Skip to main content

Advertisement

SpringerLink
Log in

Patterns and Correlates of Serostatus Disclosure to Sexual Partners by Perinatally-Infected Adolescents and Young Adults

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

Abstract

Similar to same-age peers, perinatally HIV-infected (PHIV+) youth in the US are engaging in sex, including condomless sex. Understanding decisions about serostatus disclosure to sexual partners is important to domestic and global HIV prevention efforts, since large numbers of PHIV+ children are entering adolescence and becoming sexually active. Using Social Action Theory (SAT) to inform variable selection, we examined correlates of disclosure among 98 PHIV+ adolescents/young adults in New York City. Over half of these youth reported not disclosing to any casual partners (59 %) or to any partners when using condoms (55 %). In bivariate analyses, increased disclosure was associated with older age; being female; earlier age of learning one’s serostatus; and increased STD knowledge, disclosure intentions, and parent–child communication. Multiple regression analyses revealed a strong fit with the SAT model. As with adults, disclosure to sexual partners is difficult for PHIV+ youth and challenges prevention efforts. Effective interventions that help youth with disclosure decisions are needed to curb the epidemic.

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

Access this article

Log in via an institution

Price includes VAT (Austria)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Elkington KS, Bauermeister JA, Robbins RN, Gromadzka O, Abrams EJ, Wiznia A, et al. Individual and contextual factors of sexual risk behavior in youth perinatally infected with HIV. AIDS Patient Care STDS. 2012;26(7):411–22.

    PubMed  PubMed Central  Google Scholar 

  2. Elkington KS, Bauermeister JA, Brackis-Cott E, Dolezal C, Mellins CA. Substance use and sexual risk behaviors in perinatally human immunodeficiency virus-exposed youth: Roles of caregivers, peers and HIV status. J Adolesc Health. 2009;45(2):133–41.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Elkington KS, Bauermeister JA, Santamaria EK, Dolezal C, Mellins CA. Substance use and the development of sexual risk behaviors in youth perinatally exposed to HIV. J Pediatr Psychol. 2014; Epub ahead of print.

  4. Ezeanolue EE, Wodi AP, Patel R, Dieudonne A, Oleske JM. Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: experience of an urban tertiary center. J Adolesc Health. 2006;38(6):719–25.

    Article  PubMed  Google Scholar 

  5. Tassiopoulos K, Moscicki AB, Mellins C, Kacanek D, Malee K, Allison S, et al. Sexual risk behavior among youth with perinatal HIV infection in the United States: predictors and implications for intervention development. Clin Infect Dis. 2013;56(2):283–90.

    Article  PubMed  Google Scholar 

  6. Mellins CA, Brackis-Cott E, Dolezal C, Abrams EJ. The role of psychosocial and family factors in adherence to antiretroviral treatment in human immunodeficiency virus-infected children. Pediatr Infect Dis J. 2004;23(11):1035–41.

    Article  PubMed  Google Scholar 

  7. Usitalo A, Leister E, Tassiopoulos K, Allison S, Malee K, Paul ME, et al. Relationship between viral load and self-report measures of medication adherence among youth with perinatal HIV infection. AIDS Care. 2014;26(1):107–15.

    Article  PubMed  Google Scholar 

  8. Van Dyke RB, Lee S, Johnson GM, Wiznia A, Mohan K, Stanley K, et al. Reported adherence as a determinant of response to highly active antiretroviral therapy in children who have human immunodeficiency virus infection. Pediatrics. 2002;109(4):e61.

    Article  PubMed  Google Scholar 

  9. Wiener L, Riekert K, Ryder C, Wood LV. Assessing medication adherence in adolescents with HIV when electronic monitoring is not feasible. AIDS Patient Care STDS. 2004;18(9):527–38.

    Article  PubMed  Google Scholar 

  10. Williams PL, Storm D, Montepiedra G, Nichols S, Kammerer B, Sirois PA, et al. Predictors of adherence to antiretroviral medications in children and adolescents with HIV infection. Pediatrics. 2006;118(6):e1745–57.

    Article  PubMed  Google Scholar 

  11. Marks G, Burris S, Peterman TA. Reducing sexual transmission of HIV from those who know they are infected: the need for personal and collective responsibility. AIDS. 1999;13(3):297–306.

    Article  CAS  PubMed  Google Scholar 

  12. Fisher JD, Fisher WA. Changing AIDS-risk behavior. Psychol Bull. 1992;111(3):455–74.

    Article  CAS  PubMed  Google Scholar 

  13. Lyles CM, Kay LS, Crepaz N, Herbst JH, Passin WF, Kim AS, et al. Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for US populations at high risk, 2000-2004. Am J Public Health. 2007;97(1):133–43.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: Implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446–53.

    Article  PubMed  Google Scholar 

  15. 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 

  16. 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):224–31.

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Gielen AC, O’Campo P, Faden RR, Eke A. Women’s disclosure of HIV status: experiences of mistreatment and violence in an urban setting. Women Health. 1997;25(3):19–31.

