National Centre in HIV Social Research, The University of New South Wales, Sydney, NSW 2052, Australia.
AIDS Behav. 2011 Aug;15(6):1128-39. doi: 10.1007/s10461-009-9645-8.
We analysed HIV disclosure between Australian men who have sex with men (MSM) who reported anal intercourse with their last casual male partner. Of 804 MSM included in the analysis, 413 reported HIV disclosure and 391 reported no disclosure. After identifying bivariate associations with HIV disclosure, we developed three models of HIV disclosure (one for untested, one for HIV-negative and one for HIV-positive MSM). A range of factors was found to be associated with HIV disclosure. Having previously had sex with the last casual male partner and expecting HIV-negative and HIV-positive men to disclose before sex were predictors of HIV disclosure shared by more than one serostatus group. As unprotected anal intercourse was more common among MSM who disclosed (across all serostatus groups), we suggest caution should be exercised before encouraging HIV disclosure as a prevention strategy. Nondisclosure remains more strongly associated with safe sex among Australian MSM.
我们分析了澳大利亚男男性行为者(MSM)中与最近的偶然男性伴侣发生肛交后报告的 HIV 披露情况。在纳入分析的 804 名 MSM 中,413 名报告了 HIV 披露,391 名报告了未披露。在确定与 HIV 披露相关的双变量关联后,我们开发了三种 HIV 披露模型(一种针对未检测、一种针对 HIV 阴性和一种针对 HIV 阳性 MSM)。发现一系列因素与 HIV 披露有关。与最后一位偶然男性伴侣发生过性行为,以及期望 HIV 阴性和 HIV 阳性男性在性行为前披露,是多个血清学群体共有的 HIV 披露预测因素。由于披露者中无保护的肛交更为常见(在所有血清学群体中),因此我们建议在鼓励将 HIV 披露作为预防策略之前应谨慎行事。在澳大利亚 MSM 中,不披露与安全性行为的关联仍然更强。