The paradox of public HIV disclosure.

In order to examine the impact on HIV-positive people of publicly disclosing their status, in-depth interviews were conducted with 75 HIV-positive speakers from 20 countries in Africa and the Asia-Pacific region. Decreasing stigma and stopping new infections were equally strong motivators in becoming community AIDS educators. Although few respondents were trained, most had good support from peers and/or family. Public disclosure led to a diminution of discrimination. Speaking out was extremely rewarding. Disclosure led to a less stressful, more productive life and to improved wellbeing. Virtually all speakers from every setting had no regrets and saw only the benefits of public disclosure. The paradox of coming out openly as an HIV-positive person is that by facing AIDS-related stigma, one finds psychological release-liberation from the burden of secrecy and shame. Disclosure is beneficial to all concerned. It enriches the speakers' lives and it helps the community. HIV-positive speakers may be a fundamental component of successful AIDS education campaigns, but increasing the numbers of people who are 'out' is only possible in a conducive environment. Governments and AIDS organizations must provide adequate emotional and optimal organizational support to those who do so, including peer support, counselling and appropriate training.