HIV Disclosure and Low HIV Stigma in a Gay Serodiscordant Couple: An Interpretative Phenomenological Case Study of the Discloser-Confidant Dynamics

Introduction HIV stigma levels are high in Greece. HIV stigma hinders testing, healthcare access, and treatment adherence, often leading to non-disclosure. The discloser navigates challenges by balancing the confidant's potential reactions, ranging from rejection and discrimination to the benefits of increased intimacy and liking. However, much research focuses on either the confidant's reactions or the discloser's role, leaving gaps in understanding the full disclosure process. Methods This qualitative case study explores how HIV disclosure, stigma, and trust-building unfold, focusing on the timing, reasons, and impact of disclosing HIV-positive status on the relationship dynamics between the discloser and the confidant. Semi-structured interviews were conducted with a serodiscordant gay couple, recruited from a hospital in Greece. Results Through interpretative phenomenological analysis, we identified a Superordinate Theme: The HIV Disclosure Process with three sub-themes: (1) Navigating HIV Disclosure: Decision Making and the Disclosure Event, (2) HIV Acceptance and Stigma: Pathways to Disclosure, and (3) HIV Disclosure: Building a Foundation of Trust and Navigating Life's Broader Uncertainties. Investigator triangulation was used, enhancing the credibility and reliability of the findings. Conclusion Our case study explores HIV disclosure as a unified process, revealing that both avoidance and approach goals coexist. Avoidance delayed disclosure by withholding emotions in conflicted family relationships, yet led to positive outcomes, while approach goals encouraged earlier, open, and factual disclosure in romantic relationships, resulting in better positive outcomes. Greater HIV knowledge, approach goals, and trust encouraged protective behaviors and advocacy. HIV was normalized within the relationship, allowing the couple to manage it alongside everyday uncertainties.