HIV Status Disclosure To Sexual Partners And Its Related Factors Among HIV-positive Men Who Have Sex With Men

Objectives The purposes of this study were to understand the prevalence of HIV status disclosure to sexual partners and sexual behavior and to assess the related factors associated with nondisclosure of HIV status to primary sexual partners among HIV-positive men who have sex with men through cross-sectional survey.Methods This survey was conducted in Guangzhou, Chongqing and Chengdu using “snowballing” sample. With help of HIV-positive MSM volunteers, between December 2012 and May 2013, we collected 600 participants who were eighteen years old or elder, had sex with men and confirmed HIV infection by the local CDC. Written informed consent was obtained from each participant and then participants completed electronic questionnaire anonymously guided by investigators online. Totally 600 HIV-positive MSM participated the survey and 501 questionnaires were qualified. The content of survey in electronic questionnaire included socioeconomic characteristics of participants, utilization of health services related to HIV/AIDS, the HIV status of sexual partners(HIV-positive or negative partners and unknown of HIV status partners) and sexual behaviors in the past 6 months, variety of sexual partners(primary sexual partners, casual sexual partners and female sexual partners) after HIV infection confirmed, the prevalence of HIV status disclosure to sexual partners(including the prevalence of disclosure HIV status to different kind of sexual partners, when and ways of HIV status disclosure as well as how sexual partnership influenced by disclosure)Results The age of the participants were between 18 and 63 years old and the mean age was(30.0±7.5) years old. Of participants, nearly two thirds(318/501) had college or higher education and 79.0%(396/501) were unmarried and 81.4%(408/501) identified themselves as homosexual orientation among participants. The proportion of participants who had primary sexual partners, casual/commercial sexual partners and female sexual partners were 76.4%(383/501), 59.7%(299/501) and 11.4%(57/501) respectively after HIV infection diagnosed.Of the participants who had primary sexual partners, the proportion of disclosure their HIV infection to all or some primary partners were 44.7%(171/383) and 20.6%(79/383) respectively and 34.7%(133/383) of them reported never disclosure to their primary sexual partners. The proportion of nondisclosure of HIV status to casual/commercial sexual partners was 78.9% among participants who have casual/commercial sexual partners and about 59.6%(34/57) nondisclosure of HIV status to their wives among participants who have wives.The result showed that participants who disclosure their HIV status to all primary sexual partners were significantly less likely to have sexual transmission behaviors(14.6%) than those who did not(31.1%).The analysis of factors associated with nondisclosure of HIV status to primary sexual partners showed that the proportion of nondisclosure of HIV status to primary sexual partners was higher among participants who did not receive CD4 cell counts detection, HIV viral loads detection and receiving antiviral therapy(52.8%%, 40.9% and 43.8%, respectively) than those who did not utilized related services(32.9%, 6.8% and 17.4%, accordingly). Compared with participants who had not depressive symptom, participants who had depressive symptom were less likely to disclosure of HIV status to primary sexual partners(30.6%v.s.40.2%). Participants who had HIV-positive status partners in the past six months were more likely to disclosure their HIV status to primary sexual partners than those who had not(5.1%v.s.51.2%). Participants who had unknown HIV status partners were less likely to disclose their HIV status to primary sexual partners than those who had not this kind of sexual partners(51.9%v.s.18.7%). Proportion of nondisclosure of HIV status to primary sexual partners among participants who had casual/commercial male sexual or heterosexual intercourse were significantly higher(47.9%v.s.27.0%, 78.6%v.s.33.1%, respectively) than those who had not.Results of Multiple Logistic Regression showed that the nondisclosure of HIV status to primary sexual partners among participants who have primary sexual partners were significantly associated with had two or more sexual partners in the past six months(OR=3.095, 95%CI=1.493~6.416), had depressive symptom(OR=2.034, 95%CI=1.211~3.416) and hadn’t on antiviral therapy(OR=0.291, 95%CI=0.154~0.548). Participants confirmed HIV-positive more than 2 year were less likely to report nondisclosure of HIV status to primary sexual partners than those diagnosed in one year(OR=0.336, 95%CI=0.166~0.682). With score of self-disclosure efficacy and sense of responsibility of self-disclosure increasing one point, the risk of nondisclosure of HIV status to primary sexual partners was decreased about 1/5(OR=0.792, 95%CI=0.735~0.852, OR=0.844, 95%CI=0.775~0.920, respectively).Conclusions Multiple sexual partners and sexual transmission behaviors of HIV-positive MSM make HIV epidemic rapidly among MSM and spread HIV from MSM to general population. Disclosure of HIV status to sexual partners can reduce sexual transmission behaviors, thus calling for developing strategies targeted for sexual partners notification by promoting health service utilization related HIV/AIDS, improving mental health and enhancing self-disclosure efficacy and sense of responsibility of self-disclosure among HIV-positive MSM.