Trauma of discovery: women's narratives of being informed they are HIV-infected.

The purposes of this research report are to describe women's subjective experiences of being informed of a positive HIV antibody test and, from their point of view, to explain the meaning and impact of discovering that one is HIV-infected. In this qualitative narrative study, a racially diverse, low-income sample of 38 HIV-infected women shared their stories of HIV discovery during in-depth interviews. Findings of a multi-staged narrative analysis suggest that, for women like those in this study, the discovery of HIV seropositivity is a traumatic event, carrying with it elements that are common to other types of trauma: perceived threat to one's life and perceived responsibility for the deaths of others. Overarching personal meanings, or metaphors, framed these women's experiences of the trauma of HIV discovery. HIV discovery was an epiphany for 10% of the sample, a confirmation for 37%, and a calamity for 53%. Among their calamitous reactions were shock, fear, anguish, and suicidality. The impact of learning that they were HIV-infected often took its toll in unrelenting misery, escalated drug use, transmission risks, and destabilization of relationships, income, and shelter. Extensive excerpts from participants' interviews illustrate analytic findings. Implications for counselling and follow-up at diagnosis and early in the course of HIV illness are elaborated.