title: STI/HIV test result disclosure between female sex workers and their primary, non-commercial male partners in two Mexico-US border cities: a prospective study.
abstract: OBJECTIVE
  Disclosure of sexually transmitted infections (STI)/HIV diagnoses to sexual partners is not mandated by public health guidelines in Mexico. To assess the feasibility of couples-based STI/HIV testing with facilitated disclosure as a risk-reduction strategy within female sex workers' (FSW) primary partnerships, we examined STI/HIV test result disclosure patterns between FSWs and their primary, non-commercial male partners in two Mexico-US border cities.
  
  
  METHODS
  From 2010 to 2013, 335 participants (181 FSWs and 154 primary male partners) were followed for 24 months. At semiannual visits, participants were tested for STIs/HIV and reported on their disclosure of test results from the previous visit. Multilevel logistic regression was used to identify individual-level and partnership-level predictors of cumulative (1) non-disclosure of ≥1 STI test result and (2) non-disclosure of ≥1 HIV test result within couples during follow-up.
  
  
  RESULTS
  Eighty-seven percent of participants reported disclosing all STI/HIV test results to their primary partners. Non-disclosure of ≥1 STI test result was more common among participants who reported an STI diagnosis as part of the study (adjusted OR=3.05, 95% CI 1.13 to 8.25), while non-disclosure of ≥1 HIV test result was more common among participants in longer-duration partnerships (AOR=1.15 per year, 95% CI 1.03 to 1.28). Drug use before/during sex within partnerships was associated with non-disclosure of both STI (AOR=5.06, 95% CI 1.64 to 15.62) and HIV (AOR=4.51, 95% CI: 1.32 to 15.39) test results.
  
  
  CONCLUSIONS
  STI/HIV test result disclosure was highly prevalent within FSWs' primary partnerships, suggesting couples-based STI/HIV testing with facilitated disclosure may be feasible for these and potentially other high-risk, socially marginalised couples.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: Heather A
authors.identifier: http://orcid.org/0000-0002-7173-1981
authors.initials: HA
authors.lastname: Pines
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, USA.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.affiliation: Department of Population Studies, El Colegio de La Frontera Norte, Tijuana, Baja California, México.
authors.forename: Gudelia
authors.initials: G
authors.lastname: Rangel
authors.affiliation: Federación Mexicana de Asociaciones Privadas (FEMAP), Ciudad Juárez, Chihuahua, México.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Martinez
authors.affiliation: Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Bazzi
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla, USA.
authors.forename: Monica D
authors.initials: MD
authors.lastname: Ulibarri
authors.affiliation: Department of Anthropology, The Ohio State University, Columbus, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Syvertsen
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Natasha K
authors.initials: NK
authors.lastname: Martin
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
mesh_terms: D000293:Adolescent; D000328:Adult; D016358:Contact Tracing / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011446:Prospective Studies; D060386:Sex Workers; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control*; D055815:Young Adult
keywords: CHLAMYDIA INFECTION; GONORRHOEA; HIV; PREVENTION; SYPHILIS