Skip to main content

Advertisement

SpringerLink
Log in

Effectiveness of Interventions Promoting HIV Serostatus Disclosure to Sexual Partners: A Systematic Review

  • Substantive Review
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Disclosure of HIV serostatus to sexual partners is mandated within certain states in the United States and other countries. Despite these laws implemented and public health efforts to increase disclosure, rates of disclosure to sexual partners among people living with HIV (PLWH) remain low, suggesting the need for interventions to assist PLWH with the disclosure process. We conducted a systematic review of studies testing whether HIV serostatus disclosure interventions increase disclosure to sexual partners. We searched six electronic databases and screened 484 records. Five studies published between 2005 and 2012 met inclusion criteria and were included in this review. Results showed that three of the HIV serostatus disclosure-related intervention studies were efficacious in promoting disclosure to sexual partners. Although all three studies were conducted in the United States the intervention content and measurements of disclosure across the studies varied, so broad conclusions are not possible. The findings suggest that more rigorous HIV serostatus disclosure-related intervention trials targeting different populations in the United States and abroad are needed to facilitate disclosure to sexual partners.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Stutterheim SE, Shiripinda I, Bos AE, Pryor JB, de Bruin M, Nellen JF, et al. HIV status disclosure among HIV-positive African and Afro-Caribbean people in the Netherlands. AIDS Care. 2011;23(2):195–205.

    Article  PubMed  Google Scholar 

  2. Klitzman R, Kirshenbaum S, Dodge B, Remien R, Ehrhardt A, Johnson M, et al. Intricacies and inter-relationships between HIV disclosure and HAART: a qualitative study. AIDS Care. 2004;16(5):628–40.

    Article  CAS  PubMed  Google Scholar 

  3. Stirratt MJ, Remien RH, Smith A, Copeland OQ, Dolezal C, Krieger D. The role of HIV serostatus disclosure in antiretroviral medication adherence. AIDS Behav. 2006;10(5):483–93.

    Article  PubMed  Google Scholar 

  4. Parsons JT, VanOra J, Missildine W, Purcell DW, Gómez CA. Positive and negative consequences of HIV disclosure among seropositive injection drug users. AIDS Educ Prev. 2004;16(5):459–75.

    Article  PubMed  Google Scholar 

  5. Simoni JM, Demas P, Mason HR, Drossman JA, Davis ML. HIV disclosure among women of African descent: associations with coping, social support, and psychological adaptation. AIDS Behav. 2000;4(2):147–58.

    Article  Google Scholar 

  6. Conserve DF, King G. An examination of the HIV serostatus disclosure process among Haitian immigrants in New York City. AIDS Care. 2014;26(10):1270–4.

  7. Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75.

    Article  PubMed  Google Scholar 

  8. Skhosana NL, Struthers H, Gray GE, McIntyre JA. HIV disclosure and other factors that impact on adherence to antiretroviral therapy: the case of Soweto, South Africa. Afr J AIDS Res. 2006;5(1):17–26.

    Article  PubMed  Google Scholar 

  9. Anglewicz P, Chintsanya J. Disclosure of HIV status between spouses in rural Malawi. AIDS Care. 2011;23(8):998–1005.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Hightow-Weidman LB, Phillips G II, Outlaw AY, Wohl AR, Fields S, Hildalgo J, et al. Patterns of HIV disclosure and condom use among HIV-infected young racial/ethnic minority men who have sex with men. AIDS Behav. 2013;17(1):360–8.

    Article  PubMed  Google Scholar 

  11. Maman S, Mbwambo JK, Hogan NM, Weiss E, Kilonzo GP, Sweat MD. High rates and positive outcomes of HIV-serostatus disclosure to sexual partners: reasons for cautious optimism from a voluntary counseling and testing clinic in Dar es Salaam. Tanzania AIDS Behavior. 2003;7(4):373–82.

    Article  PubMed  Google Scholar 

  12. Crepaz N, Marks G. Serostatus disclosure, sexual communication and safer sex in HIV-positive men. AIDS Care. 2003;15(3):379–87.

    Article  CAS  PubMed  Google Scholar 

  13. O’Connell AA, Reed SJ, Serovich JA. The efficacy of serostatus disclosure for HIV transmission risk reduction. AIDS Behav. 2014. doi:10.1007/s10461-014-0848-2.

