title: HIV Disclosure and Transmission Risks to Sex Partners Among HIV-Positive Men.
abstract: Disclosure of HIV-positive status to sex partners is critical to protecting uninfected partners. In addition, people living with HIV often risk criminal prosecution when they do not inform sex partners of their HIV status. The current study examined factors associated with nondisclosure of HIV status by men living with HIV in Atlanta, GA (92% African African, mean age = 43.8), who engage in condomless sex with uninfected sex partners. Sexually active HIV-positive men (N = 538) completed daily electronic sexual behavior assessments over the course of 28 days and completed computerized interviews, drug testing, medication adherence assessments, and HIV viral load retrieved from medical records. Results showed that 166 (30%) men had engaged in condomless vaginal or anal intercourse with an HIV-uninfected or unknown HIV status sex partner to whom they had not disclosed their HIV status. Men who engaged in nondisclosed condomless sex were less adherent to their HIV treatment, more likely to have unsuppressed HIV, demonstrated poorer disclosure self-efficacy, enacted fewer risk reduction communication skills, and held more beliefs that people with HIV are less infectious when treated with antiretroviral therapy. We conclude that undisclosed HIV status is common and related to condomless sex with uninfected partners. Men who engage in nondisclosed condomless sex may also be more infectious given their nonadherence and viral load. Interventions are needed in HIV treatment as prevention contexts that attend to disclosure laws and enhance disclosure self-efficacy, improve risk reduction communication skills, and increase understanding of HIV infectiousness.
authors.affiliation: Department of Psychology, University of Connecticut , Storrs, Connecticut.
authors.forename: Seth C
authors.initials: SC
authors.lastname: Kalichman
authors.affiliation: Department of Psychology, University of Connecticut , Storrs, Connecticut.
authors.forename: Moira O
authors.initials: MO
authors.lastname: Kalichman
authors.affiliation: Department of Psychology, University of Connecticut , Storrs, Connecticut.
authors.forename: Chauncey
authors.initials: C
authors.lastname: Cherry
authors.affiliation: Department of Psychology, University of Connecticut , Storrs, Connecticut.
authors.forename: Tamar
authors.initials: T
authors.lastname: Grebler
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001727:Bisexuality; D044383:Black People; D017280:Condoms / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000523:psychology / Q000635:transmission; D006679:HIV Seropositivity / Q000523:psychology / Q000635:transmission*; D020010:Heterosexuality; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D021841:Safe Sex; D012650:Self Disclosure; D012725:Sexual Behavior; D012747:Sexual Partners; D014342:Truth Disclosure; D047568:Unsafe Sex / Q000706:statistics & numerical data; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents