Decision-making pathways of voluntary sexual partner disclosure among newly diagnosed people living with HIV: a qualitative study informed by the health belief model.

OBJECTIVE

To explore the decision-making pathways and influencing factors of voluntary sexual partner disclosure among newly diagnosed people living with HIV, informed by the Health Belief Model.

METHODS

A descriptive qualitative design was adopted. Guided by the HBM, semi-structured in-depth interviews were conducted with 31 newly diagnosed people living with HIV between January and March 2026. Participants were purposively recruited from a tertiary infectious disease hospital in Chongqing, China, including both inpatient wards and outpatient clinics. Data collection and analysis were conducted concurrently and continued until thematic saturation was achieved. Data were analyzed using directed content analysis, while allowing for the retention of emerging themes beyond the original theoretical framework.

RESULTS

Six themes and 18 subthemes were identified: (1) emotional shock, (2) risk perception, (3) perceived benefits, (4) barriers, (5) disclosure pathways, and (6) outcomes and support. Participants commonly experienced significant emotional shock during the early stage after diagnosis. Perceived health risks to sexual partners and the expected benefits of disclosure served as important foundations for voluntary disclosure, whereas stigma-related concerns, perceived relationship risks, concerns about privacy control, and insufficient knowledge and communication confidence constituted major barriers. Through the dynamic balancing of these factors, participants mainly followed three pathways: direct disclosure, delayed disclosure after internal deliberation, and non-disclosure.

CONCLUSION

Voluntary sexual partner disclosure among newly diagnosed people living with HIV is a dynamic decision-making process shaped by risk perception, benefit appraisal, and barrier evaluation. Disclosure support should be moved forward to the early post-diagnosis stage, with enhanced communication guidance, psychosocial support, and privacy protection provided alongside disease-related knowledge support, so as to promote more timely and appropriate partner disclosure.