  14. Madiba S, Letsoalo R. HIV disclosure to partners and family among women enrolled in prevention of mother to child transmission of HIV program: implications for infant feeding in poor resourced communities in South Africa. Global J Health Sci. 2013;5(4):p1.

    Article  Google Scholar 

  15. Awiti Ujiji O, Ekström AM, Ilako F, Indalo D, Wamalwa D, Rubenson B. Reasoning and deciding PMTCT-adherence during pregnancy among women living with HIV in Kenya. Cult Health Sex. 2011;13(7):829–40.

    Article  PubMed  Google Scholar 

  16. Medley A, Garcia-Moreno C, McGill S, Maman S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: implications for prevention of mother-to-child transmission programmes. Bull World Health Organ. 2004;82(4):299–307.

    PubMed Central  PubMed  Google Scholar 

  17. Msuya S, Mbizvo E, Hussain A, Uriyo J, Sam N, Stray-Pedersen B. Low male partner participation in antenatal HIV counselling and testing in northern Tanzania: implications for preventive programs. AIDS Care. 2008;20(6):700–9.

    Article  CAS  PubMed  Google Scholar 

  18. Gielen AC, Fogarty L, O’Campo P, Anderson J, Keller MJ, Faden R. Women living with HIV: disclosure, violence, and social support. J Urban Health. 2000;77(3):480–91.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Bird JD, Voisin DR. “You’re an Open Target to Be Abused”: a qualitative study of stigma and HIV self-disclosure among black men who have sex with men. Am J Public Health. 2013;103(12):2193–9.

    Article  PubMed  Google Scholar 

  20. Petrak JA, Doyle AM, Smith A, Skinner C, Hedge B. Factors associated with self-disclosure of HIV serostatus to significant others. Br J Health Psychol. 2001;6(1):69–79.

    Article  CAS  PubMed  Google Scholar 

  21. Ciccarone DH, Kanouse DE, Collins RL, Miu A, Chen JL, Morton SC, et al. Sex without disclosure of positive HIV serostatus in a US probability sample of persons receiving medical care for HIV infection. Am J Public Health. 2003;93(6):949–54.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A. Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Trans Infect. 2007;83(1):29–34.

    Article  CAS  Google Scholar 

  23. Siegel K, Lekas H-M, Schrimshaw EW. Serostatus disclosure to sexual partners by HIV-infected women before and after the advent of HAART. Women Health. 2005;41(4):63–85.

    Article  PubMed  Google Scholar 

  24. Longinetti E, Santacatterina M, El-Khatib Z. Gender perspective of risk factors associated with disclosure of HIV status, a cross-sectional study in Soweto, South Africa. PLoS ONE. 2014;9(4):e95440.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Przybyla S, Golin C, Widman L, Grodensky C, Earp JA, Suchindran C. Examining the role of serostatus disclosure on unprotected sex among people living with HIV. AIDS Patient Care STDs. 2014;28(12):677–84.

  26. Lee L, Bastos FI, Bertoni N, Malta M, Kerrigan D. The role of HIV serostatus disclosure on sexual risk behaviours among people living with HIV in steady partnerships in Rio de Janeiro, Brazil. Global Public Health. 2014;9(9):1093–106.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Allen AH, Forrest JI, Kanters S, O’Brien N, Salters KA, McCandless L, et al. Factors associated with disclosure of HIV status among a cohort of individuals on antiretroviral therapy in British Columbia Canada. AIDS Behav. 2014;18(6):1014–26.

    Article  Google Scholar 

  28. Conserve DF, King G, Dévieux JG, Jean-Gilles M, Malow R. Determinants of HIV serostatus disclosure to sexual partner among HIV-positive alcohol users in Haiti. AIDS Behav. 2014;18(6):1037–45.

  29. Vu L, Andrinopoulos K, Mathews C, Chopra M, Kendall C, Eisele TP. Disclosure of HIV status to sex partners among HIV-infected men and women in Cape Town South Africa. AIDS Behav. 2012;16(1):132–8.

