Information about Participant Rights and Consent to Participate

1. Introduction:
We are requesting your participation to complete a survey aimed to better understand the disclosure process and assess factors that may be related to disclosure of one’s HIV status. This research is being conducted by Mary Talbot a PhD candidate at Loyola University Chicago. This research has been reviewed and approved by the Loyola University Chicago Institutional Review Board (IRB).

You are being asked to participate because you are HIV+ and you are 18 years of age or older. Your input is invaluable for understanding the disclosure process and the impact disclosure or non-disclosure has on HIV+ people.

Please read this form carefully before deciding whether to participate in the study.

The purpose of this study is to measure and understand the impact of first disclosure experience and internalized stigma on subsequent/future disclosures. We are also interested in the relation between the pattern of disclosure, social support, and health indicators, such as CD4 numbers. We hope that a better understanding of these processes and relationships will lead increased HIV education and a reduction of HIV-related stigma.

If you agree to be in the study, you will be asked to:
• Complete a survey about your disclosure experiences and factors that may be related to your disclosure experiences. The survey should take between 15-20 minutes to complete.

There are no foreseeable risks involved in participating in this research beyond those experienced in everyday life. To counter any risk, all information that you share with researchers will be stored on password protected computers in a securely locked office.

There may be minimal direct benefits to you from participation. However, the information you provide will help society to gain a better understanding disclosure and perhaps underscore the necessity for more education on HIV and the reduction of HIV-related stigma.


Your participation in this study will be confidential. You will not be asked to provide any information that would identify you and thus any responses you provide cannot be matched to individual participants. All findings will be reported without using identifying information.

Confidentiality will be maintained in presentations and publications made beyond the researcher and faculty sponsor. Results will not be released in any way that can be matched to individual participants. Data, including completed surveys, will be stored in the researchers’ locked office files and on password protected computers. These data will only be used by the research team for research purposes. Raw data will be maintained until the end for the research project and then destroyed.

Voluntary Participation:
Participation in this study is voluntary. If you do not want to be in this study, you do not have to participate. Even if you decide to participate, you are free not to answer any question or to withdraw from participation at any time without penalty. If you do not wish to participate it will not adversely affect your relationship with Loyola University Chicago.

No compensation will be provided for your participation in the survey.

Contacts and Questions:
If you have questions about this research study, please feel free to contact Mary Talbot at or R. Scott Tindale at

If you have questions about your rights as a research participant, you may contact the Loyola University Office of Research Services at (773) 508-2689.

Statement of Consent:
Clicking below indicates that you have read the information provided above, and agree to participate in this research study. You may have copy of this form to keep for your records if you by requesting a copy from the researchers.