It's not just what you say: Relationships of HIV dislosure and risk reduction among MSM in the post-HAART era

R. Klitzman, T. Exner, J. Correale, S. B. Kirshenbaum, R. Remien, A. A. Ehrhardt, M. Lightfoot, Sheryl L Catz, L. S. Weinhardt, M. O. Johnson, S. F. Morin, M. J. Rotheram-Borus, J. A. Kelly, E. Charlebois

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

In the post-HAART era, critical questions arise as to what factors affect disclosure decisions and how these decisions are associated with factors such as high-risk behaviors and partner variables. We interviewed 1,828 HIV-positive men who have sex with men (MSM), of whom 46% disclosed to all partners. Among men with casual partners, 41.8% disclosed to all of these partners and 21.5% to none. Disclosure was associated with relationship type, perceived partner HIV status and sexual behaviors. Overall, 36.5% of respondents had unprotected anal sex (UAS) with partners of negative/unknown HIV status. Of those with only casual partners, 80.4% had ≥1 act of UAS and 58% of these did not disclose to all partners. This 58% were more likely to self-identify as gay (versus bisexual), be aware of their status for ≤5 years and have more partners. Being on HAART, viral load and number of symptoms were not associated with disclosure. This study - the largest conducted to date of disclosure among MSM and one of the few conducted post-HAART - indicates that almost 1/5th reported UAS with casual partners without disclosure, highlighting a public health challenge. Disclosure needs to be addressed in the context of relationship type, partner status and broader risk-reduction strategies.

Original languageEnglish (US)
Pages (from-to)749-756
Number of pages8
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Volume19
Issue number6
DOIs
StatePublished - Jul 2007
Externally publishedYes

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

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