions, approach/avoidance behavior. Paper II comprised two experiments, and the aim was to investigate the effect of frontline employees’ personal self-disclosure on consumers’ reciprocal behavior. Paper III comprised three experiments, and the aim was to investigate the influence of employee’s direct eye gaze/ averted eye gaze on consumer emotions, social impression of the frontline employee and encounter satisfaction in different purchase situations. The results in this thesis show that music affects consumers in both positive and negative ways (Paper I). Self-disclosure affects consumers negatively, in such a way that it decreases encounter satisfaction  (Paper II) and, finally, eye gaze affects consumers by regulating both positively – and in some cases also negatively – consumers’ social impression of the frontline employee and their encounter satisfaction (Paper III). The conclusions of this thesis are that both ambient and social stimuli in a servicescape affect consumers’ internal responses, which in turn affect their behavior. Depending on the purchase situation, type of retail, and stimuli, the internal and behavioral responses are different.

Links between attachment orientations and dispositional and diary-based measures of disclosure in dating couples: A study of actor and partner effects

Issues concerning the influence of attachment characteristics on own and partner's disclosure were addressed using a sample of 113 couples in medium-term dating relationships. Individual differences in attachment were assessed in terms of relationship anxiety and avoidance. Disposition to disclose was assessed using questionnaire measures of self-disclosure, relationship-focused disclosure, and the ability to elicit disclosure from the partner; in addition, structured diaries were used to assess aspects of disclosure (amount, intimacy, emotional tone, and satisfaction) in the context of couples' everyday interactions. Couple-level analyses showed that avoidance strongly predicted dispositional measures of disclosure, whereas anxiety (particularly partner's anxiety) was related to negative evaluations of everyday interactions. Interactive effects of attachment dimensions and gender were also obtained, highlighting the complexity of communication behavior. The results are discussed in terms of the goals and strategies associated with working models of attachment.

Differences in self-reported prevalence and management of cardiovascular risk factors in Switzerland, 2007

Purpose: To assess the prevalence of four self-reported cardiovascular risk factors (CV RFs: smoking, hypertension, dyslipidaemia and diabetes) and their reported management in seven Swiss regions (Léman, MiUelland, Zurich, North-West Switzerland, Oriental Switzerland, Central Switzerland and Tessin). Methods: National health interview survey conducted in 2007 in a representative sample of the Swiss population (17,879 subjects). Age-adjusted data on prevalence of self-reported CV RFs, treatment among participants reporting a RF, control of RFs among treated participants and CV RF screening in the last 12 months levels were computed after weighting. Results: The prevalence of hypertension was highest in North-West Switzerland (27.3%) and lowest in Central Switzerland (21.0%, p<0.001). Antihypertensive treatment was highest in Léman region (62.7%) and lowest in Oriental Switzerland (55.2%, p<0.001). Screening was higher in Tessin (89.3%) and lowest in Léman region (81.8%, p<0.001). Prevalence of dyslipidaemia was highest in Tessin and Léman region (20.7% and 20.1 %, respectively) and lowest in Oriental Switzerland (14.5%, p<0.001). Lipid-Iowering treatment was highest in Tessin and Léman region (44.3% each) and lowest in Central Switzerland (30.7%, p<0.001). Dyslipidaemia screening was highest in Tessin (76.6%) and lowest in Central Switzerland (58.6%, p<0.001). Prevalence of diabetes was highest in North-West Switzerland (5.4%) and lowest in Central Switzerland (3.3%, p<0.05). Diabetes screening was highest in Tessin (78.1%) and lowest in Oriental Switzerland (64.0%, p<0.001). Conversely, no between-region differences were found for hypertension or dyslipidaemia control (see table). Conclusion: there are significant differences between the Swiss regions in self-reported prevalence and management of CV RFs. Screening is beUer in Tessin than in the other regions.

