Psychological outcomes of dementia risk estimation in MCI patients: Results from the PreDADQoL project.

INTRODUCTION: Understanding the impact of biomarker-based dementia risk estimation in people with mild cognitive impairment (MCI) and their care partners is critical for patient care. METHODS: MCI patients and study partners were counseled on Alzheimer's disease (AD) biomarker and dementia risk was disclosed. Data on mood, quality of life (QoL), and satisfaction with life (SwL) were obtained 1 week and 3 months after disclosure. RESULTS: Seventy-six dyads were enrolled, and two-thirds of the patients opted for biomarker testing. None of the participants experienced clinically relevant depression or anxiety after disclosure. All dyads reported moderate to high QoL and SwL throughout the study. Patients reported more subthreshold depressive symptoms 1 week and lower QoL and SwL 3 months after disclosure. In patients, depression (odds ratio [OR]: 0.76) and anxiety (OR: 0.81) were significant predictors for the decision against biomarker testing. DISCUSSION: No major psychological harm is to be expected in MCI patients and care partners after dementia risk disclosure. TRIAL REGISTRATION: This study is registered in the German clinical trials register (Deutsches Register Klinischer Studien, DRKS): http://www.drks.de/DRKS00011155, DRKS registration number: DRKS00011155, date of registration: 18.08.2017. HIGHLIGHTS: Patients with mild cognitive impairment (MCI) and study partners were counseled on Alzheimer's disease (AD) biomarker-based dementia risk estimation. About two-thirds of patients opted for biomarker testing and received their dementia risk based on their AD biomarker status. Patients who decided in favor or against CSF biomarker testing differed in psychological features. We did not observe major psychological harm after the dementia risk disclosure. Coping strategies were associated with better subsequent mood and well-being in all participants.

Why do prospective and retrospective measures of childhood maltreatment differ? Qualitative analyses in a cohort study.

BACKGROUND: Research indicates that prospective and retrospective measures of maltreatment often identify different groups of individuals, yet the reasons for these discrepancies remain understudied. OBJECTIVE: This study explores potential sources of disagreement between prospective and retrospective measures of maltreatment, utilising qualitative data from interviewers' notes. PARTICIPANTS AND SETTING: The Environmental Risk Longitudinal Twin Study includes 2232 children followed from ages 5-18. Prospective measures relied on caregiver interviews and researcher observations from ages 5-12, while retrospective measures involved self-reports via the Childhood Trauma Questionnaire at age 18. METHODS: We purposively sampled written interviewer notes from 36 participants who reported more types of maltreatment retrospectively than prospectively ('new reports' group) and 31 participants who reported fewer types retrospectively than prospectively ('omitted reports' group). We conducted a framework analysis of the notes, comparing between the two groups to explore explanations for measurement disagreement. RESULTS: Three categories of themes emerged related to measurement discrepancies: challenges with prospective measures, highlighting reasons given by the 'new reports' group for why maltreatment went undetected or was not adequately responded to prospectively; challenges with retrospective measures that highlight difficulties with openness and accuracy of self-reports; and differences in appraisals of violence or distressing childhood experiences between the two groups that might lead to new or omitted retrospective reports. CONCLUSIONS: Our findings underscore potential mechanisms underlying the disagreement between prospective and retrospective measures, contributing to better understanding of these different constructs and more balanced interpretation of related findings.

The motivations and methods behind sharing a pediatric Prader-Willi syndrome diagnosis.

Prader-Willi syndrome (PWS) is a genetic condition caused by a lack of paternally-expressed imprinted genes at chromosome 15q11.2-q13 and characterized by hyperphagia, behavioral challenges, and variable intellectual disability. Once a PWS diagnosis is established, sharing diagnosis information with an affected child can be challenging due to its early age of onset and diverse phenotype. This mixed-methods study aimed to evaluate how parents and guardians have shared a PWS diagnosis with their child and examine the motivating and influencing factors behind their disclosure. Parents and guardians of children with PWS aged at least 5 years completed a survey, and a select group completed an interview. A total of 51 surveys and 15 interviews were completed, with the majority of participants (n = 46; 90%) having shared at least some diagnosis information with their child. Parents and guardians were more likely to disclose if they self-reported a higher level of knowledge about PWS (p = 0.004) and if their child is currently older (p = 0.02) and/or has at least one sibling (p = 0.046). Interview analysis revealed 15 themes and 10 subthemes that illustrated parents' motivations, methods, and experiences with disclosure. This research provides information for others considering disclosure of PWS or another rare diagnosis with their child.

