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HIV+ women's narratives of non-disclosure: Resisting the label of immorality

机译：HIV +妇女的不公开叙述：抵制不道德的标签

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Increasing partner disclosure rates among HIV+ individuals is widely seen as an important public health strategy to reduce HIV transmission. One approach for encouraging disclosure is to emphasise individuals' moral responsibility to disclose their status to their partners. We use South Africa as a case study to draw attention to two problems with labelling non-disclosure as immoral. First, we argue that because women are tested for HIV at much higher rates than men, any approach that involves blaming HIV+ individuals for not disclosing their status will disproportionately burden women. Second, through the narratives of six HIV+ women, we highlight how a focus on morality undervalues the complexity of sexual partnerships. Specifically, women describe how their perceived obligation to disclose their status is directly influenced by communication with their sexual partners. Women also discuss how the onset of different life events might alter the meaning of HIV and change obligations regarding disclosure within the partnership. The differences in testing rates across gender combined with the complexity of sexual partnerships leads us to suggest that labelling non-disclosure as immoral does little to advance HIV prevention. There is an urgent need to identify alternative interventions that support women through the disclosure process.
机译：人们普遍认为，增加艾滋病毒+感染者之间的伴侣披露率是减少艾滋病毒传播的重要公共卫生策略。鼓励公开的一种方法是强调个人的道德责任，向其伴侣公开其身份。我们以南非为案例研究，以提请注意将不公开标记为不道德的两个问题。首先，我们认为，由于女性接受艾滋病毒的检测率要比男性高得多，因此任何指责艾滋病毒+感染者没有公开其身份的方法都会给妇女造成不成比例的负担。其次，通过六位HIV +妇女的叙述，我们强调了对道德的重视如何低估了性伴侣的复杂性。具体来说，妇女描述了与性伴侣的沟通如何直接影响她们公开的身份义务。妇女们还讨论了不同生活事件的发生如何改变艾滋病毒的含义，以及如何改变伙伴关系中有关披露的义务。跨性别的测试率的差异以及性伴侣关系的复杂性使我们建议，将不公开标记为不道德的行为并不能促进艾滋病毒的预防。迫切需要确定在披露过程中支持妇女的其他干预措施。

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