Attitudes Toward HIV-Positive Status Disclosure Among U=U-Aware Sexual and Gender Minority Individuals in the USA: a Consensual Qualitative Research Approach

Abstract

Introduction The U=U (i.e., undetectable equals untransmittable) campaign is founded upon biomedical advancements that have positioned HIV as a manageable condition with effectively zero risk of transmission. In spite of these developments, attitudes of sexual and gender minority populations regarding the necessity of seropositive status disclosure remain unexamined. Methods The current study analyzed qualitative data regarding the necessity of seropositive status disclosure from 62 sexual minority men as well as transgender and gender non-conforming individuals who have sex with men from 2020 to 2021. Results The majority of participants believed disclosure to be necessary and invoked several social and structural factors that informed their attitudes. Participants cited HIV criminalization laws, the ethics of non-disclosure, and disclosure as a means of educating sex partners when appraising the necessity of disclosure. Participants also presented concerns regarding U=U efficacy and HIV stigma. Conclusions Findings indicate that the disclosure of seropositive status to sex partners is still important to U=U-aware sexual and gender minority individuals. The majority of the study sample, irrespective of HIV status, believed seropositive status disclosure was necessary in advance of sex. Policy Implications Findings suggest opportunities for public health messaging to remediate concerns about U=U efficacy, combat misinformation, and clarify out-of-date information on HIV criminalization.

Desires for Individual- and Interpersonal-Level Patient Portal Use for HIV Prevention Among Urban Sexual Minority Men: Cross-sectional Study

“…These advances include pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP) for persons at risk for HIV, and ART, which has led to the medical reality that people living with HIV who have achieved sustained viral suppression may finally live free of worry about transmitting HIV if they remain undetectable (also known as U=U or undetectable equals untransmittable) [14]. For sexual minority men at risk for and living with HIV alike, these biomedical advances allow for greater sexual freedom and confidence when engaging sexually with partners of HIV status different from their own [15,16].…”

“…Nevertheless, conversations with sexual partners about sexual behavior, sexual health, history of STIs, and ongoing testing habits can remain anxiety-provoking for many sexual minority men. This may be especially true for sexual minority men living with HIV, who may fear rejection, other stigmatizing reactions such as outing and even violence from potential sex partners [16]. Despite the interpersonal risks associated with the disclosure of HIV seropositivity, sexual minority men living with HIV cite their sense of sexual ethics, awareness of laws requiring disclosure of seropositive HIV status before engaging in sex, and other sociohistorical factors that motivate them to share this aspect of their health with sexual partners [16].…”

“…This may be especially true for sexual minority men living with HIV, who may fear rejection, other stigmatizing reactions such as outing and even violence from potential sex partners [16]. Despite the interpersonal risks associated with the disclosure of HIV seropositivity, sexual minority men living with HIV cite their sense of sexual ethics, awareness of laws requiring disclosure of seropositive HIV status before engaging in sex, and other sociohistorical factors that motivate them to share this aspect of their health with sexual partners [16]. Therefore, innovative strategies to support sexual minority men living with HIV in making such disclosures before engaging in sexual behaviors have been identified as an ongoing need [14].…”

“…Portals can also be used to disseminate educational information for partners of sexual minority men living with HIV, including the definitive finding that people living with HIV who have achieved sustained viral suppression cannot transmit HIV through sex or U=U [14]. Future research could examine ways sexual minority men living with HIV can use patient portals to deliver information about U=U and their undetectable viral load to potential sexual partners and whether portal-facilitated disclosures might reduce anxiety, awkwardness, or fear of disclosure [16].…”

Perception and Experience of Sexual and Gender Minority Korean Youth in School Counseling

“…CQR also allows researchers to embrace the uniqueness of their participants’ experiences and capture similarities in such experiences (Hill, 2012 ). Especially, CQR has been widely used to explore underrepresented minority individuals’ experiences, such as attitudes toward HIV-positive status disclosure among SGM individuals (Sauermilch et al, 2022 ), experience and coping during the school-age years with transgender people of color (Simons et al, 2021 ), racialized experience in Christian higher education among Asian American faculties (Hyun et al, 2022 ), and discriminated experience with Muslim Arab American women (Alsaidi et al, 2021 ).…”