HIV Disclosure Anxiety:A Systematic Review and Theoretical Synthesis

HIV disclosure can help people living with HIV to access social support, enhance antiretroviral adherence, facilitate engagement in care and reduce unprotected sex. Given interpersonal risks associated with HIV disclosure, however, anxiety about sharing one’s status is common. To investigate anxiety about HIV disclosure in HIV-positive populations, we conducted a systematic review of qualitative and quantitative studies, with 119 studies included. The review demonstrated that perceived interpersonal risks are associated with HIV disclosure and outlined evidence of associations with anxiety, fear and worry. We present a new cognitive model of HIV disclosure anxiety adapted from clinical theories of health and social anxiety, consistent with evidence from the review. The model attempts to explain the development and maintenance of anxiety in individuals whose functioning is most affected by concerns about sharing their status. Implications for helping people living with HIV struggling with significant levels of anxiety about HIV disclosure are discussed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10461-016-1453-3) contains supplementary material, which is available to authorized users

When simulated environments make the difference: the effectiveness of different types of training of car service procedures

An empirical analysis was performed to compare the effectiveness of different approaches to training a set of procedural skills to a sample of novice trainees. Sixty-five participants were randomly assigned to one of the following three training groups: (1) learning-by-doing in a 3D desktop virtual environment, (2) learning-by-observing a video (show-and-tell) explanation of the procedures, and (3) trial-and-error. In each group, participants were trained on two car service procedures. Participants were recalled to perform a procedure either 2 or 4 weeks after the training. The results showed that: (1) participants trained through the virtual approach of learning-by-doing performed both procedures significantly better (i.e. p < .05 in terms of errors and time) than people of non-virtual groups, (2) the virtual training group, after a period of non-use, were more effective than non-virtual training (i.e. p < .05) in their ability to recover their skills, (3) after a (simulated) long period from the training—i.e. up to 12 weeks—people who experienced 3D environments consistently performed better than people who received other kinds of training. The results also suggested that independently from the training group, trainees’ visuospatial abilities were a predictor of performance, at least for the complex service procedure, adj R2 = .460, and that post-training performances of people trained through virtual learning-by-doing are not affected by learning styles. Finally, a strong relationship (p < .001, R2 = .441) was identified between usability and trust in the use of the virtual training tool—i.e. the more the system was perceived as usable, the more it was perceived as trustable to acquire the competences