COLUMBUS, Ohio -- People diagnosed with HIV often turn to friends for support, and that's encouraged by doctors and therapists. But Ohio State University research suggests this advice may not go far enough.

"It's just as important to approach family members, as well as friends, for support," said Julie Serovich, associate professor of human development and family science at Ohio State. Serovich has studied HIV-infected men since 1997 under a grant from the National Institutes of Mental Health.

In Serovich's most recent study, published in the journal AIDS CARE, she found that the 134 HIV-positive men were less likely to be depressed if they received support from their families. In another study of 142 HIV-positive men, published in AIDS Education and Prevention, she found that subjects who received social support from their families were less likely to engage in risky sexual behaviors than were men who did not get social support from their families.

That's vital information in helping reduce the spread of HIV and AIDS, which has infected more than three-quarters of a million Americans in the last two decades, and has killed more than 430,000. It's also important in helping protect HIV-positive people from becoming infected with other strains of HIV or other sexually-transmitted diseases.

However, because of the complexities often inherent in gay men's family relationships, therapists often don't even attempt to encourage their clients to open up to their families, Serovich said.

"For some men, especially gay men, family relationships can be problematic," Serovich said. "The feeling up to now has been that most gay people just don't see the family as an important source of support. But I'm finding that support you get from family is different than support you get from friends."

These findings have led Serovich to believe that doctors, therapists and counselors should do more to encourage HIV-positive men to turn to their families for support and work on family relationships if necessary. However, she admits that sometimes that just won't work.

"I don't think all HIV-positive people should tell family members, nor do I believe all family will be supportive -- in fact, they may actually be hateful," Serovich said. So, HIV-positive men should consider seeking guidance from therapists or other helping professionals in making decisions about disclosure to family. And therapists need to encourage exploring those options, she said.

"We have to take a wider view of family relations with these men, and therapists might take more time to investigate how to help these men with family difficulties whenever possible," Serovich said. "If we can't help family members change, at least we can, and should, help gay men deal with the loss inherent when someone feels abandoned by their family. The impact of family cannot be ignored or replaced."

People often need help in figuring out how to disclose their HIV-positive status to anyone, but it's important that they do so, Serovich said. "People who disclose are more likely to get necessary medical help and find out about clinical trials, new therapies or other options available to them.

"Obviously, they're also more likely to get social support. That can help alleviate the mental anguish that people experience when they're diagnosed."

Another reason not to hide HIV-status: It is possible for HIV-positive people to have satisfying sex lives and not put themselves or others at risk, Serovich said. But they often discover ways to help them do so only after disclosing their HIV status, she said.

In a recent issue of the Journal of Marital and Family Therapy, Serovich offers guidance to therapists in helping clients disclose their HIV-positive status. She suggests that therapists and their clients take a close look at the nature of each relationship, assessing any special circumstances among friends and family members to take under consideration, anticipating reactions, and reviewing the benefits of disclosure.

Serovich has also begun to study HIV-positive women, examining similar issues as in her work with HIV-positive men. Her NIMH grant runs through 2002.

---Ohio State University 

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