Older Adolescents’ Self-Determined Motivations to Disclose Their HIV Status

Disclosure of HIV status is an important topic for youth living with HIV/AIDS, yet theoretical frameworks for understanding HIV disclosure motivations have been poorly applied. Self-determination theory (SDT) proposes that people are at optimal functioning when they are engaging in activities that are interesting and enlivening. This study utilized SDT to understand young adults’ motivations to disclose their HIV status. Interviews and observations were conducted with nine youth aged 17–19 and two adult staff. Results indicate that SDT is useful for understanding types of motivation (i.e., amotivation, controlled, and autonomous motivation) to disclose. Amotivation was the most common type of motivation, and came from two recursive sources: fear of stigma and previous experiences of others disclosing without their consent. Controlled motivation to disclose occurred when participants were motivated to disclose because of reasons related to other people, rather than internal or personal reasons, and included the reasons of wanting to gain a closer relationship, reciprocate a shared secret, for psychological or emotional relief, and for attention. Autonomous motivation included two themes: the life perspective that “Having HIV is just part of who I am,” and valuing educating others because education was perceived as important and beneficial to others. This study extends SDT into the domain of HIV disclosure in older adolescents. People providing guidance and support to older adolescents with HIV/AIDS can use SDT to understand different motivations to disclose.