The psychological process and support needs of HIV-positive individuals who disclose their status to sexual partners: a qualitative study

Objective To explore the psychological journey and core needs of People living with HIV (PLWH) intending to disclose their status to sexual partners, providing a theoretical basis for constructing a disclosure support system. Methods A descriptive qualitative study was conducted using semi-structured interviews with 15 People living with HIV at a hospital in Changzhou, China. Thematic analysis was used to analyze the interview data. Results Five themes were identified regarding disclosure to sexual partners: (1) disclosure motivation and internal drivers; (2) risk perception during the disclosure process; (3) preparation and perceived capacity for disclosure; (4) safety protection strategies; and (5) external and social support needs. These themes reveal a multidimensional and interwoven risk perception system in disclosure decision-making, including fears of discrimination, relationship breakdown, social stigma, and threats to economic security. They further systematically outline the proactive and strategic safety behaviors individuals employ to mitigate such risks, including scenario selection, information control, and exit planning. Conclusion The findings highlight that the decisions of People living with HIV to disclose their status to sexual partners involve a dynamic interplay of emotional, ethical, and stigma-related pressures. Clinical care should establish dedicated disclosure counseling roles, provide role-play-based communication skills training, and build multidisciplinary support networks.