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Sexual Ethics
Disclosure of HIV-Positive Status to Partners
Michael D. Stein, MD;
Kenneth A. Freedberg, MD, MSc;
Lisa M. Sullivan, PhD;
Jacqueline Savetsky, MPH;
Suzette M. Levenson, MPH;
Ralph Hingson, ScD;
Jeffrey H. Samet, MD, MA, MPH
Arch Intern Med. 1998;158:253-257.
Objective To determine factors associated with disclosure of human immunodeficiency virus (HIV)–positive status to sexual partners.
Methods We interviewed 203 consecutive patients presenting for primary care for HIV at 2 urban hospitals. One hundred twenty-nine reported having sexual partners during the previous 6 months. The primary outcome of interest was whether patients had told all the sexual partners they had been with over the past 6 months that they were HIV positive. We analyzed the relationships between sociodemographic, alcohol and drug use, social support, sexual practice, and clinical variables; and whether patients had told their partners that they were HIV positive was analyzed by using multiple logistic regression.
Results Study patients were black (46%), Latino (23%), white (27%), and the majority were men (69%). Regarding risk of transmission, 41% were injection drug users, 20% were homosexual or bisexual men, and 39% were heterosexually infected. Sixty percent had disclosed their HIV status to all sexual partners. Of the 40% who had not disclosed, half had not disclosed to their one and only partner. Among patients who did not disclose, 57% used condoms less than all the time. In multiple logistic regression analysis, the odds that an individual with 1 sexual partner disclosed was 3.2 times the odds that a person with multiple sexual partners disclosed. The odds that an individual with high spousal support disclosed was 2.8 times the odds of individuals without high support, and the odds that whites or Latinos disclosed was 3.1 times the odds that blacks disclosed.
Conclusions Many HIV-infected individuals do not disclose their status to sexual partners. Nondisclosers are not more likely to regularly use condoms than disclosers. Sexual partners of HIV-infected persons continue to be at risk for HIV transmission.
From the Department of Medicine, Brown University School of Medicine, Providence, Rhode Island (Dr Stein), and the Department of Medicine, Boston Medical Center and the Departments of Social and Behavioral Sciences, Epidemiology and Biostatistics, Boston University School of Medicine and Public Health, Boston, Mass (Drs Freedberg, Sullivan, Hingson, and Samet and Mss Savetsky and Levenson).
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