Missed opportunity: low awareness of undetectable equals untransmittable (U = U) among adolescents living with HIV.

In 2022, South Africa (SA) had the second-highest HIV incidence rate among adolescents worldwide. This study's participants were boys living in SA aged 15-19 years old, in a current dating or sexual relationship, and diagnosed with HIV before the age of 10. Despite the launch of campaigns to spread awareness of Undetectable equals Untransmittable (U = U), our findings showed that a significant number of adolescents living with HIV do not demonstrate an understanding of the concept. This highlights the importance of integrating U = U messaging in ongoing conversations with healthcare workers given the potential positive impact on adolescent wellbeing, transmission risk perception, and safer sexual practices.

The impact of environmental, social and governance disclosure on stock prices: Empirical research in Vietnam.

The aims of this research is to evaluate the impact of Environmental, Social and Governance (ESG) information disclosure (using both financial and non-financial information) on stock prices of businesses in Vietnam; From there, propose recommendations to promote transparent practices and information disclosure about ESG of businesses related activities; Contribute to developing sustainable investment goals in businesses, and the financial market in general. Based on the (Ohlson, 1995) [40] valuation model, and developed by Barth and Clinch (2009) [41] the research was conducted empirically in 30 listed companies in Vietnam in the period 2019-2022. Research results based on the GLS method show that ESG positively impacts stock prices. Additionally, this paper conducted an in-depth analysis of each individual pillar and found that the environmental pillar was considered the most meaningful to market participants. However, the correlation between ESG and stock prices is weakened for environmentally sensitive businesses. This study also makes a valuable contribution to the current literature on non-financial information reporting by using manually collected data and investigating the effects of ESG reporting on market participants in the public system voluntary information disclosure system of an emerging market like Vietnam.

Environmental information disclosure and green transformation: Evidence from Chinese manufacturing enterprises.

Green transformation (GT) is pivotal for global sustainability, with environmental information disclosure (EDI) playing a significant role, especially in the Chinese corporate landscape. This study, spanning 2009 to 2020 and leveraging a comprehensive dataset of listed companies, explores the intricate relationship between EDI and GT in Chinese manufacturing enterprises by constructing a fixed-effect model. Motivated by the imperative to address crucial issues in GT in China, this research utilizes empirical data to uncover the mechanisms through which EDI fosters GT. The study reveals how EDI reinforces environmental consciousness within manufacturing firms. Findings underscore the crucial role of EDI in enhancing GT in manufacturing enterprises, operating through two primary mechanisms. Firstly, EDI alleviates financing constraints towards GT within these firms. Secondly, it facilitates the adoption of enhanced internal governance practices, catalyzing the development of high-quality capital renewal projects. A battery of mechanism tests provides robust evidence that EDI enhances environmental awareness, mitigates financing constraints, and amplifies the motivation and capability of manufacturing enterprises for GT. This multifaceted approach ultimately fosters high-quality GT within companies. Further research reveals that the incentive effect of EDI on GT is more significant among private enterprises and heavily polluting industries. The study reveals the subtle interplay between EDI and GT, highlighting its relevance to policymaking and practical considerations. It provides valuable insights into the ongoing pursuit of sustainability and the integration of green practices into the corporate world.

Breaking the Silence: Addressing Domestic Abuse in Mental Health Settings-Identification, Screening, and Responding.

