HIV serostatus disclosure to sexual partners among HIV-positive injection drug users

Abstract

Utilizing mixed methods analyses with cross-sectional data from an ethnically diverse sample of HIV-seropositive injection drug users (IDUs), we sought to examine disclosure and sexual behavior based on partner type, partner serostatus, and transmission risk. Results indicated that more participants disclosed to their HIV-positive sex partners than to their HIV-negative or unknown status sex partners. However, unexpectedly, we found that more participants disclosed to casual sex partners than primary partners before first sexual contact. Consistent disclosers reported more unprotected sexual activity compared to nondisclosers, and were more likely to believe they had a responsibility to disclose. Nondisclosers were less likely than consistent disclosers to believe it was important to protect sex partners from HIV and were more resentful of wearing condoms. In terms of the qualitative data, we found that the emotionally upsetting narratives came from those we defined as "eventual disclosers." This category represented those participants who were in relationships and had not disclosed their status to their primary partners until after having had sex with that partner. These narratives indicated that researchers looking at disclosure behavior should be aware of varying disclosure contexts as well as the emotional consequences impacting disclosure decision-making within these contexts.