Disclosure of HIV status: cultural issues of Asian patients.

Disclosure of human immunodeficiency virus (HIV) status is a difficult emotional task creating opportunities for both support and rejection. For Asian patients there may be additional self-imposed barriers to disclosure that are rooted in cultural values. The purpose of this article is to describe how Asian cultural values of harmony and avoidance of conflict affect the disclosure experiences of HIV-positive Asian American and immigrants. Effective practice guidelines have been developed based on this information. Based on in-depth interviews with 16 HIV-positive Asian men, three focal issues were identified that serve as barriers to disclosure to family members: protection of family from shame, protection of family from obligation to help, and avoidance of communication regarding highly personal information. Additionally, patients felt disclosure was inhibited by the lack of HIV education to which families living overseas may have access. This is compounded by their lack of access to translated materials that they could send to family members. Similar to past disclosure research with non-Asian samples, the findings suggest that gay Asian men seek emotional support from gay friends. They would consider disclosing to relatives only when health reasons necessitated it. It is essential that helping professionals be attentive to the dishonor that patients may experience through disclosure and the stigma associated with being gay. Patients who are considering making a disclosure may need assistance with thinking through ways to provide HIV/acquired immune deficiency syndrome (AIDS) education to those family members that have little knowledge in this area. This may include translating or locating informational brochures translated into the family's language.

Nagging and other drinking control efforts of spouses of uncooperative alcohol abusers: assessment and modification.

This article presents a conception of spouse drinking control and an approach to assessment and modification to reduce the customary drinking control efforts of spouses of alcohol abusers unmotivated to enter treatment. Modification of the nonalcoholic spouse's customary drinking control is offered as an important early step in helping to prepare him or her to become a positive rehabilitative influence. Based on its use in unilateral family therapy with 68 spouses of uncooperative alcohol abusers, procedural guidelines, criteria for use, and two case examples from a crossover experimental dyad are described. Also presented are clinical results illustrating the success of the program, benefits and conditions relating to its use, and areas of possible application.