More than 25 years into the epidemic, AIDS stigma persists, making it difficult for many to reveal their status. But for those on the verge of saying “I’m positive,” a new study may provide that final bit of encouragement.

The journal Psychosomatic Medicine reported this past January that people who disclosed their HIV status to friends and family had CD4 counts that were about 10% higher on average than those of people who didn’t. People who were, in the study’s terms, “always” or “mostly” open about being positive had higher counts, even allowing for other typical factors liked missed med doses.

This comes as no surprise to Steven Lee, MD, a psychiatrist in New York who works with many HIV-positive people. “People who disclose their status usually [do better at] coping with the illness,” he says, because they are able to take control of their health care. It’s not just about taking meds, Lee adds. “Not fully accepting [that you have] HIV means that there’s a lot more anxiety about it, not as much self-care, and less social connection or support, because people can’t talk to their friends or partners about something that is very stressful.”

And stress, for people with HIV, is a very bad thing. In addition to its impact on mood, “stress causes your body to release a chemical called cortisol,” Lee says, “which has been shown to slow wound healing and [increase] rates of cancer and heart disease.”

Family and friends are crucial in helping you cope in the face of serious diseases; they can provide emotional support and assist with health care decisions. Concealing that you’re HIV positive puts major limits on these relationships by undercutting honesty and trust. The disclosure study measured the impact of these limitations on the immune system. It also found that HIV-positive gay men who were open about their sexuality—even if not necessarily about HIV—had higher CD4 counts than those who weren’t.

Lora Tucker, 47, of New York City, came out to her family and friends in 2004 after seven years of living with HIV. “There’s nothing better than when you can be yourself,” she says, “and this disease is a part of me. It’s a part of my life, and it’s important not to have to hide or go without emotional and even spiritual support. The more secrets you release, the more genuine you can be. There are still a lot of stresses from HIV. But why in the hell would I want more stress trying to keep a secret?” Tell us about it.