Quantitative and qualitative aspects of HIV serostatus self-disclosure: Their relationship to immune function, cortisol, and posttraumatic growth

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Ron Duran - Committee Chair


The present study investigated the relationship of HIV serostatus self-disclosure to three biological outcomes (viral load, CD4%, and 24-hour urinary free cortisol) and one psychological outcome (HIV-related posttraumatic growth) in a sample of 81 HIV positive gay/bisexual men recruited from the community. Emotional expression (EE) and emotional/cognitive (E/C) processing variables, which were obtained through audiotaped, emotional expression interviews, were tested as mediators of the above relationships. Additional qualitative data collected from the emotional expression interviews, namely reasons for seeking HIV testing and spontaneously cited experiences of posttraumatic growth (PTG), were also analyzed. Results revealed that higher levels of serostatus disclosure to one's immediate social network were significantly related to both lower CD4% and increased reports of PTG. Higher rates of serostatus disclosure were also significantly related to the total E/C Processing score and three of that measure's subscales, while the relationship between serostatus disclosure and one EE variable approached significance. Moderate rates of serostatus disclosure were significantly related to one EE variable and two subscales of the E/C Processing scale. True co-mediation of the EE and E/C variables could not be explored with the biological outcomes due to many non-significant relationships. A number of mediational analyses were also investigated, but none of these proved to be statistically significant. Contrary to hypotheses, neither PTG nor the immune outcomes were related to 24-hour urinary cortisol. Higher PTG scores and higher levels of serostatus disclosure, however, were significantly related to lower CD4%, supporting the notion that declining health status promotes both processes. Results from the qualitative analyses indicated that "Emergence of symptoms" was the most common reason for seeking HIV testing, while "Personal growth" was the most frequently cited form of PTG. Analyses revealed that those individuals who independently cited growth during the EE interviews scored higher on this study's measure of PTG, suggesting that use of a questionnaire to assess PTG may accurately capture participants' experiences.


Psychology, Clinical

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