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Correlates of and reasons for and against disclosure of HIV status to sex partners
H. Kwakwa1, A. O'Donnell2, A. Nunn3
1PHMC Care Clinic, Philadelphia, United States, 2Haverford College, Haverford, United States, 3Brown University, Providence, United States
Background: This study quantitatively determines correlates of disclosure of HIV-status to sexual partners, qualitatively examines reasons for and against disclosure, and investigates whether individuals inquire about their partners' HIV-status, an issue absent from most disclosure studies.
Methods: Demographic data and information regarding sexual behaviors, drug use, history of STDs and perspectives on disclosure of HIV status were collected from 121 persons infected with HIV at two Philadelphia HIV/AIDS clinics. Quantitative data were analyzed using logistic regression for both discrete and continuous variables. Qualitative responses concerning reasons for and against disclosure were classified and summarized according to thematic issues. The dominant themes were compared qualitatively to participant characteristics.
Results: Patients in the study identified as men (59%), women (40%), and transgender (1%). Patients were infected through heterosexual contact (59%), MSM contact (28%), injection drug use (11%), or the mode of transmission was unknown (2%). Overall, 67% of patients disclosed their status to all sexual partners. In the bivariate analyses, female patients (p=0.043), younger individuals (p=0.043), and currently sexually active individuals (p< 0.005) were more likely to disclose, but the significance of this finding decreased when other factors were included. Strong predictors included knowledge of partner's HIV status (p< 0.001) and disclosure to non-partners (p< 0.001). The most common reason for disclosure was a sense of personal responsibility. The most common reason for nondisclosure was fear of rejection. Only 7% of partners had asked participants about their HIV status.
Conclusions: Knowledge of a partner´s HIV status and disclosure to non-partners were the strongest correlates of disclosure, indicating that disclosure counseling should incorporate a patient's support system of family, friends, and other community members. Only 7% of patients had asked about partners' HIV status in a population with relatively high risk behavior, and this finding suggests a need for more intervention and aggressive educational efforts.
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