    Article  CAS  PubMed  Google Scholar 

  19. Obermeyer CM, Baijal P, Pegurri E. Facilitating HIV disclosure across diverse settings: a review. Am J Public Health. 2011;101(6):1011–23.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dempsey AG, MacDonell KE, Naar-King S, Lau CY. Adolescent Medicine Trials Network for HIVAI. Patterns of disclosure among youth who are HIV-positive: a multisite study. J Adolesc Health. 2012;50(3):315–7.

    Article  PubMed  Google Scholar 

  21. Havens JF, Mellins CA. Psychiatric aspects of HIV/AIDS in childhood and adolescence. In: Rutter M, Taylor E, editors. Child and adolescent psychiatry. 5th ed. Oxford: Blackwell; 2008.

    Google Scholar 

  22. 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 

  23. Koenig LJ, Pals SL, Chandwani S, Hodge K, Abramowitz S, Barnes W, et al. Sexual transmission risk behavior of adolescents with HIV acquired perinatally or through risky behaviors. J Acquir Immune Defic Syndr. 2010;55(3):380–90.

    Article  PubMed  Google Scholar 

  24. Peele YL, D’Angelo LJ, Chandwani S, Abramowitz S, Koenig LJ. 164. Determinants of HIV serostatus self-disclosure among adolescents participating in the Adolescent Impact Study. Abstract. J Adolesc Health. 2012;50(2):S91–2.

    Article  Google Scholar 

  25. D’Angelo LJ, Abdalian SE, Sarr M, Hoffman N, Belzer M. Network. AMHIVAR. Disclosure of serostatus by HIV infected youth: The experience of the REACH study. Reaching for excellence in adolescent care and health. J Adolesc Health. 2001;29(Supplement 3):72–9.

    Article  PubMed  Google Scholar 

  26. Batterham P, Rice E, Rotheram-Borus MJ. Predictors of serostatus disclosure to partners among young people living with HIV in the pre- and post-HAART eras. AIDS Behav. 2005;9(3):281–7.

    Article  PubMed  Google Scholar 

  27. Simon-Rosser BR, Horvath KJ, Hatfield LA, Peterson JL, Jacoby S, Stately A. Predictors of HIV disclosure to secondary partners and sexual risk behavior among a high-risk sample of HIV-positive MSM: Results from six epicenters in the US. AIDS Care. 2008;20(8):925–30.

    Article  CAS  PubMed  Google Scholar 

  28. Nachega JB, Morroni C, Zuniga JM, Sherer R, Beyrer C, Solomon S, et al. HIV-related stigma, isolation, discrimination, and serostatus disclosure: a global survey of 2035 HIV-infected adults. J Int Assoc Physicians AIDS Care. 2012;11(3):172–8.

    Article  Google Scholar 

  29. Fernet M, Wong K, Richard ME, Otis J, Levy JJ, Lapointe N, et al. Romantic relationships and sexual activities of the first generation of youth living with HIV since birth. AIDS Care. 2011;23(4):393–400.

    Article  PubMed  Google Scholar 

  30. Michaud PA, Suris JC, Thomas LR, Kahlert C, Rudin C, Cheseaux JJ. 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 

  31. Kalichman SC, 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 

  32. Ewart CK. Social action theory for a public health psychology. Am Psychol. 1991;46(9):931–46 Epub 1991/09/01.

    Article  CAS  PubMed  Google Scholar 

  33. Webel A, Phillips JC, Rose C, Holzemer WL, Chen W-T, Tyer-Viola L, et al. A cross-sectional description of social capital in an international sample of persons living with HIV/AIDS (PLWH). BMC Public Health. 2012;12(1):1–11.

    Article  Google Scholar 

  34. Remien RH, Mellins CA, Robbins RN, Kelsey R, Rowe J, Warne P, et al. Masivukeni: development of a multimedia based antiretroviral therapy adherence intervention for counselors and patients in South Africa. AIDS Behav. 2013;17(6):1979–91.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Traube DE, Holloway IW, Smith L. Theory development for HIV behavioral health: empirical validation of behavior health models specific to HIV risk. AIDS Care. 2011;23(6):663–70.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Mellins CA, Dolezal C, Brackis-Cott E, Nicholson O, Warne P, Meyer-Bahlburg HFL. Predicting the onset of sexual and drug risk behaviors in HIV-negative youths with HIV-positive mothers: The role of contextual, self-regulation, and social-interaction factors. J Youth Adolesc. 2007;36(3):265–78.

    Article  PubMed  Google Scholar 

  37. Mellins CA, Brackis-Cott E, Leu CS, Elkington KS, Dolezal C, Wiznia A, et al. Rates and types of psychiatric disorders in perinatally human immunodeficiency virus-infected youth and seroreverters. J Child Psychol Psychiatry. 2009;50(9):1131–8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Centers for Disease Control and Prevention. HIV Surveillance Report, Volume 25: Diagnoses of HIV Inflection in the United States and Dependent Areas, 2013. Atlanta, Georgia: CDC, February 2015.

  39. Dolezal C, Marhefka SL, Santamaria EK, Leu CS, Brackis-Cott E, Mellins CA. A comparison of audio computer-assisted self-interviews to face-to-face interviews of sexual behavior among perinatally HIV-exposed youth. Arch Sex Behav. 2012;41(2):401–10.