    Article  PubMed  Google Scholar 

  30. Overstreet NM, Earnshaw VA, Kalichman SC, Quinn DM. Internalized stigma and HIV status disclosure among HIV-positive black men who have sex with men. AIDS Care. 2013;25(4):466–71.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Przybyla SM, Golin CE, Widman L, Grodensky CA, Earp JA, Suchindran C. Serostatus disclosure to sexual partners among people living with HIV: examining the roles of partner characteristics and stigma. AIDS Care. 2013;25(5):566–72.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Lunze K, Cheng DM, Quinn E, Krupitsky E, Raj A, Walley AY, et al. Nondisclosure of HIV infection to sex partners and alcohol’s role: a Russian experience. AIDS Behav. 2013;17(1):390–8.

    Article  PubMed Central  PubMed  Google Scholar 

  33. Kalichman SC, Nachimson D. Self-efficacy and disclosure of HIV-positive serostatus to sex partners. Health Psychol. 1999;18(3):281.

    Article  CAS  PubMed  Google Scholar 

  34. Walcott MM, Hatcher AM, Kwena Z, Turan JM. Facilitating HIV status disclosure for pregnant women and partners in rural Kenya: a qualitative study. BMC public Health. 2013;13(1):1115.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Arnold EA, Rebchook GM, Kegeles SM. ‘Triply cursed’: racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young black gay men. Cult Health Sex. 2014;16(6):710–22.

  36. Maman S, van Rooyen H, Groves AK. HIV status disclosure to families for social support in South Africa (NIMH Project Accept/HPTN 043). AIDS Care. 2014;26(2):226–32.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Clum GA, Czaplicki L, Andrinopoulos K, Muessig K, Hamvas L, Ellen, et al. Strategies and outcomes of HIV status disclosure in HIV-positive young women with abuse histories. AIDS Patient Care STDs. 2013;27(3):191–200.

    Article  PubMed Central  PubMed  Google Scholar 

  38. Psaros C, Barinas J, Robbins GK, Bedoya CA, Safren SA, Park ER. Intimacy and sexual decision making: exploring the perspective of HIV positive women over 50. AIDS patient care STDs. 2012;26(12):755–60.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Sobo E. Human immunodeficiency virus seropositivity self-disclosure to sexual partners: a qualitative study. Holist Nurs Pract. 1995;10(1):18–28.

    Article  CAS  PubMed  Google Scholar 

  40. Serovich JM, Oliver DG, Smith SA, Mason TL. Methods of HIV disclosure by men who have sex with men to casual sexual partners. AIDS Patient Care STDs. 2005;19(12):823–32.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Relf MV, Bishop TL, Lachat MF, Schiavone DB, Pawlowski L, Bialko MF, et al. A qualitative analysis of partner selection, HIV serostatus disclosure, and sexual behaviors among HIV-positive urban men. AIDS Educ Prev. 2009;21(3):280–97.

    Article  PubMed  Google Scholar 

  42. Michaud P-A, Suris J-C, Thomas LR, Kahlert C, Rudin C, Cheseaux J-J. To say or not to say: a qualitative study on the disclosure of their condition by human immunodeficiency virus–positive adolescents. J Adolesc Health. 2009;44(4):356–62.

    Article  PubMed  Google Scholar 

  43. King R, Katuntu D, Lifshay J, Packel L, Batamwita R, Nakayiwa S, et al. Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda. AIDS Behav. 2008;12(2):232–43.

    Article  PubMed  Google Scholar 

  44. Klitzman RL. Self-disclosure of HIV status to sexual partners: a qualitative study of issues faced by gay men. J Gay Lesbian Med Assoc. 1999;3(2):39–49.

    Article  Google Scholar 

  45. Maman S, Cathcart R, Burkhardt G, Omba S, Behets F. The role of religion in HIV-positive women’s disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo. Soc Sci Med. 2009;68(5):965–70.

    Article  PubMed  Google Scholar 

  46. Sowell RL, Seals BF, Phillips KD, Julious CH. Disclosure of HIV infection: how do women decide to tell? Health Educ Res. 2003;18(1):32–44.

    Article  CAS  PubMed  Google Scholar 

  47. Busza J, Besana GV, Mapunda P, Oliveras E. “I have grown up controlling myself a lot”. Fear and misconceptions about sex among adolescents vertically-infected with HIV in Tanzania. Reprod Health Matters. 2013;21(41):87–96.

