Disclosing HIV serostatus to family members: Effects on psychological and physiological health in minority women living with HIV

Background: Directly disclosing a positive HIV serostatus to family members can have psychological and physiological health benefits. Perceptions that one is in a supportive family environment may enhance these benefits. Purpose: We examined a mediated moderation model in which we expected interactions between serostatus disclosure to family members and HIV-specific family support to be associated with women's perceived stress, which in turn would explain depressive symptoms and 24-h urinary cortisol in women living with HIV (WLWH). Method: Low-income ethnic minority WLWH (n = 82) reported the percentage of family members they had directly disclosed their serostatus to, perceptions of HIV-related support from family members, perceived stress, and depressive symptoms. Cortisol was measured via 24-h urinary collection. Results: Disclosure to spouses and children coupled with high levels of family support was associated with higher levels of depressive symptoms in women. For disclosure to spouses, this relationship was explained by higher perceived stress. Direct disclosure to mothers in tandem with high support was associated with lower cortisol, and this relationship was explained through higher levels of perceived stress. Conclusion: The effects of serostatus disclosure on perceived stress and health in WLWH may depend, in part, on women's family environment and to whom they disclose to within that environment.