HIV Disclosure by Perinatal Women in Thailand Ratchneewan Ross, Andrea W. Stidham, and Barbara L. Drew Little is known about HIV disclosure among perinatal women, although we do know that disclosure can facilitate timely initiation of appropriate interventions for infected individuals and their families. This study, there- fore, examined predictors of HIV disclosure among perinatal Thai women. Data (N = 207) were extracted from two larger studies of depressive symp- toms in HIV-positive pregnant or postpartum women in Thailand in which participants completed questionnaires. Most participants had low socioeco- nomic status. Logistic regression indicated that significant predictors of disclosure included older age, employment, and high family support. Psychiatric mental health nursing interventions to promote family support are critical during this time. © 2012 Elsevier Inc. All rights reserved. H IV INFECTIONS GENERALLY have greater effects on people in developing countries such as Thailand than on people living in developed countries ( Ross, Sawatphanit, Mizuno, & Takeo, 2011). At the end of 2009, the Joint United Nations Programme on HIV/AIDS (UNAIDS, 2011) estimated that 33.3 million people were living with HIV, including at least 600,000 Thai adults (ages 15–49 years), 21,000 of whom were pregnant women. Since the introduction of antiretroviral therapies (ART) in Thailand, HIV has shifted from a terminal to a chronic illness, making the need for disclosure essential (Lee et al., 2010). However, disclosure of HIV status is a complex concern for those living with the illness and, in particular, for pregnant women (Lee et al., 2010). Disclosure to others carries unique risks and challenges. Because increasing numbers of Thai women are being tested for HIV during pregnancy to reduce perinatal transmission of the illness, more women now learn of their infection during pregnancy (Ross, Sawatphanit, & Zeller, 2009). As a result, they must choose whether to disclose their diagnosis during the relatively short period before the birth of their babies. Meanwhile, HIV-positive women in Thailand who are pregnant encounter physical symptoms, depression, social isolation, and fears about transmitting the virus to their unborn children (Ross et al., 2009, 2011). HIV disclosure involves a complex process that is influenced by a number of factors, including psychological state, ability to communicate, moti- vation, and anticipated reactions (Visser, Neufeld, Villiers, Makin, & Forsyth, 2008). The stages of disclosure include coming to terms with the traumatic diagnosis; deciding upon the appropri- ateness of disclosure to a specific person; weighing the anticipated consequences and benefits of disclosure; and then choosing an appropriate situation for disclosure (Kimberly & Serovich, Available online at www.sciencedirect.com From the College of Nursing, Kent State University, Kent, OH. Corresponding Author: Ratchneewan Ross, PhD, RN, Associate Professor, College of Nursing, Kent State University, Kent, OH 44242. E–mail addresses: rross1@kent.edu (R. Ross), awarner@kent.edu (A.W. Stidham), bdrew@kent.edu (B.L. Drew) © 2012 Elsevier Inc. All rights reserved. 0883-9417/1801-0005$34.00/0 doi:10.1016/j.apnu.2011.09.005 Archives of Psychiatric Nursing, Vol. 26, No. 3 (June), 2012: pp 232–239 232