    Article  PubMed  Google Scholar 

  48. Van Nuil JI, Mutwa P, Asiimwe-Kateera B, Kestelyn E, Vyankandondera J, Pool R, et al. “Let’s Talk about Sex”: a qualitative study of Rwandan adolescents’ views on sex and HIV. PLoS ONE. 2014;9(8):e102933.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Shikwane ME, Villar-Loubet OM, Weiss SM, Peltzer K, Jones DL. HIV knowledge, disclosure and sexual risk among pregnant women and their partners in rural South Africa. SAHARA-J. 2013;10(2):105–12.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Crankshaw TL, Mindry D, Munthree C, Letsoalo T, Maharaj P. Challenges with couples, serodiscordance and HIV disclosure: healthcare provider perspectives on delivering safer conception services for HIV-affected couples, South Africa. J Int AIDS Soc. 2014;17(1):1–7.

  51. Colombini M, Mutemwa R, Kivunaga J, Moore LS, Mayhew SH. Experiences of stigma among women living with HIV attending sexual and reproductive health services in Kenya: a qualitative study. BMC Health Serv Res. 2014;14(1):412.

    Article  PubMed Central  PubMed  Google Scholar 

  52. Rujumba J, Neema S, Byamugisha R, Tylleskär T, Tumwine JK, Heggenhougen HK. “Telling my husband I have HIV is too heavy to come out of my mouth”: pregnant women’s disclosure experiences and support needs following antenatal HIV testing in eastern Uganda. J Int AIDS Soc. 2012;15(2):1–10.

  53. Gaskins SW. Disclosure decisions of rural African American men living with HIV disease. J Assoc Nurses AIDS Care. 2006;17(6):38–46.

    Article  PubMed Central  PubMed  Google Scholar 

  54. Paiva V, Segurado AC, Filipe EMV. Self-disclosure of HIV diagnosis to sexual partners by heterosexual and bisexual men: a challenge for HIV/AIDS care and prevention. Cadernos de Saúde Pública. 2011;27(9):1699–710.

    PubMed  Google Scholar 

  55. Mburu G, Hodgson I, Kalibala S, Haamujompa C, Cataldo F, Lowenthal ED, et al. Adolescent HIV disclosure in Zambia: barriers, facilitators and outcomes. J Int AIDS Soc. 2014;17(1):1–9.

  56. Fair C, Albright J. “Don’t tell him you have HIV unless he’s ‘the one’”: romantic relationships among adolescents and young adults with perinatal HIV infection. AIDS Patient Care STDs. 2012;26(12):746–54.

    Article  PubMed  Google Scholar 

  57. Mayfield Arnold E, Rice E, Flannery D, Rotheram-Borus M. HIV disclosure among adults living with HIV. AIDS Care. 2008;20(1):80–92.

    Article  CAS  PubMed  Google Scholar 

  58. Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005;16(6):33–47.

    Article  PubMed  Google Scholar 

  59. Olley B. Improving well-being through psycho-education among voluntary counseling and testing seekers in Nigeria: a controlled outcome study. AIDS Care. 2006;18(8):1025–31.

    Article  CAS  PubMed  Google Scholar 

  60. Greene K, Carpenter A, Catona D, Magsamen-Conrad K. The Brief Disclosure Intervention (BDI): facilitating African Americans’ disclosure of HIV. J Commun. 2013;63(1):138–58.

    Article  Google Scholar 

  61. Murphy DA, Armistead L, Marelich WD, Payne DL, Herbeck DM. Pilot trial of a disclosure intervention for HIV + mothers: the TRACK program. J Consult Clin Psychol. 2011;79(2):203.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Nicastro E, Continisio GI, Storace C, Bruzzese E, Mango C, Liguoro I, et al. Family group psychotherapy to support the disclosure of HIV status to children and adolescents. AIDS Patient Care STDs. 2013;27:363–9.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Kaaya SF, Blander J, Antelman G, Cyprian F, Emmons KM, Matsumoto K, et al. Randomized controlled trial evaluating the effect of an interactive group counseling intervention for HIV-positive women on prenatal depression and disclosure of HIV status. AIDS Care. 2013;25(7):854–62.

