Issues of disclosure and condom use in adolescents with hemophilia and HIV. Hemophilia Behavioral Evaluative Intervention Project Staff.
OBJECTIVE
To examine the patterns, facilitators, and barriers to disclosure of HIV seropositivity in an adolescent population and to determine the relationship between disclosure and condom use.


BACKGROUND
In recent years, public health efforts have focused on methods to prevent the transmission of the Human Immunodeficiency Virus (HIV). These efforts have included safer sex education, skill building and self-efficacy training, behavioral change techniques, and encouragement of serostatus disclosure to sexual partners. In 1990, the Centers for Disease Control and Prevention (CDC) funded 10 hemophilia treatment centers to develop and implement a theory-based behavioral intervention to prevent the sexual transmission of HIV.


METHODS
A baseline survey, focusing on barriers to safer sex, the influence of parents, peers, and sexual partners, alcohol and drug use, and communication and disclosure patterns, was administered to 321 young males (ages 12 to 25) with hemophilia and HIV.


RESULTS
Fifty-eight percent of the sexually experienced adolescents did not disclose their HIV status to their most recent sexual partners (i.e., nondisclosers) compared to 42 percent who reported that either they informed their partners or their partners already knew their HIV status (i.e., disclosers). There was no correlation between disclosure and condom use. The most significant predictor of disclosure was the perception that peers would disclose their HIV status.


CONCLUSIONS
The results suggest that disclosure does not necessarily facilitate condom use in this population. This conclusion may have implications for future public health efforts in HIV prevention. Rather than focusing primarily on the promotion of serostatus disclosure, behavioral interventions should emphasize the practice of safer sex, utilizing peer educators and support networks.
Geary
M K
MK
New England Hemophilia Center, Medical Center of Central Massachusetts, Worcester, USA.
King
G
G
Forsberg
A D
AD
Delaronde
S R
SR
Parsons
J
J
D000293:Adolescent; D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D017280:Condoms; D015658:HIV Infections / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012650:Self Disclosure; D012747:Sexual Partners / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States