HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men

Abstract

Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. Results showed that 166 (30%) men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. Men who engaged in nondisclosed condomless sex were less adherent to their HIV treatment, more likely to have unsuppressed HIV, demonstrated poorer disclosure self-efficacy, enacted fewer risk reduction communication skills, and held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness.

Awareness, utilization of HIV testing and counselling services and sero-status among commercial motorcyclists in Dar es Salaam, Tanzania

“…It was shown that majority of BBRs had multiple sexual relationships including those with regular sexual partners (apart from their spouses or permanent girlfriends) and only few of them (~37%) used condoms during sex. The act of having multiple sexual partners and the reckless behaviour of not using condom during sexual relationships may increases the risk of getting HIV infection as previously described [28,29]. Moreover, our study reported that about 23% and 11.5% of all BBRs had had sexual relationships with causal and commercial partners, respectively; but majority of these (>62%) used condoms during their encounters.…”

HIV Disclosure and Unprotected Sex Among Vietnamese Men with a History of Drug Use

“…Self-disclosure plays an important role in stemming HIV transmission and enhancing HIV prevention and treatment (1, 2). Disclosing HIV serostatus to others helps people living with HIV (PLH) garner greater tangible and emotional social support and helps them obtain better health care and counseling services (3-5).…”

Perspectives on Factors Related to HIV Risk and Preventative Interventions at Multiple Levels: A Study of African Immigrant Women Survivors of Cumulative Trauma

“…Kalichman et al (2016), in their study, with 538 sexually active HIV+ men found that undisclosed HIV+ status was common and associated with unprotected sex with uninfected partners and less adherence to care. Thus, interventions are needed that enhance disclosure self-efficacy, and increase understanding of HIV infectiousness (Kalichman et al, 2016). The relationship-level interventions, therefore, must focus on promoting healthy relationships, addressing IPV, building healthy communication including condom negotiation skills and skills in identifying and addressing risks associated with a high-risk partner.…”

“…Disclosure of HIV+ status to a sexual partner is critical for HIV prevention (Kalichman, Kalichman, Cherry, & Grebler, 2016). Kalichman et al (2016), in their study, with 538 sexually active HIV+ men found that undisclosed HIV+ status was common and associated with unprotected sex with uninfected partners and less adherence to care. Thus, interventions are needed that enhance disclosure self-efficacy, and increase understanding of HIV infectiousness (Kalichman et al, 2016).…”