Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Master of Science (MS)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Gail Ironson

Second Committee Member

Michael Antoni

Third Committee Member

Rick Stuetzle

Fourth Committee Member

Julie Barroso


Several studies have demonstrated the deleterious impact that psychological inhibition can have on psychological and immunological well-being. In the field of HIV, this psychological inhibition has often been operationalized as (a) lack of disclosure of HIV status or, for gay men, (b) disclosure of sexual orientation. However, research on the effect of disclosure on HIV disease status is limited, with only one study having examined both forms of disclosure simultaneously (Strachan et al., 2007). The present study seeks to replicate these findings by investigating whether or not disclosure of HIV status and disclosure of sexual orientation are related to HIV disease progression. The study seeks to extend the prior findings by Strachan et al. (2007) by employing a longer follow-up period (4 years) and using a more generalizable sample. Participants included 177 HIV-infected men and women recruited from hospitals and specialty clinics. At baseline, participants completed self-report measures of disclosure of both HIV status and sexual orientation. Participants also underwent a blood draw to assess CD4 cell count. Questionnaires and blood draws were repeated every 6 months for 4 years. Hierarchical Linear Modeling (HLM) analysis revealed that increased disclosure worries as measured by the HAT-QoL were significantly related to lower CD4 cell counts over a period of four years. Results did not suggest that this relationship was mediated by depressive symptoms or social support. No significant results were found for any other HIV disclosure measures or sexual orientation disclosure measures. Possible reasons for non-significant findings are discussed. Significant findings may warrant close attention to disclosure worries as a person living with HIV begins to disclose their status.


HIV; Disclosure; Prognosis; Sexual Orientation