Individuals experiencing domestic abuse (DA) struggle to disclose victimization, but as frequent users of mental health services, this is a pivotal setting for identification and addressing DA. This systematic review of 20 studies investigates DA identification, screening, and responses within mental health settings. Three databases were searched using these inclusion criteria: adults aged 18 and older accessing mental health services, samples comprising mental health professionals (or combination). No geographical restrictions were applied. All studies were peer-reviewed and published in English between January 2000 and December 2023. Studies had to incorporate screening for DA between (ex-)partners and/or response to disclosure within mental health settings. The findings revealed considerable variation in DA screening methods from direct screening tools to retrospective analyses of patient files. Professionals report barriers in identifying DA, including uncertainty about their role, time constraints, and the importance of building trust with service users. Nonetheless, many highlight the importance of routinely asking about DA. A small number of interventions have been effective in enhancing professionals' readiness to address DA, but it remains unclear what format of training is most effective. Service users report feelings of shame and fear of not being believed when disclosing DA, but are aided by therapeutic engagement and enhanced professional awareness. There is a lack of diverse inclusion in the research. In summary, there is considerable scope to develop good practice to support mental health professionals' ability to identify and respond to DA across assessment tool and training, but also in understanding what facilitates service users to disclose.

Dyadic effects of perceived stress, relationship satisfaction and distress disclosure on emotional distress in colorectal cancer patients and their family caregivers: An actor-partner interdependence mediation model.

Objective: This study adopted a dyadic analysis method to examine the effect of perceived stress on emotional distress and determine whether relationship satisfaction and distress disclosure act as mediators in colorectal cancer (CRC) enterostomy patient-caregiver dyads. Methods: A total of 312 patient-caregiver dyads completed measures assessing perceived stress, relationship satisfaction, distress disclosure, and emotional distress. The data were analyzed using the actor-partner interdependence mediation model. Results: This study found that the perceived stress of patients and caregivers both had direct and indirect actor effects on emotional distress (through relationship satisfaction). Another important finding is that perceived stress had indirect actor-partner effects (through distress disclosure) on emotional distress. Conclusions: This study highlights that perceived stress, relationship satisfaction, and distress disclosure of patients and their caregivers are key factors that can be considered for improving emotional distress. It also partially confirmed the interdependence of patients with CRC and their caregivers.

Navigating who I was and who I am online: How people with dementia use social media platforms to support identity.

A diagnosis of dementia can have a powerful impact on identity, and social media platforms offer promising avenues for identity expression and reconciliation. Addressing limited research in this area, we used semi-structured interviews to explore how 10 people with dementia used social media to navigate their identity. Our thematic analysis produced four themes, showing how social media platforms afford unique opportunities for self-expression, visibility, and association, thereby empowering users to maintain their sense of self, challenge stereotypes, and foster community connections. Additionally, social media facilitated a multifaceted and holistic sense of identity beyond the confines of diagnosis. While there were concerns about online self-disclosure, sharing experiences of dementia had therapeutic benefits, aiding in acceptance and adjustment. Participants also leveraged social media to establish continuity between their pre- and post-diagnostic selves, providing a sense of stability amid uncertainty. With the increasing prevalence of social media use among people with dementia, proactive measures by healthcare professionals, policymakers, technology developers, and carers are required to cultivate online experiences that are safe, supportive, and inclusive of people with dementia.

Individual and relational factors related to disclosure of epilepsy in the workplace.

BACKGROUND: The decision to disclose epilepsy in the workplace is complex, as it entails both advantages and disadvantages. In this study, we aimed to identify the factors associated with disclosure of epilepsy in the workplace based on the disclosure decision-making model for patients who required underwent comprehensive assessment in the Epilepsy Monitoring Unit (EMU). METHODS: This retrospective study included 193 patients with epilepsy (112 men, aged 18-66 years) who underwent comprehensive assessment, including long-term video-EEG monitoring, neuroimaging studies, and neuropsychological and psychosocial assessment in the Tohoku University Hospital EMU. Data were obtained from the medical records and self-reported questionnaires at our EMU. The outcome variable was disclosure of epilepsy. Predictive variables were selected based on the disclosure decision-making model: individual factors (i.e., age, sex, age at onset of epilepsy, seizure frequency, generalized tonic-clonic seizures or focal to bilateral tonic-clonic seizures in the last 2 years, experiences of viewing own seizure, and felt stigma), and relational factors (i.e., experiences of discrimination, enacted stigma, and social support). Data were analyzed using a logistic regression analysis model. RESULTS: Our results indicated that 43.5% of patients disclosed epilepsy to their employer. The factors that associated with disclosure of epilepsy were experiences of discrimination (odds ratio [OR], 7.78; 95% confidence interval [CI], 2.84-21.34, p < 0.01), experiences of viewing own seizure (OR, 3.51; 95% CI, 1.27-9.72, p < 0.05), and level of enacted stigma (OR, 0.69; 95% CI, 0.48-0.99, p < 0.05). CONCLUSION: This study indicated that the decision to disclose epilepsy was associated with both individual factors, such as experience of viewing own seizures, and relational factors, such as experience of discrimination and enacted stigma.

