Firstly, the spell is a Phantasm, rules for which mention
This impression is totally in the minds of the subjects. It is a personalized mental impression, all in their heads and not a fake picture or something that they actually see.
So - the person affected is perceiving clues that makes them think they are affected by the various afflictions. The rules for disbelief say, in part -
Creatures encountering an illusion usually do not receive saving throws to recognize it as illusory until they study it carefully or interact with it in some fashion.
Taking the Curse option specifically, I would take this to mean that no disbelief save is allowed until the target tries to make an attack roll, or rolls a skill check, or a save, while under the effect. Or, somehow, examines specifically what's going on, maybe with detect magic, or by trying to make attacks or something similar. Potentially, making a Spellcraft check to identify the spell as it is cast would also provide an opportunity to disbelieve.
Regardless, by the time the person is making a save to disbelieve, they are already under the effects of the illusory curse. So, the save to disbelieve would include the modifier for the illusory curse of -4. Assuming this save succeeds, the illusory curse is still in effect, even though the target has realised it is an illusion. The second save is to break free of that illusion, and would still receive the -4 to save, since the curse is still in effect.
As an added note, the description of the Save line seems inconsistent with the Poison and Disease entries. Although the Curse seems to be in effect even after disbelieving, neither the Poison nor Disease effects mention this. So, I would actually expect that making the Disbelieve save would prevent both of those options from having an effect, even though the save entry implies the opposite.