Sexual orientation disclosure and its relationship to psychological distress, immune, and physical health status variables in HIV-infection

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael H. Antoni - Committee Chair


This study investigated the effects of sexual orientation disclosure on levels of psychological distress, immune, and physical health status variables within a sample (N = 43) of HIV-positive gay men. Cross-sectional findings indicated that four out of five measures of sexual orientation disclosure were associated with lower levels of psychological distress, as measured by avoidant cognitions and Beck Depression. In addition, sexual orientation disclosure was also related to several measures of immune status, including: NKCC, NK percentages, and neopterin. Ethnicity seemed to play some role in moderating the effects of sexual orientation disclosure on measures of psychological distress, immune, and physical health status within this sample. Longitudinally, experimental group subjects exhibiting low baseline disclosure levels experienced reduced levels of anger and greater immune benefits (i.e. increased NK percentages and CD4+CD3+ cell counts) when compared to experimental subjects exhibiting higher levels of baseline disclosure. This suggests that individuals with low levels of sexual orientation disclosure may benefit more from stress management interventions than those individuals who already disclose at high levels. Taken together, these findings suggest that issues of sexual orientation disclosure should be addressed in stress management interventions in terms of helping participants to reduce levels of avoidant thinking and depression, and perhaps, bring about higher levels of immune status. In addition, clinicians should take into account the disclosure needs of varying ethnic groups in designing these interventions, as well as baseline levels of sexual orientation disclosure in terms of selecting participants who are most likely to benefit from these stress management interventions. Of course, the findings from this study must be replicated in other HIV populations and in other chronic disease groups, with larger sample sizes, in order to reliably document the mechanisms by which sexual orientation disclosure is associated with measures of psychological and physical health.


Psychology, Clinical

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