    Article  PubMed  Google Scholar 

  40. Tukey JW. Exploratory data analysis. Reading: Addison-Wesley; 1977.

    Google Scholar 

  41. Dunn LM, Dunn DM. Peabody picture vocabulary test. 4th ed. Minneapolis: Pearson Education; 2007.

    Google Scholar 

  42. Campbell JM, Brown RT, Cavanagh SE, Vess SF, Segall MJ. Evidence-based assessment of cognitive functioning in pediatric psychology. J Pediatr Psychol. 2008;33(9):999–1014.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Jacob S, Jearld S. Transitioning your HIV+ youth to healthy adulthood: a guide for health care providers. New York: Children’s Hope Foundation and the Partnership for Family Health; 2007.

    Google Scholar 

  44. hivcareforyouth.org. Treating adolescents with HIV: Tools for building skills in cultural competence, clinical care, and support. 2007. www.hivcareforyouth.org.

  45. Miller KS, Kotchick BA, Dorsey S, Forehand R, Ham AY. Family communication about sex: What are parents saying and are their adolescents listening? Fam Plann Perspect. 1998;30(5):218-22, 35.

  46. Sahay S. Coming of age with HIV: a need for disclosure of HIV diagnosis among children/adolescents. J HIV AIDS Infect Dis. 2013;1:1–7.

    Google Scholar 

  47. Fife BL, Wright ER. The dimensionality of stigma: a comparison of its impact on the self of persons with HIV/AIDS and cancer. J Health Soc Behav. 2000;41(1):50–67.

    Article  CAS  PubMed  Google Scholar 

  48. Achenbach TM. Integrative guide for the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington: University of Vermont, Department of Psychiatry; 1991.

    Google Scholar 

  49. 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  PubMed Central  Google Scholar 

  50. Evangeli M, Foster C. Who, then what? The need for interventions to help young people with perinatally acquired HIV disclose their HIV status to others. AIDS. 2014;28(Suppl 3):S343–6.

    Article  PubMed  Google Scholar 

  51. Kirby DB, Laris BA, Rolleri LA. Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world. J Adolesc Health. 2007;40(3):206–17.

    Article  PubMed  Google Scholar 

  52. Whitaker DJ, Miller KS. Parent-adolescent discussions about sex and condoms: Impact on peer influences of sexual risk behavior. J Adolesc Res. 2000;15(2):251–73.

    Article  Google Scholar 

  53. Whitaker DJ, Miller KS, May DC, Levin ML. Teenage partners’ communication about sexual risk and condom use: The importance of parent-teenager discussions. Fam Plan Perspect. 1999;31(3):117–21.

    Article  CAS  Google Scholar 

  54. Miller BC, Norton MC, Fan X, Christopherson CR. Pubertal development, parental communication, and sexual values in relation to adolescent sexual behaviors. J Early Adolesc. 1998;18(1):27–52.

    Article  Google Scholar 

  55. Santamaria EK, Dolezal C, Marhefka SL, Hoffman S, Ahmed Y, Elkington K, et al. Psychosocial implications of HIV serostatus disclosure to youth with perinatally acquired HIV. AIDS Patient Care STDS. 2011;25(4):257–64.

    Article  PubMed  PubMed Central  Google Scholar 

  56. UNAIDS. The gap report. Geneva: UNAIDS; 2014.

  57. Dindia K, Allen M. Sex differences in self-disclosure: A meta-analysis. Psychol Bull. 1992;112(1):106–24.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Susie Hoffman, Dr. P.H., for her early contributions to this paper. This research was supported by a grant from the National Institute of Mental Health (NIMH; R01-MH69133, Principal Investigator: Claude Ann Mellins, Ph.D.) and a center grant from NIMH to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520; Principal Investigator: Robert H. Remien, Ph.D.). Dr. Elkington was also supported by Grant #K01-MH89832 from NIMH. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIMH or the National Institutes of Health.

Author information

Authors and Affiliations

  1. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA

    Amy Weintraub, Claude A. Mellins, Patricia Warne, Curtis Dolezal, Katherine Elkington, Amelia Bucek & Cheng-Shiun Leu

  2. Metropolitan Hospital Center, New York, NY, USA

    Mahrukh Bamji

  3. Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Andrew Wiznia

  4. ICAP, Mailman School of Public Health, and College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Elaine J. Abrams

Authors
  1. Amy Weintraub
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claude A. Mellins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patricia Warne
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Curtis Dolezal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katherine Elkington
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amelia Bucek
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Cheng-Shiun Leu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mahrukh Bamji
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Andrew Wiznia
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Elaine J. Abrams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amy Weintraub.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Weintraub, A., Mellins, C.A., Warne, P. et al. Patterns and Correlates of Serostatus Disclosure to Sexual Partners by Perinatally-Infected Adolescents and Young Adults. AIDS Behav 21, 129–140 (2017). https://doi.org/10.1007/s10461-016-1337-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1337-6

Keywords

Search

Navigation