Trends in self-reported prevalence and management of hypertension, dyslipidaemia and diabetes in adults in Switzerland, 1992-2007

Purpose: to assess the trends of self-reported prevalence of cardiovascular risk factors (CV RFs: hypertension, dyslipidaemia, diabetes) and their management for period 1992 to 2007 in the Swiss population. Methods: four National health interview surveys conducted between 1992 and 2007 in representative samples of the Swiss population (63,782 subjects overall). Self-reported CV RFs prevalence, treatment and controllevels were computed after weighting. Weights were calculated by raking ratio such that the marginal distribution of the weighted totals conforms to the marginal distribution of the targeted population. Multivariate analysis adjusted on age, sex, education, nationality and SMI was conducted using logistic regression. Results: prevalence of ail CV RFs increased between 1992 and 2007, see table. Although the self-reported prevalence of treatment among subjects with CV RFs increased, and this was confirmed by multivariate analysis: OR for hypocholesterolaemic treatment relative to 1992: 0.64 [0.52-0.78]; 1.39 [1.18-1.65] and 2.00 [1.69-2.36] for 1997, 2002 and 2007, respectively. Still, in 2007, circa 40% of hypertensive, 60% of dyslipidaemic and 50% of diabetic subjects weren't treated. Conversely, an adequate control of CV RFs was reported by treated subjects, with an increase during the study period. This increase was confirmed by multivariate analysis (not shown). Conclusion: the self-reported prevalence of hypertension, dyslipidaemia and diabetes increased between 1992 and 2007 in the Swiss population. Despite a good control of treated subjects, still a significant percentage of subjects with CV RFs are not treated.

Self-reported non-adherence to antiretroviral therapy repeatedly assessed by two questions predicts treatment failure in virologically suppressed patients.

BACKGROUND: The aim of this study was to explore the predictive value of longitudinal self-reported adherence data on viral rebound. METHODS: Individuals in the Swiss HIV Cohort Study on combined antiretroviral therapy (cART) with RNA <50 copies/ml over the previous 3 months and who were interviewed about adherence at least once prior to 1 March 2007 were eligible. Adherence was defined in terms of missed doses of cART (0, 1, 2 or >2) in the previous 28 days. Viral rebound was defined as RNA >500 copies/ml. Cox regression models with time-independent and -dependent covariates were used to evaluate time to viral rebound. RESULTS: A total of 2,664 individuals and 15,530 visits were included. Across all visits, missing doses were reported as follows: 1 dose 14.7%, 2 doses 5.1%, >2 doses 3.8% taking <95% of doses 4.5% and missing > or =2 consecutive doses 3.2%. In total, 308 (11.6%) patients experienced viral rebound. After controlling for confounding variables, self-reported non-adherence remained significantly associated with the rate of occurrence of viral rebound (compared with zero missed doses: 1 dose, hazard ratio [HR] 1.03, 95% confidence interval [CI] 0.72-1.48; 2 doses, HR 2.17, 95% CI 1.46-3.25; >2 doses, HR 3.66, 95% CI 2.50-5.34). Several variables significantly associated with an increased risk of viral rebound irrespective of adherence were identified: being on a protease inhibitor or triple nucleoside regimen (compared with a non-nucleoside reverse transcriptase inhibitor), >5 previous cART regimens, seeing a less-experienced physician, taking co-medication, and a shorter time virally suppressed. CONCLUSIONS: A simple self-report adherence questionnaire repeatedly administered provides a sensitive measure of non-adherence that predicts viral rebound.

(Mis)communicating across boundaries - Interpersonal and intergroup considerations

The metaphor of boundary is ubiquitous and has guided much research on interpersonal and intergroup communication This article explores the metaphor by reviewing the literature on boundaries with a focus on miscommunication and problematic talk. In particular, the tensions around privacy and self-disclosure, and rules about family communication are good examples of communication and miscommunication across interpersonal boundaries. In the intergroup arena, the negotiation of boundaries implicates the sociostructural relations between, groups and the choices individuals make based on the identities that are salient to them in a given context. We argue that miscommunication can best be conceived of as an indicator of tension in negotiating boundaries as they emerge and change in interaction.

Attachment, marital interaction, and relationship satisfaction: A diary study

The relations among measures of attachment, spouse behavior, and marital satisfaction were assessed in a broad sample of 193 married couples, using both questionnaire and diary methods. Insecure attachment was associated with less favorable reports of spouse behavior, as assessed by diary checklists. Marital satisfaction was predicted by attachment treasures and reports of spouse behavior. The relation between attachment security and marital satisfaction was moderated, but not mediated, by reported spouse behavior. Specifically, insecure individuals' evaluations of their relationships were more reactive to recent spouse behavior, an effect that was especially marked for fearful participants and for those in longer-term marriages. Some gender differences in patterns of prediction were obtained. The results are discussed in terms of the working models associated with attachment styles, and the processes by which relationship satisfaction may be eroded over time.