Disclosure of HIV serostatus to sex partners: a new approach to measurement.

OBJECTIVE

The objective of this study was to assess measurement of full HIV serostatus disclosure (before sex), delayed disclosure (after sex), and no disclosure to both current and recent past (in the last year) sex partners.

GOAL

The goal of this study was to propose a refined measure of HIV disclosure.

STUDY DESIGN

This study consisted of a cross-sectional study using audio computer-assisted survey interviews with 63 persons with HIV/AIDS who reported on 145 sex partnerships.

RESULTS

Considering all sex partners in the past year, full disclosure occurred in 54%, delayed disclosure in 22%, and no disclosure occurred in 24%. Delayed/no disclosure among all partners in the past year was substantially higher than standard measures of no disclosure among current partners only, 46% (95% confidence interval [CI], 38-54%) versus 12% (95% CI, 5-19%). No disclosure was more common in past partnerships than current partnerships (40% vs. 12%, P < 0.01). Predictors of disclosure included partnership characteristics of having an HIV-positive partner and being in a primary, heterosexual relationship.

CONCLUSIONS

Standard measures may underestimate nondisclosure. Counseling and interventions that promote disclosure should include strategies for disclosure in ongoing relationships, assistance in notifying past partners, and a focus on partnership characteristics and dynamics.