Decoding privacy concerns: the role of perceived risk and benefits in personal health data disclosure.

BACKGROUND: Personal health data is crucial for effective medical care, personalized treatment, and health monitoring. It enables accurate diagnosis, efficient treatment plans, and informed healthcare decisions. Personal health data should be protected to ensure patient privacy, prevent misuse or unauthorized access, and maintain trust in healthcare systems, thereby safeguarding individuals' sensitive information from potential harm or exploitation. Therefore, this study aimed to investigate whether perceived risk and perceived benefits have mediating roles in the relationships among individuals' personal health information disclosure behaviour, perceived control, and privacy concerns. METHOD: The population of the study consisted of individuals living in the provinces of Izmir, Konya and Adana. The sample of the study consisted of individuals who were reached through a convenience sampling method. The scales for privacy concerns, perceived control, perceived risk, perceived benefits and information disclosure behaviour were used in the study. Cronbach's alpha and the AVE were calculated, and a confirmatory factor analysis was performed. A path analysis was performed using the structural equation model to test the hypotheses. RESULTS: The analysis revealed a significant negative relationship between individuals' personal health data disclosure behaviour and their privacy concerns. However, perceived risk and perceived benefit did not mediate this relationship. Additionally, a significant positive relationship was found between individuals' behaviour of disclosing their perceived control and personal health data, with perceived risk and benefits playing a mediating role in this relationship. CONCLUSION: The study concluded that as individuals' concerns about sharing personal health data increase, they are less likely to share these data. It was also found that perceived risk and perceived benefit mediate this relationship. Additionally, higher perceived risk intensifies privacy concerns, further discouraging data sharing, while perceived benefits can mitigate these concerns, promoting greater willingness to disclose health information.

Effectiveness of written exposure therapy for Korean patients with post-traumatic stress disorder: non-randomized treatment-as-usual waitlist-controlled study.

Written exposure therapy (WET) is a five-session exposure-based protocol for treating post-traumatic stress disorder (PTSD). The brevity and tolerability of WET present the potential to overcome barriers in implementing evidence-based therapy for PTSD within the Korean mental healthcare system. This study investigated the effectiveness of WET in Korean patients with PTSD through a waitlist-controlled trial (KCT0008112). A total of 57 patients with PTSD were allocated non-randomly to either WET (n = 27) or treatment-as-usual waitlist groups (n = 30). Both groups were followed up until the twenty-fourth week after the initial session. Primary outcomes assessed included PTSD symptoms, depressive symptoms, and general function. In the WET group, significant improvements were observed in PTSD symptoms, depressive symptoms, and general function compared to the control group. After the waiting period, the waitlist group also participated in WET, and exhibited significant improvement in all scores. The between- and within-group effect sizes were large. The dropout rate in both groups was 10.9%, and the mean satisfaction ratings were 28.24 ± 3.33 (range 22-32; scale range 8-32). The present study provides evidence of WET successfully reducing PTSD and depressive symptoms and improving general function among Korean patients with PTSD. Moreover, WET was well tolerated and received by Korean patients with PTSD.

"I Wish This Tool Was Available to Me Sooner": Piloting a Workplace Autism Disclosure Decision-Aid Tool for Autistic Youth and Young Adults.