  64. Mundell JP, Visser MJ, Makin JD, Kershaw TS, Forsyth BW, Jeffery B, et al. The impact of structured support groups for pregnant South African women recently diagnosed HIV positive. Women Health. 2011;51(6):546–65.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Serovich JM, Reed SJ, Grafsky EL, Hartwell EE, Andrist DW. An intervention to assist men who have sex with men disclose their serostatus to family members: results from a pilot study. AIDS Behav. 2011;15(8):1647–53.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Kairania R, Gray RH, Kiwanuka N, Makumbi F, Sewankambo NK, Serwadda D, et al. Disclosure of HIV results among discordant couples in Rakai, Uganda: a facilitated couple counselling approach. AIDS Care. 2010;22(9):1041–51.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Semrau K, Kuhn L, Vwalika C, Kasonde P, Sinkala M, Kankasa C, et al. Women in couples antenatal HIV counseling and testing are not more likely to report adverse social events. AIDS. 2005;19(6):603.

    Article  PubMed Central  PubMed  Google Scholar 

  68. De Rosa CJ, Marks G. Preventive counseling of HIV-positive men and self-disclosure of serostatus to sex partners: new opportunities for prevention. Health Psychol. 1998;17(3):224.

    Article  PubMed  Google Scholar 

  69. Serovich JM, Reed S, Grafsky EL, Andrist D. An intervention to assist men who have sex with men disclose their serostatus to casual sex partners: results from a pilot study. AIDS Educ Prev. 2009;21(3):207.

    Article  PubMed Central  PubMed  Google Scholar 

  70. Hirshfield S, Chiasson MA, Joseph H, Scheinmann R, Johnson WD, Remien RH, et al. An online randomized controlled trial evaluating HIV prevention digital media interventions for men who have sex with men. PLoS ONE. 2012;7(10):e46252.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  71. Chiasson MA, Shaw FS, Humberstone M, Hirshfield S, Hartel D. Increased HIV disclosure three months after an online video intervention for men who have sex with men (MSM). AIDS Care. 2009;21(9):1081–9.

    Article  PubMed  Google Scholar 

  72. Teti M, Bowleg L, Cole R, Lloyd L, Rubinstein S, Spencer S, et al. A mixed methods evaluation of the effect of the protect and respect intervention on the condom use and disclosure practices of women living with HIV/AIDS. AIDS Behav. 2010;14(3):567–79.

    Article  PubMed  Google Scholar 

  73. Wolitski RJ, Gómez CA, Parsons JT. Effects of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men. AIDS. 2005;19:S99–109.

    Article  PubMed  Google Scholar 

  74. Maiorana A, Koester KA, Myers JJ, Lloyd KC, Shade SB, Dawson-Rose C, et al. Helping patients talk about HIV: inclusion of messages on disclosure in prevention with positives interventions in clinical settings. AIDS Educ Prev. 2012;24(2):179–92.

    Article  PubMed  Google Scholar 

  75. Nellen JF, Sprangers MA, Prins JM, Nieuwkerk PT, Sumari-de Boer IM. Personalized stigma and disclosure concerns among HIV-infected immigrant and indigenous HIV-infected persons in the Netherlands. J HIV/AIDS Soc Serv. 2012;11(1):42–56.

    Article  Google Scholar 

  76. Chin D, Kroesen KW. Disclosure of HIV infection among Asian/Pacific Islander American women: cultural stigma and support. Cult Diversity Ethnic Minor Psychol. 1999;5(3):222.

    Article  Google Scholar 

Download references

Acknowledgments

This research was supported by a training grant from the National Institute of Health, National Institute of Allergy and Infectious Diseases (T32 AI007001).

Author information

Authors and Affiliations

  1. Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27509, USA

    Donaldson F. Conserve & Suzanne Maman

  2. Department of Sociology, Center on Health, Risk and Society, American University, Washington, DC, USA

    Allison K. Groves

Authors
  1. Donaldson F. Conserve
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Allison K. Groves
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suzanne Maman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donaldson F. Conserve.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Conserve, D.F., Groves, A.K. & Maman, S. Effectiveness of Interventions Promoting HIV Serostatus Disclosure to Sexual Partners: A Systematic Review. AIDS Behav 19, 1763–1772 (2015). https://doi.org/10.1007/s10461-015-1006-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-015-1006-1

Keywords

Search

Navigation