Male Self-Disclosure of HIV-Positive Serostatus to Sex Partners: A Review of the Literature

Abstract

HIV-positive men face multiple challenges when deciding whether to disclose their serostatus to sex partners. The purpose of this literature review (1996-2004) is to identify valid and reliable research results that identify factors influencing serostatus disclosure to sex partners by men who are HIV-positive. Articles included in the review were identified through an electronic search using pertinent terms related to disclosure to sex partners, followed by a search of references for additional articles. A compilation of research results for 17 articles is presented under the headings of background, contextual, and psychosocial factors influencing disclosure. An analysis of the data suggests that differences in disclosure rates vary based on sex partner factors including serostatus, relationship status, and number of sex partners. Rates of disclosure to primary sex partners ranged from 67% to 88%, suggesting that nearly one third of main sex partners were not disclosed to and were at risk of contracting HIV, whereas a pattern of lower disclosure among casual partners was evident. As the number of sex partners increased, the likelihood of disclosure to all sex partners decreased, ranging from one quarter (25%) to slightly over half (58%). In addition, perceived efficaciousness and positive outcome expectations were the most frequent theoretical constructs embedded in the research associated with disclosure, suggesting that these factors play an important role in the process of disclosure to sex partners. Interpersonal factors that positively influenced self-disclosure included spousal support, emotional investment, and communication about safe sex, including asking about a partner's serostatus. Self-disclosure was not consistently associated with safer sex. Recommendations for future research are presented, based on the results included in this review.

Sexual Behaviour, Sero-Status Disclosure and Willingness to Disclose Status among HIV Positive Male Patients Receiving Care in Hospitals in Imo State, Nigeria

“…With respect to engaging in sexual activity and having multiple sexual partners, the present study was similar to the study by Berniera et al [28] who reported that 23% of the male participants stopped having sex after HIV diagnosis and also, according to Denue et al [25] who reported that, about 39% of HIV patients on ART for a length of time, had multiple sexual partners. Sullivan in his study [29] reported that, as the number of sex partners for men increases, the likelihood of disclosure will decrease. Furthermore, our study was not consistent with a review of studies conducted in Africa by Kennedy et al [30], where it was observed that a majority of HIV patients on ART abstained from sexual activity.…”

Risk-Taking Behaviors Among Vertically HIV-Infected Adolescents in Northern Thailand

“…17 This difficulty is not confined to adolescents; previous studies have recognized that up to one third of sex partners of HIV-infected male adults had not been informed of the diagnosis of HIV infection, with worsening patterns of disclosure with casual partners and with increasing numbers of sexual partners. 18 Thai adults have shown a higher rate of disclosure (88%) to regular sexual partners. 19 Unprotected sexual intercourse, often without disclosing HIV status, has also been reported by about one third of HIV-infected adults in the United States, but the relationship between increased disclosure and safer sexual practices remains unclear.…”

Depression and HIV Serostatus Disclosure to Sexual Partners Among Newly HIV-Diagnosed Men Who Have Sex with Men

“…8 Men living with HIV have difficulty disclosing their HIV status to their sexual partners, 9 and MSM are less likely to disclose to all of their sexual partners compared to women and heterosexual men. 10 In deciding to disclose, PLHIV weigh the benefits and risks of sharing one's serostatus.…”