Skip to main content
SpringerLink
Log in

Factors Associated with Disclosure of HIV Status Among a Cohort of Individuals on Antiretroviral Therapy in British Columbia, Canada

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

We sought to examine the prevalence and correlates of HIV-disclosure among treatment-experienced individuals in British Columbia, Canada. Study participants completed an interviewer-administered survey between July 2007 and January 2010. The primary outcome of interest was disclosing one’s HIV-positive status to all new sexual partners within the last 6 months. An exploratory logistic regression model was developed to identify variables independently associated with disclosure. Of the 657 participants included in this analysis, 73.4 % disclosed their HIV-positive status to all of their sexual partners. Factors independently associated with non-disclosure included identifying as a woman (adjusted odds ratio [AOR] 1.92; 95 % confidence interval [95 % CI] 1.13–3.27) or as a gay or bisexual man (AOR 2.45; 95 % CI 1.47–4.10). Behaviours that were independently associated with non-disclosure were having sex with a stranger (AOR 2.74; 95 % CI 1.46–5.17), not being on treatment at the time of interview (AOR 2.67; 95 % CI 1.40–5.11), and not always using a condom (AOR 1.78; 95 % CI 1.09–2.90). Future preventative strategies should focus on environmental and social factors that may inhibit vulnerable HIV-positive populations, such as women and gay or bisexual men, from safely disclosing their positive status.

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.

Similar content being viewed by others

References

  1. Pinkerton S, Galletly C. Reducing HIV transmission risk by increasing serostatus disclosure: a mathematical modeling analysis. AIDS Behav. 2007;11:698–705.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Chen S, et al. Unprotected anal intercourse between potentially HIV-serodiscordant men who have sex with men, San Francisco. JAIDS. 2003;33:166–70.

    PubMed  Google Scholar 

  3. Golden M, et al. Importance of sex partners HIV status in HIV risk assessment among men who have sex with men. JAIDS. 2004;36:734–42.

    PubMed  Google Scholar 

  4. Klitzman R, et al. It’s not just what you say: relationship of HIV disclosure and risk reduction among MSM in the post-HAART era. AIDS Care. 2007;19:749–56.

    Article  CAS  PubMed  Google Scholar 

  5. Simone J, Pantalone D. Secrets and safety in the age of AIDS: Does HIV disclosure lead to safer sex? Int AIDS Soc USA. 2004;4:109–18.

    Google Scholar 

  6. Bird J, Fingerhurt D, McKirnan. Ethnic differences in HIV-disclosure and sexual risk. AIDS Care. 2011;23:444–8.

    Article  PubMed  Google Scholar 

  7. King R, et al. Processes and outcomes of HIV serostatus disclosure to sexual partners among people living with HIV in Uganda. AIDS Behav. 2008;12:232–43.

    Article  PubMed  Google Scholar 

  8. Serovich J. A test of two HIV disclosure theories. AIDS Educ Prev. 2001;13(4):355–64.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Lovejoy N. AIDS: impact on the gay man’s homosexual and heterosexual families. Marriage Fam Rev. 1990;14:285–316.

    Article  Google Scholar 

  10. Macklin E. AIDS: implications for families. Fam Relat. 1998;37:141–9.

    Article  Google Scholar 

  11. Eustace R, Ilagan P. HIV disclosure among HIV positive individuals: a concept analysis. J Adv Nurs. 2010;66:2094–103.

    PubMed  Google Scholar 

  12. Petrak J, et al. Factors associated with self-disclosure of HIV serostatus to significant others. British J Health Psychol. 2001;6:69–79.

    Article  CAS  Google Scholar 

  13. Dempsey A, et al. Patterns of disclosure among youth who are HIV-positive: a multisite study. J Adolesc Health. 2012;50:315–7.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Marks G, Crepaz N. HIV-positive men’s sexual practices in the context of self-disclosure of HIV status. JAIDS. 2001;27:79–85.

