Drawbacks associated with secondary disclosure among family members of the discordant couples: Findings from a qualitative study at a regional hospital in Johannesburg, South Africa

Abstract

This study explored the drawbacks associated with secondary disclosure among family members of discordant couples at a regional hospital in Johannesburg, South Africa. This was a qualitative study utilising an Interpretative Phenomenological Analysis (IPA) design. A purposive sampling method was used, and participants were recruited using snowball sampling. Data was collected from eight family members of HIV serodiscordant couples using one-on-one semi-structured in-depth interviews, and data was analysed thematically using the IPA framework. The findings indicated that family members of the HIV serodiscordant couples were distressed, and this led participants to show reluctance and opposition to secondary disclosure of the results of discordant couples to other family members. Drawbacks to secondary disclosure stem from being shaped by family differences, family gossip, lack of support, the stigma associated with HIV, and the HIV topics being regarded as a taboo in the family. To minimise disclosure tension and manage stress among family members of discordant couples, HIV programs should be directed at addressing stigma related issues and promote the importance and benefits of secondary disclosure counseling services among discordant couples and family members. This study contributes to our understanding of how discordant couple’s family members are negatively affected by secondary disclosure. The study can further contribute to the improvement of policies and guidelines to include discordant families in the planning and implementation of their programs to enhance, strengthen, and promote secondary disclosure, including the comprehensive services of discordant couples and their families.