It's not just what you say: relationships of HIV dislosure and risk reduction among MSM in the post-HAART era. AIDS Care 2007 Jul;19(6):749-56
Date
06/19/2007Pubmed ID
17573594DOI
10.1080/09540120600983971Scopus ID
2-s2.0-34250672876 (requires institutional sign-in at Scopus site) 56 CitationsAbstract
In the post-HAART era, critical questions arise as to what factors affect disclosure decisions and how these decisions are associated with factors such as high-risk behaviors and partner variables. We interviewed 1,828 HIV-positive men who have sex with men (MSM), of whom 46% disclosed to all partners. Among men with casual partners, 41.8% disclosed to all of these partners and 21.5% to none. Disclosure was associated with relationship type, perceived partner HIV status and sexual behaviors. Overall, 36.5% of respondents had unprotected anal sex (UAS) with partners of negative/unknown HIV status. Of those with only casual partners, 80.4% had >1 act of UAS and 58% of these did not disclose to all partners. This 58% were more likely to self-identify as gay (versus bisexual), be aware of their status for <5 years and have more partners. Being on HAART, viral load and number of symptoms were not associated with disclosure. This study - the largest conducted to date of disclosure among MSM and one of the few conducted post-HAART - indicates that almost 1/5th reported UAS with casual partners without disclosure, highlighting a public health challenge. Disclosure needs to be addressed in the context of relationship type, partner status and broader risk-reduction strategies.
Author List
Klitzman R, Exner T, Correale J, Kirshenbaum SB, Remien R, Ehrhardt AA, Lightfoot M, Catz SL, Weinhardt LS, Johnson MO, Morin SF, Rotheram-Borus MJ, Kelly JA, Charlebois EAuthors
Jeffrey A. Kelly PhD Professor in the Psychiatry and Behavioral Medicine department at Medical College of WisconsinLance S. Weinhardt MS,PhD Associate Dean for Research and Professor of Community and Behavioral Health Promotion in the Joseph. J. Zilber School of Public Health department at University of Wisconsin - Milwaukee
MESH terms used to index this publication - Major topics in bold
Attitude to HealthHIV Infections
Homosexuality, Male
Humans
Male
Self Disclosure
Sexual Partners
Truth Disclosure
Unsafe Sex