    CAS  PubMed  Google Scholar 

  15. Siegel K, Lune H, Meyer I. Stigma management among gay-bisexual men with HIV/AIDS. Qual Sociol. 1998;21(1):3–24.

    Article  Google Scholar 

  16. Logie C, et al. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS One. 2011;8:11.

    Google Scholar 

  17. Overstreet N, et al. 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  Google Scholar 

  18. C.H.A.L. Network, HIV Disclosure and the Criminal Law in Canada: Responding to the Media and the Public. Briefing paper, 2003. 30 Oct 2003.

  19. Kalichman S, et al. Stress, social support, and HIV-status disclosure to family and friends among HIV-positive men and women. J Behav Med. 2003;26(4):315–32.

    Article  PubMed  Google Scholar 

  20. Olley B, Seedat S, Stein D. Self-disclosure of HIV serostatus in recently diagnosed patients with HIV in South Africa. Afr J Reprod Health. 2004;8:71–6.

    Article  CAS  PubMed  Google Scholar 

  21. Stein M, et al. Sexual ethics. Disclosure of HIV-positive status to partners. Arch Intern Med. 1998;158:253–7.

    Article  CAS  PubMed  Google Scholar 

  22. Gorbach P, et al. Don’t ask, don’t tell: patterns of HIV disclosure among HIV positive men who have sex with men with recent STI practicing high-risk behavior in Los Angeles and Seattle. Sex Trans Infect. 2004;80:512–7.

    Article  CAS  Google Scholar 

  23. McLean J, et al. Regular partners and risky behavior: why do gay men have unprotected intercourse? AIDS Care. 1994;6:331–41.

    Article  CAS  PubMed  Google Scholar 

  24. Obermeyer C, Baijal P, Pegurri E. Facilitating HIV disclosure across diverse settings: a review. Am J Public Health. 2011;101:1011–22.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Hart J, et al. Effect of directly observed therapy for highly active antiretroviral therapy on virologic, immunologic, and adherence outcomes: a meta-analysis and systematic review. JAIDS. 2010;54:167–79.

    PubMed  Google Scholar 

  26. Pryzbyla S, et al. 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  Google Scholar 

  27. Derlega V, et al. Perceived HIV-related stigma and HIV disclosure to relationship partners after finding out about the seropositive diagnosis. J Health Psychol. 2002;7:415–32.

    Article  PubMed  Google Scholar 

  28. Wolitski R, et al. HIV serostatus disclosure among gay and bisexual men in four American cities: general patterns and relation to sexual practices. AIDS Care. 1998;10(5):599–610.

    Article  CAS  PubMed  Google Scholar 

  29. Thompson M, Aberg JA, Cahn P, et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the international AIDS society-USA panel. JAMA. 2010;304(3):13.

    Article  Google Scholar 

  30. Akaike H. A new look at the statistical model identification. Inst Stat Math. 1974;19:7160723.

    Google Scholar 

  31. Lin D, Wei L, Wing Z. Model-checking techniques based on cumulative residuals. Biometrics. 2002;58:1–12.

    Article  CAS  PubMed  Google Scholar 

  32. Niccolai L, et al. Disclosure of HIV status to sexual partners: predictors and temporal patterns. Sex Trans Dis. 1999;26:281–5.

    Article  CAS  Google Scholar 

  33. Ciccarone D, 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;93:949–54.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Kalichman S, Nachimson D. Self-efficacy and disclosure of HIV-positive serostatus to sex partners. Health Psychol. 1999;18(3):281–7.

    Article  CAS  PubMed  Google Scholar 

  35. Gielen A, et al. Women’s lives after an HIV-positive diagnosis: disclosure and violence. Matern Child Health J. 2000;4:111–20.

    Article  CAS  PubMed  Google Scholar 

  36. Vyavaharkar M, et al. HIV-disclosure, social support, and depression among HIV-infected African American women living in the rural Southeastern United States. AIDS Educ Prev. 2011;23:78–90.

    Article  PubMed  Google Scholar 

  37. Gielen A, et al. Women living with HIV: disclosure, violence, and social support. J Urban Health. 2000;77(3):480–91.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  38. Gielsen A, et al. Women’s lives after an HIV-positive diagnosis: disclosure & violence. Matern Child Health J. 2000;4(2):111–20.

