Attitudes to disclosure of HIV-serostatus to new sexual partners and sexual behaviours among HIV-diagnosed gay, bisexual and other men who have sex with men in the UK

ABSTRACT

We assessed attitudes to disclosure to new sexual partners and association with sexual behaviours among HIV-diagnosed gay, bisexual, and other men who have sex with men (GBMSM) in the UK Antiretrovirals, Sexual Transmission Risk and Attitudes (ASTRA) study in 2011-12. Among 1373 GBMSM diagnosed with HIV for ≥3 months and reporting sex in the past three months (84% on antiretroviral therapy (ART), 75% viral load (VL) ≤50c/mL), 56.3% reported higher sexual disclosure (“agree” or “tend to agree” with “I’d expect to tell a new partner I’m HIV-positive before we have sex”). GBMSM on ART with self-reported undetectable VL had lower disclosure than those on ART without self-reported undetectable VL and those not on ART. Higher sexual disclosure was associated with higher prevalence of CLS in the past three months; this was due to its association with CLS with other HIV-positive partners. Higher sexual disclosure was more common among GBMSM who had CLS with other HIV-positive partners only (72.1%) compared to those who had higher-risk CLS with HIV-serodifferent partners (55.6%), other CLS with HIV-serodifferent partners (45.9%), or condom-protected sex only (47.6%). Findings suggest mutual HIV-disclosure and HIV-serosorting were occurring in this population. Knowledge of VL status may have impacted on disclosure to sexual partners.

KEYWORDS:

• HIV
• disclosure
• condom use
• sexual behaviour
• gay men

Acknowledgements

All ASTRA study participants, ASTRA clinic teams: Royal Free Hospital: Alison Rodger; Margaret Johnson; Jeff McDonnell; Adebiyi Aderonke, Mortimer Market Centre: Richard Gilson; Simon Edwards; Lewis Haddow; Simon Gilson; Christina Broussard; Robert Pralat; Sonali Wayal, Brighton and Sussex University Hospital: Martin Fisher; Nicky Perry; Alex Pollard; Serge Fedele; Louise Kerr; Lisa Heald; Wendy Hadley; Kerry Hobbs; Julia Williams; Elaney Youssef; Celia Richardson; Sean Groth, North Manchester General Hospital: Ed Wilkins; Yvonne Clowes; Jennifer Cullie; Cynthia Murphy; Christina Martin; Valerie George; Andrew Thompson, Homerton University Hospital: Jane Anderson; Sifiso Mguni; Damilola Awosika; Rosalind Scourse East Sussex Sexual Health Clinic: Kazeem Aderogba; Caron Osborne; Sue Cross; Jacqueline Whinney; Martin Jones, Newham University Hospital: Rebecca O’Connell; Cheryl Tawana, Whipps Cross University Hospital: Monica Lascar; Zandile Maseko; Gemma Townsend; Vera Theodore; Jas Sagoo. ASTRA core team: Fiona Lampe; Alison Rodger; Andrew Speakman; Andrew Phillips. ASTRA data management: Andrew Speakman; Marina Daskalopoulou; Fiona Lampe. ASTRA advisory group: Lorraine Sherr; Simon Collins; Jonathan Elford; Alec Miners; Anne Johnson; Graham Hart; Anna-Maria Geretti; Bill Burman. CAPRA grant Advisory Board: Nick Partridge; Kay Orton; Anthony Nardone; Ann Sullivan. The ASTRA Study Group acknowledges the support of the NIHR, through the Comprehensive Clinical Research Network. FCL, ANP, AJR, AS, EW, LS, WJB conceived and designed the study. AS, AJR, EW, JM collected the data, MD drafted the manuscript and conducted all analyses. All authors contributed to data interpretation, writing, revision, and approval of the final manuscript. The views expressed in this manuscript are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0608–10142).