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Multicenter Study
. 2017 Nov 25;17(1):730.
doi: 10.1186/s12879-017-2814-x.

HIV serostatus knowledge and serostatus disclosure with the most recent anal intercourse partner in a European MSM sample recruited in 13 cities: results from the Sialon-II study

Ulrich Marcus  1 , Susanne Barbara Schink  2 , Nigel Sherriff  3 , Anna-Marie Jones  3   4 , Lorenzo Gios  5 , Cinta Folch  6   7 , Torsten Berglund  8 , Christiana Nöstlinger  9 , Marta Niedźwiedzka-Stadnik  10 , Sonia F Dias  11 , Ana F Gama  11 , Emilia Naseva  12 , Ivailo Alexiev  13 , Danica Staneková  14 , Igor Toskin  15 , Daniela Pitigoi  16   17 , Alexandru Rafila  18 , Irena Klavs  19 , Massimo Mirandola  20 ; Sialon II Network
Collaborators, Affiliations
Multicenter Study

HIV serostatus knowledge and serostatus disclosure with the most recent anal intercourse partner in a European MSM sample recruited in 13 cities: results from the Sialon-II study

Ulrich Marcus et al. BMC Infect Dis. .

Abstract

Background: Knowledge of HIV status can be important in reducing the risk of HIV exposure. In a European sample of men-who-have-sex-with-men (MSM), we aimed to identify factors associated with HIV serostatus disclosure to the most recent anal intercourse (AI) partner. We also aimed to describe the impact of HIV serostatus disclosure on HIV exposure risks.

Methods: During 2013 and 2014, 4901 participants were recruited for the bio-behavioural Sialon-II study in 13 European cities. Behavioural data were collected with a self-administered paper questionnaire. Biological specimens were tested for HIV antibodies. Factors associated with HIV serostatus disclosure with the most recent AI partner were examined using bivariate and multilevel multivariate logistic regression analysis. We also describe the role of serostatus disclosure for HIV exposure of the most recent AI partner.

Results: Thirty-five percent (n = 1450) of the study participants reported mutual serostatus disclosure with their most recent AI partner or disclosed having HIV to their partner. Most of these disclosures occurred between steady partners (74%, n = 1077). In addition to the type of partner and HIV diagnosis status, other factors positively associated with HIV serostatus disclosure in the multilevel multivariate logistic regression model were recent testing, no condom use, and outness regarding sexual orientation. Disclosure rates were lowest in three south-eastern European cities. Following condom use (51%, n = 2099), HIV serostatus disclosure (20%, n = 807) was the second most common prevention approach with the most recent AI partner, usually resulting in serosorting. A potential HIV exposure risk for the partner was reported by 26% (111/432) of HIV antibody positive study participants. In 18% (20/111) of exposure episodes, an incorrect HIV serostatus was unknowingly communicated. Partner exposures were equally distributed between steady and non-steady partners.

Conclusions: The probability of HIV exposure through condomless AI is substantially lower after serostatus disclosure compared to non-disclosure. Incorrect knowledge of one's HIV status contributes to a large proportion of HIV exposures amongst European MSM. Maintaining or improving condom use for anal intercourse with non-steady partners, frequent testing to update HIV serostatus awareness, and increased serostatus disclosure particularly between steady partners are confirmed as key aspects for reducing HIV exposures amongst European MSM.

Keywords: Bio-behavioural survey; HIV exposure; HIV serostatus disclosure; Men who have sex with men.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the World Health Organization (WHO) Research Project Review Panel (RP2: A65- SIALON II: Capacity building in combining targeted prevention with meaningful HIV surveillance among men who have sex with men (MSM), Multi-country (Europe) protocol) and the WHO Research Ethics Review Committee (WHO-ERC: RPC557 - Capacity building in combining targeted prevention with meaningful HIV surveillance among men who have sex with men (MSM)), and by ethics review committees in all participating countries (see list below). Written informed consent was not obtained from the study participants, because this would have compromised their anonymity.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Proportion of potentially HIV-exposed partners during last anal intercourse by type of partner and HIV serostatus disclosure*, Sialon-II bio-behavioural survey, 2013–2014. *excluded: potential exposures associated with disclosed HIV infection status
See this image and copyright information in PMC

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