    Article  Google Scholar 

  39. Sowell R, et al. Disclosure of HIV infection: how do women decide to tell? Health Educ Res. 2003;18(1):32–44.

    Article  CAS  PubMed  Google Scholar 

  40. Serovich J, et al. 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;21:207–19.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Klitzman R. 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 

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

    Article  PubMed  Google Scholar 

  43. Parsons J, et al. Consistent, inconsistent, and non-disclosure to casual sexual partners among HIV-seropositive gay and bisexual men. AIDS. 2005;19(1):s87–97.

    Article  PubMed  Google Scholar 

  44. Schnell D, Higgins D, Wilson R. Men’s disclosure of HIV test results to male primary sex partners. Am J Public Health. 1992;82(12):1675–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The LISA research team is thankful for the cooperation of our various research sites. We are inspired by their amazing dedication to their clients and the communities they serve. We would especially like to thank the participants of the LISA study who trust us with sensitive and intimate information and share their stories in hopes of supporting research projects that will make a difference in their communities. We respectfully listen and interpret their experiences and hope that we are doing them justice. We are also grateful for the contributions of the LISA Community Advisory Committee: Terry Howard, Rosa Jamal, Isabella Kirchner, Sandy Lambert, Kecia Larkin, Steve Levine, Melissa Medjuck, Stacie Migwans, Sam Mohan, Lori Montgomery, Glyn Townson, Michelle Webb, Sarah White; and Study Co-Investigators: Dr. Rolando Barrios, Dr. David Burdge, Dr. Marianne Harris, Dr. David Henderson, Dr. Thomas Kerr, Dr. Julio S.G. Montaner, Dr. Thomas Patterson, Dr. Eric Roth, Dr. Mark Tyndall, Dr. Brian Willoughby, and Dr. Evan Wood. Finally, we thank colleagues who have provided additional assistance with the dataset and manuscript: David Milan, Dragan Lesovski, Anya Shen, and Svetlana Draskovic.

Conflict of interest

Dr. Robert Hogg has held grant funding from the National Institutes of Health, Canadian Institutes of Health Research National Health Research Development Program, and Health Canada. He has also received funding from GlaxoSmithKline and Merck Frosst Laboratories for participating in continued medical education programmes. Dr. Julio Montaner has received grants from Abbott, Biolytical, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck and ViiV Healthcare. He is also is supported by the Ministry of Health Services and the Ministry of Healthy Living and Sport, from the Province of British Columbia; through a Knowledge Translation Award from the Canadian Institutes of Health Research (CIHR); and through an Avant-Garde Award (No. 1DP1DA026182-01) from the National Institute of Drug Abuse, at the US National Institutes of Health. He has also received support from the International AIDS Society, United Nations AIDS Program, World Health Organization, National Institute on Drug Abuse, National Institutes of Health Research-Office of AIDS Research, National Institute of Allergy & Infectious Diseases, The United States President’s Emergency Plan for AIDS Relief (PEPfAR), Bill & Melinda Gates Foundation, French National Agency for Research on AIDS & Viral Hepatitis (ANRS), Public Health Agency of Canada. He has academic partnerships with the University of British Columbia, Simon Fraser University, Providence Health Care and Vancouver Coastal Health. This study was supported by a fund received from the Canadian Institutes for Health Research (Grant number 53396).

Author information

Authors and Affiliations

  1. Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada

    A. J. Hirsch Allen, Lawrence McCandless & Robert S. Hogg

  2. HIV/AIDS Drug Treatment Program, British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Jamie I. Forrest, Steve Kanters, Nadia O’Brien, Kate A. Salters, Julio S. G. Montaner & Robert S. Hogg

  3. Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada

    Julio S. G. Montaner

Authors
  1. A. J. Hirsch Allen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jamie I. Forrest
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steve Kanters
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nadia O’Brien
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kate A. Salters
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lawrence McCandless
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Julio S. G. Montaner
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Robert S. Hogg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert S. Hogg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hirsch Allen, A.J., Forrest, J.I., Kanters, S. et al. Factors Associated with Disclosure of HIV Status Among a Cohort of Individuals on Antiretroviral Therapy in British Columbia, Canada. AIDS Behav 18, 1014–1026 (2014). https://doi.org/10.1007/s10461-013-0623-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-013-0623-9

Keywords

Search

Navigation