Background: For autistic youth and young adults, deciding whether to disclose their autism at work may be complex since they are newly entering the workforce and are at an impressionable developmental period. Decision-aid tools can help someone make a choice regarding a topic/situation. We developed a workplace autism disclosure decision-aid tool called DISCLOSURE (Do I Start the Conversation and Let On, Speak Up, and REveal?) to support autistic youth and young adults navigate disclosure decision-making. In this study, we aimed to assess the DISCLOSURE tool's (1) impact on decision-making and self-determination capabilities and (2) usability, feasibility, and acceptability. Methods: This was a single-arm pre-post pilot study. The DISCLOSURE tool comprises three interactive PDF documents and videos. Thirty participants (mean age of 23.5 years) completed online surveys before and after interacting with the DISCLOSURE tool. We used descriptive statistics for usability, feasibility, and acceptability. We calculated the Wilcoxon signed rank and paired t-tests to determine pre-post changes in decision-making and self-determination capabilities (Decisional Conflict Scale-Low Literacy Version [DCS-LL]; adapted Arc's Self-Determination Scale). We analyzed open-ended data using conventional (inductive) content analysis. Results: There were significant decreases in DCS-LL total and subscale scores (p < 0.0001) and a significant increase in Arc's total score (p = 0.01), suggesting important improvements. There were no significant increases for Arc's psychological empowerment and self-realization subscales (p = 0.05; p = 0.09). Median scores (4.0/5.0) indicate that participants agreed that the DISCLOSURE tool is acceptable, feasible, and meets the usability criteria. We developed four categories to describe the open-ended data: (1) disclosure capabilities, (2) the role of others, (3) positive tool impact and feedback, and (4) minimal tool impact and constructive feedback. Discussion: Findings are suggestive of the DISCLOSURE tool's ability to support workplace autism disclosure decision-making. Future studies should ascertain the DISCLOSURE tool's effectiveness, explore others' feedback (e.g., employers), and how to incorporate the tool into relevant employment and vocational programs.

Why is this topic important? Autistic youth and young adults face a dilemma when starting their first jobs: should they disclose their autism at work? This is a complicated decision and involves considering many factors, benefits, and risks. Our team developed a decision-aid tool to help with this decision-making process called DISCLOSURE (Do I Start the Conversation and Let On, Speak Up and REveaL?). This study is important because it is the first to assess the DISCLOSURE tool and explore if it may be helpful. What is the purpose of this article? This study had two main goals. First, we assessed if the DISCLOSURE tool helps to build self-determination and decision-making knowledge, skills, and confidence. Second, we explored if participants thought that the DISCLOSURE tool is usable, acceptable, and can be used in the real world (feasible). What did the researchers do? We recruited 30 participants (average age of 23.5 years) to complete two online surveys­one before and one after using the DISCLOSURE tool. We analyzed the data to observe if there were changes in decision-making and self-determination knowledge, skills, and confidence. We also explored how participants rated the acceptability, feasibility, and usability of the DISCLOSURE tool. We read through open-ended answers to group them into categories. What did the researchers find? We found important improvements in participants' decision-making knowledge, skills, and confidence. The DISCLOSURE tool shows promise to improve self-determination. Participants agreed that the DISCLOSURE tool is usable, acceptable, and feasible. Many participants said that the DISCLOSURE tool can help them make disclosure decisions at work. Some participants said that the tool was not as helpful for them. This is because they already had disclosure knowledge and experience. Overall, the study results suggest that the tool may support some autistic young people with the disclosure decision-making process. What do these findings add to what is already known? Few tools exist that support disclosure decision-making. Research also shows that young autistic people find it hard to make autism disclosure decisions at work and may need help. This study is the first to assess a tool that may close important gaps and help autistic young people make disclosure choices. What are potential weaknesses in the study? We need to continue testing the DISCLOSURE tool since this is the first time that we assessed it. We also missed some important perspectives in this study. Most participants were white, cisgender women, or nonbinary from Ontario, Canada, and needed internet and a tech device to take part. How will these findings help autistic young people now or in the future? Results show that the DISCLOSURE tool may help autistic youth and young adults make disclosure choices at work. We will continue to assess the DISCLOSURE tool to make sure it is effective. Autistic youth and young adults could use the DISCLOSURE tool in the future to help guide their disclosure choices at work. Relevant service providers could also use the DISCLOSURE tool with their autistic clients.

Strengths and Weaknesses of HIV Partner Notification Implementation in Iran.

