About the Book
In the era of the Internet and Oprah, in which formerly taboo information is readily available or freely confided, secrecy and privacy have in many ways given way to an onslaught of confession. Yet for those who are HIV positive, decisions about disclosure of their diagnosis force them to confront intimate, fundamental and rarely discussed questions about truth, lies, sex and trust. Drawing from interviews with over 70 gay men and women, intravenous drug users, sex workers, bisexual men, and heterosexual men and women, the authors provide a detailed portrait of moral, social and psychological decision making. The interviews convey the complex emotions of love, lust, longing, hope, despair and fear that shape individual dilemmas about whether to disclose to, deceive, or trust others concerning this disease. Some of those interviewed revealed their diagnosis widely; others told no one. Some struggled and ultimately told their partners; others spoke in codes or half-truths. One woman discovered her husband's diagnosis in a diary; when confronted, he denied it.
Each year in the United States, 40,000 new cases of HIV arise, yet approximately one-third of the 900,000 Americans who are infected do not know it. As treatments have improved, unsafe sexual behaviour has increased and efforts at prevention have stalled. Many of those infected continue to fear and experience rejection and discrimination. Addressing broad debates about the nature of secrecy, morality and silence, this book explores public policy questions in light of the nuanced, private decisions that are shaping the course of an epidemic and has broader indications for all.
Table of Contents:
Contents:Introduction Secrets, Lies, and Private Life1. Getting Tested Uncovering the Truth 2. Sexual Partners Sex, Love, and Disclosure 3. Secrets and "Secret Secrets" | Disclosure in Families 4. Disclosure in Other Worlds Friends, Co-Workers, and Going Public 5. Dangerous Acts 6. Making Moral JudgmentsConclusion Secrets in Public Life
About the Author :
Robert Klitzman, M.D., is an assistant professor in the department of psychiatry and is codirector of the Center for Bioethics at Columbia University. He is the author of The Trembling Mountain: A Personal Account of Kuru, Cannibals and Mad Cow Disease (2001), In a House of Dreams and Glass: Becoming a Psychiatrist (1996), Being Positive: The Lives of Men and Women with HIV (1997), and A Year-long Night: Tales of a Medical Internship (1989).Ronald Bayer, Ph.D., is a professor in the Department of Sociomedical Sciences at Columbia University's School of Public Health. He is the author of AIDS Doctors: Voices from the Epidemic(2000), and Private Acts, Social Consequences: AIDS and the Politics of Public Health (1989).
Review :
An engaging consideration of the competing and sometime contradictory values that influence disclosure decisions in the lives of HIV-positive adults... [and] a stimulating and deeply satisfying discussion of the tensions inherent in disclosure stories. -- Robert Kertzner, M.D. American Journal of Psychiatry An in-depth look at the motivations, beliefs, and practices of those who must decide to get tested and if positive, whether or not to disclose, and when... Mortal Secrets delivers a powerful message using the voices of those most affected. -- Lisa K. Waldner, Ph.D. Journal of the American Medical Association Nonjudgmental... Readers may find themselves with newly gained compassion and understanding for the dilemma of when and how to disclose HIV status. -- Marla J.Gold, MD Annals of Internal Medicine This is an interesting book that social workers need to read so as to understand their clients concerns. A recommended book for all academic libraries. AIDS Book Review Journal Klitzman and Bayer provide an engaging consideration of the competing and sometimes contradictory values that influence disclosure decisions in the lives of HIV-positive adults. Focus: A Guide to AIDS Research and Counseling It is an aim that succeeds to an extraordinary degree... So well thought-out is this study, and so well presented are the accounts of the participants, that I put the book down with a real-and rare-sense that my understanding had grown and my thinking about the ethics of HIV-in particular the responsibilities of those infected-had shifted... The examples given here put such bald statements into a new context, and make the social and cultural factors that shape the pandemic seem vivid and emotionally real. Such vividness serves powerfully to enhance understanding. -- Tamsin Wilton Journal of Neurology, Neurosurgery and Psychiatry This is a very interesting and thought-provoking book, which utilizes, but also moves beyond, the interview data in order to address broader debates around complex issues of sexuality and morality. -- Elaine Denny New Genetics and Society A useful resource for both clinicians and laypersons, and I recommend it as a highly accessible and expertly written book. International Review of Psychiatry Mortal Secrets is a book for anyone desiring to move forward in the fight against the illness, not the people. -- Erica Prigg Health Communication
