Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention

ABSTRACT

Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006–2009 identified individual and social network characteristics of Black MSM (n = 226) that are associated with disclosure that may be leveraged to increase disclosure. Over two-thirds (68.1%) of the sample had ever disclosed to HCPs. Part-time employment (AOR = 0.32, 95% CI = 0.11–0.95), bisexual identity (AOR = 0.29, 95% CI = 0.12–0.70), and meeting criteria for alcohol use disorders (AOR = 0.32, 95% CI = 0.14–0.75) were negatively associated with disclosure. Disclosers were more likely to self-report being HIV-positive (AOR = 4.47, 95% CI = 1.54–12.98), having more frequent network socialization (AOR = 2.15, 95% CI = 1.24–3.73), and having a social network where all members knew the participant had sex with men (AOR = 4.94, 95% CI = 2.06–11.86). These associations were not moderated by self-reported HIV status. Future interventions to help MSM identify social network members to safely disclose their same-sex behavior may also help disclosure of same-sex behavior to HCPs among Black MSM.

KEYWORDS:

• HIV
• men who have sex with men
• health care providers
• disclosure

Acknowledgements

This work was supported by the Centers for Disease Control and Prevention under Grant UR6PS000355; the National Institutes of Health under Grant R01DA031030-02S1 and 1P30AI094189; and the Agency for Healthcare Research and Quality under Grant K12HS022981. The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention, National Institutes of Health, and Agency for Healthcare Research and Quality.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Christina J. Sun http://orcid.org/0000-0001-5656-7055

Carl Latkin http://orcid.org/0000-0002-7931-2116

Additional information

Funding

This work was supported by Agency for Healthcare Research and Quality [grant number K12HS022981]; Centers for Disease Control and Prevention [grant number UR6 PS000355]; National Institutes of Health [grant number 1P30AI094189,3 R01 DA031030-02S1].