HIV partner notification is a key intervention to facilitate access to HIV testing and treatment. This qualitative study investigated the strengths and weaknesses of the HIV partner notification program in Iran. Additionally, it provides comprehensive recommendations to mitigate potential harms and maximize the benefits of partner notification services. Using purposive sampling, 15 participants, including policymakers, service providers, and researchers in the field of HIV, were recruited from nine provinces between September and December 2023. The qualitative content analysis was conducted using the Graneheim and Lundman approach. Several strengths were reported for the HIV partner notification program, including alignment with international guidelines, use of trained counselors, integration with current HIV testing guidelines being used by HIV testing centers funded by the Ministry of Health, and a well-developed monitoring and evaluation plan at the facility, provincial, and national levels. Notable weaknesses of the program included a lack of a detailed implementation plan overall and for some key populations at high risk for HIV, such as female sex workers, lack of integration of the program with HIV testing services provided in hospitals and HIV centers funded by the Welfare Organization in Iran, lack of a simple quality checklist for monitoring and evaluation of the program. To increase the coverage and quality of the HIV partner notification program in Iran, a more detailed implementation plan, a simple quality checklist, and more targeted advocacy and training programs are needed.

"Everything Is Changing, We Need to Adapt": Between Tradition and Modernity-Educators Coping with Child Sexual Abuse.

Socio-cultural contexts are formative to how teachers understand, conceptualize, and act when contending with child sexual abuse (CSA) cases among their students. The purpose of the present study was to investigate the experiences of Druze Arab teachers in Israel coping with cases of CSA among their students and the meaning they attribute to CSA in the context of socio-cultural change. Semi-structured interviews were conducted with 12 female Druze elementary school teachers. All of the participants taught in schools located in Druze villages, where the children of Druze families comprise the majority of the student body. The analysis used a thematic approach. The analysis revealed that a transition between tradition and modernity in the Druze socio-cultural group was the central conceptual framework through which the teachers' narratives regarding CSA emerged. As an emblem of modernity, increasing openness around sexual topics was perceived as simultaneously favorable and threatening to both the welfare of children and the well-being of the community. Coping with CSA was viewed as a negotiation between closed (traditional) and open (modern) society, as well as silence and dialogue regarding CSA. This study highlights the importance of preventing teachers' cultural biases from affecting their contributions to CSA interventions, as well as how religion can be a source of strength when confronting CSA. Implications for policy and developing bottom-up, culturally sensitive training, practice, and interventions are discussed.

Young adults living with chronic illness: disclosure strategies and peers' understanding.

PURPOSE: Many young adults living with chronic illness fear being perceived as different by their peers and excluded from social activities. This forces them to consider whether to disclose or conceal their illness. This article analyses young adults' disclosure strategies and links them to peers' understanding of illness. MATERIALS AND METHODS: The explorative study is based on episodic interviews with sixty young adults living with chronic illnesses (type 1 diabetes, cancer, chronic inflammatory bowel disease or a rare disease) and thirty peers. The interviews were thematically coded. The young adults' statements were compared to the peer perspectives on a case-by-case basis. RESULTS: We identified three groups of young adults: 1) those who are generally open with peers about their illness and its subjective meaning; 2) those who share selected health-related information's with selected peers; 3) those who refrain from active disclosure and are unsure how they might talk about their illness when it becomes apparent. Our findings also indicate that peers differ in the sophistication of their illness perceptions and the meaning they ascribe to living with a chronic illness. CONCLUSION: Trainings should target both young adults and peers, and should assist both sides in talking about (serious) chronic illness.

Rehabilitation professionals should find ways to involve peers in caring for chronically ill young adults.Rehabilitation professionals should step up their efforts to destigmatize chronic illness.Disclosure/non-disclosure of chronic diseases should be given greater consideration in rehabilitation and health care.If young adults choose not to disclose their chronic illness, rehabilitation professionals should treat this as neutral and analyse the subjective functionality of such a decision.

"If I Stay Silent, It Doesn't Help Anyone": Understanding How People Use TikTok to Talk About Sexual Violence.

