Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Gonzalo Bacigalupe

Second Advisor

Sharon Horne

Third Advisor

Markie Twist


Young Black men who have sex with men account for the greatest number of behaviorally acquired human immunodeficiency virus (HIV) infections in the United States. Young Black men who have sex with men are less likely to be engaged in care compared to other populations with HIV. Stigma inhibits developmental processes that support engagement into care for young adults with HIV. Stigma impedes social support and disclosure, two components of identity development that predict positive health behaviors in young adulthood. It is hypothesized that online patient communities have the potential to facilitate identity development by providing young adults with HIV with social support and opportunities for disclosure. However, this has yet to be empirically explored. This study sought to answer the research question, how do young Black men who have sex with men with HIV disclose within online patient communities, by taking a multi-method approach and integrating two qualitative traditions: netnography and grounded theory. By answering this question, counseling psychologists working with HIV positive young adults will have a better understanding of the potential of online communities for fostering identity development. Data was collected by observing an online patient community comprised of members with HIV and completing semi-structured interviews with seven young Black men who have sex with men with HIV receiving treatment. Results suggest that disclosure functions as a rite of passage into the online patient community. By disclosing their status, young Black men who have sex with men with HIV are also revealing their intention to seek community support. Disclosures most often result in social support including both informational and emotional guidance by other community members. Disclosure is also a means of negotiating a young adult’s identity as disclosures contain reflections on members’ intersecting racial, health, and sexual identities. This paper presents a model illustrating the process of disclosure amongst young Black men who have sex with men with HIV in online patient communities. The paper concludes with clinical and policy implications for the field of counseling psychology.


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