The disclosure of HIV status remains a salient issue due to its direct impact on prevention. While the issue has been the focus of extensive research in Northern countries and sub-Saharan Africa, it has received less attention in the Middle East and North Africa (MENA) despite the rapid and ongoing spread of the epidemic in this region. This study examines how Tunisians living with HIV have chosen to manage information about their sero-status and the consequences of their choice on their daily lives. For this purpose, we adopted a mixed method approach, combining semi-structured interviews- with 23 HIV positive individuals receiving care at the Hedi Chaker hospital in Sfax – and an archival analysis of their social and medical records. These individuals have opted for a limited and selective release of this information, either by keeping it secrecy or by sharing it with one person. The finding demonstrates the complexity of these choices, given the multiple issues involved: personal, moral, altruistic issues, aimed at avoiding stigma and protecting others. Protecting others have here two meanings: saving one’s face (Goffman 1973) or one’s psychological and physical well-being. The consequence of living with the secret refers to its dual functions in the respondent’s present lives. On the one hand, it serves a protective and integrative role by concealing information that could have destructive effects on oneself and others (Simmel 1950; Goffman 1973). On the other hand, it fulfils a structuring role by influencing and shaping their life decisions.