TikTok is the second most popular social media platform among American teenagers, suggesting it may be a way to reach young people with sexual violence-related messages. This qualitative content analysis focused on what TikTok users share about sexual violence. The content of the videos fell into two primary types of information, people sharing experiences of sexual violence (i.e., what happened, how they responded, impacts of experiences) and people sharing other information related to sexual violence (i.e., education, raising awareness). The study results demonstrate that people use TikTok as a platform to share their messages about sexual violence-related topics, underscoring the potential of this platform for prevention and recovery messages targeted toward individuals who directly or indirectly experience sexual violence.

Disclosure of HIV Status in Healthcare Settings: Practices and Considerations among Women Living with HIV/AIDS in Vietnam.

OBJECTIVE: This study investigated women living with HIV/AIDS (WLHA)'s practices and decision-making regarding disclosure of HIV status in healthcare settings in Vietnam. Introduction: Disclosure of HIV status in healthcare settings is under-studied. METHODS: We conducted in-depth interviews with 30 WLHA in Hanoi, Vietnam. Thematic analysis was conducted to investigate the patterns, considerations, and consequences of HIV disclosure. Results: Most participants chose a selective disclosure strategy based on the type of procedure and healthcare setting. They considered several factors: concerns about stigma/discrimination, risks of confidentiality breach, relevance to healthcare provision, and altruism towards protecting providers and other patients. Selective disclosure or non-disclosure often prevented participants from accessing comprehensive care. Conclusion: The study underscores the need to prepare WLHA to make informed decisions regarding disclosure and provide them with service navigations and support. It also highlights the necessity of reducing stigma and enhancing confidentiality protection to ensure safe disclosure in healthcare settings.

Telling Healthcare Providers About HIV Status: How Women with HIV/AIDS in Vietnam Decide and What They ConsiderThis study focuses on how women living with HIV/AIDS in Vietnam decide to share their HIV status with healthcare providers. We interviewed 30 women with HIV/AIDS in Vietnam and found that many choose to reveal their status only in certain situations, depending on the medical procedure and the setting. They weigh various factors before deciding to disclose, including the risk of facing stigma, the need to protect their privacy, how relevant their HIV status is to their other health issues, their wish to protect their healthcare providers and other patients, and how they have been advised by HIV specialists. Unfortunately, choosing not to disclose their status sometimes stops them from getting the full range of medical care they need. The findings stress the importance of helping these women make well-informed choices about disclosing their HIV status. We also need to provide them with additional support and navigational help through healthcare services. Moreover, reducing stigma in healthcare, enhancing providers' ability to gather necessary health information, and ensuring patient privacy are crucial to encouraging more open discussions of HIV status in medical settings.

Disclosure and Experiences of HIV-Related Stigma among Adolescents and Young Adults Living with HIV in South Africa.

Social networks expand rapidly in adolescence, increasing HIV status disclosure considerations and concerns for young people living with HIV, especially in settings where HIV-related stigma is prevalent. This study examines HIV disclosure and enacted stigma among adolescents and young adults living with HIV in South Africa. This study uses survey data from a sample of 1186 youth living with HIV, aged 14-24, and enrolled in peer support groups led by community-based organizations in KwaZulu Natal and Gauteng provinces, South Africa. Study participants completed a questionnaire on sociodemographic details, physical health, school attendance, who knew the individual's HIV status, and experiences of HIV-related mistreatment. Mixed effects logistic regression examined the association between experiences of HIV-related mistreatment and factors that may inadvertently disclose one's status, such as poor physical health and missed school, and knowledge of an individual's HIV-positive status by their caregiver, household, friends, educators, and most recent sexual partner. Almost a quarter of the sample reported an experience of HIV-related mistreatment in the past six months. After controlling sociodemographic characteristics, missed school due to illness (AOR = 1.75, 95% CI = 1.27-2.43), and knowledge of HIV status by non-family members (AOR = 2.19, 95% CI = 1.60-3.00) were significantly associated with HIV-related mistreatment. Findings suggest that experiences of enacted stigma are common among youth and linked to poor physical health and knowledge of HIV status outside the family. Effective community-level stigma reduction interventions are urgently needed. In the meantime, adolescents need individualized disclosure counseling and support managing their physical health to prevent further inadvertent disclosure and discrimination.