"Don't Tell Nobody Nothing": A Phenomenological Study on Fear of HIV Disclosure Among Older African Americans During Incarceration Living in Kentucky, USA.
Jennifer S Tinman, Nqobile Nzama, Jenifer Patterson and 2 others
PMID 39718385WHAT IT FOUND
Older African Americans living with HIV described staying silent in prison because disclosure could bring ostracism, violence, and lost privileges.
Staff breaches, visible lists, and selective glove use made confidentiality hard; trusted groups helped.
Key findings
01Participants feared that HIV disclosure in carceral settings could lead to being shunned, beaten, or denied privileges and work.
02Confidentiality was sometimes broken by guards, nurses, and providers through visible lists, overheard talk, or selective use of gloves.
03Some participants found safer disclosure in trusted settings, including a nurse-led support group and friendships with people who shared stigma.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The parent study was designed around stress and stigma in HIV care, not specifically around fear of disclosure or confidentiality in incarceration. Only 7 of the 11 participants completed follow-up interviews because of difficulty reconnecting. The data were collected before the COVID-19 pandemic, so carceral conditions may have changed. The larger study used constructivist grounded theory rather than a phenomenological design, so the interviews did not include targeted follow-up questions for this secondary analysis. As a secondary analysis, the team could not contact participants for clarification or explore how age, race, gender, HIV status, and incarceration intersected. The purposive subset was small and selected from participants who already discussed fear of disclosure or confidentiality. The coders were not part of the original data collection team, and their identities and prior experiences may have shaped interpretation.
Declared interests
The authors report no real or perceived vested interests related to the article.
The easy way to misread this
Do not read this as evidence that HIV support groups or protective custody improve outcomes. The study reports participants' experiences and desires, not tested effects.