Negotiating Intimacy and Silence: Family Disclosure Strategies Among Young Chinese Men Who Have Sex With Men Living With HIV.

This study examines how young Chinese men who have sex with men (MSM) living with HIV navigate the disclosure or concealment of their sexual orientation and HIV status within family contexts shaped by Confucian moral norms. Drawing on in-depth interviews with 24 participants and a constructivist grounded theory approach, the study identifies five disclosure strategies: prior disclosure of sexual orientation followed by HIV disclosure, prior disclosure of sexual orientation with withheld HIV disclosure, simultaneous disclosure of both identities, non-disclosure of both identities, and HIV disclosure with withheld sexual orientation. Findings show that disclosure was not a discrete act but an ongoing relational process through which participants negotiated stigma, filial obligation, and family ties. Participants navigated the unequal moral meanings attached to HIV and sexual minority identity: HIV sometimes became a culturally intelligible condition that elicited care and reduced marriage pressure, whereas sexual minority identity remained more closely associated with filial failure, lineage expectations, and family reputation. To conceptualize these dynamics, the study develops an integrated framework of relational reconfiguration and the ethics of ambiguity. Relational reconfiguration captures how family relationships are reorganized through shifting boundaries, moral expectations, and roles, whereas the ethics of ambiguity refers to the culturally grounded strategy through which such reconfiguration is enabled and sustained. These findings suggest that practitioners should not treat full disclosure as a universal goal; instead, they should support culturally and relationally attuned disclosure planning, including partial, staged, or sibling-mediated pathways that allow individuals to maintain safety, care, and family connection under intersecting stigma.