Predictors of HIV disclosure to secondary partners and sexual risk behavior among a high-risk sample of HIV-positive MSM: results from six epicenters in the US

Abstract

This study sought to identify predictors of HIV disclosure and serodiscordant unprotected anal intercourse (SDUAI) among HIV-positive men who have sex with men (MSM). Between January 2005 and April 2006, 675 HIV-positive MSM were recruited into the Positive Connections intervention trial held in six US cities with intentional over-sampling of HIV-positive MSM of Color (74%) and men engaging in unprotected anal intercourse (UAI) in the previous year. Baseline survey data showed 30 and 31%, respectively, of participants disclosed to none or some of their secondary sex partners in the last 90 days. Greater disclosure to secondary partners was associated with having fewer sexual partners, being extremely out as MSM, longer HIV diagnosis, knowledge of CD4 count, detectable viral load and being white. Disclosure to all secondary partners was associated with lower SDUAI. Recommendations for prevention for HIV-positive MSM include the promotion of serodisclosure to all secondary partners and increasing comfort with, and outness about, one's sexuality.

Keywords:

• HIV positive
• serodisclosure
• men who have sex with men
• men of Color
• sexual risk

Acknowledgements

This study was funded by the National Institute of Mental Health, Office on AIDS Research, grant #MH064412. The Positive Connections Team comprises staff at the University of Minnesota, consultants from AIDS Service Organizations and other universities who provided specialist guidance and direction and a national leadership team of HIV-positive gay and bisexual men who partnered with this project at every stage from conceptualization to submission of findings. As a multi-site trial, this study was conducted under the oversight of the University of Minnesota Institutional Review Board (IRB), study # 0302S43321, and five other community-based IRBs. We acknowledge with gratitude our community-based partners and staff who included Howard Brown Health Center, Chicago, IL; Gay City Health Project, Seattle, WA; Whitman Walker Clinic, Washington, DC; Fenway Community Health Center, Boston, MA; Gay Men's Health Crisis, New York, NY; AIDS Project Los Angeles and Black AIDS Institute, Los Angeles, CA; and Legacy Community Health Services, Houston, TX.