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HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support

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Abstract

HIV sero-status disclosure among people living with HIV (PLWH) is an important component of preventing HIV transmission to sexual partners. Due to various social, structural, and behavioral challenges, however, many HIV-infected opioid-dependent patients do not disclose their HIV status to all sexual partners. In this analysis, we therefore examined non-disclosure practices and correlates of non-disclosure among high-risk HIV-infected opioid-dependent individuals. HIV-infected opioid-dependent individuals who reported HIV-risk behaviors were enrolled (N = 133) and assessed for HIV disclosure, risk behaviors, health status, antiretroviral therapy (ART) adherence, HIV stigma, social support and other characteristics. Multivariable logistic regression was used to identify significant correlates of non-disclosure. Overall, 23% reported not disclosing their HIV status to sexual partners, who also had high levels of HIV risk: sharing of injection equipment (70.5%) and inconsistent condom use (93.5%). Independent correlates of HIV non-disclosure included: being virally suppressed (aOR 0.19, p = 0.04), high HIV-related stigma (aOR 2.37, p = 0.03), and having multiple sex partners (aOR 5.87, p = 0.04). Furthermore, a significant interaction between HIV-related stigma and living with family/friends suggests that those living with family/friends were more likely to report not disclosing their HIV status when higher levels of perceived stigma was present. Our findings support the need for future interventions to better address the impact of perceived stigma and HIV disclosure as it relates to risk behaviors among opioid-dependents patients in substance abuse treatment settings.

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Funding

This work was supported by grants from the National Institute on Drug Abuse for research (R01 DA032290) and for career development (K02 DA033139) to Michael Copenhaver, and K24 DA017072 to Frederick L. Altice.

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Authors and Affiliations

  1. Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA

    Roman Shrestha, Brian Sibilio & Michael M. Copenhaver

  2. Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA

    Roman Shrestha, Frederick L. Altice, Brian Sibilio & Michael M. Copenhaver

  3. Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA

    Frederick L. Altice

  4. Division of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, USA

    Frederick L. Altice

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  1. Roman Shrestha
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Correspondence to Roman Shrestha.

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The study protocol was approved by the Investigational Review Board (IRB) at the University of Connecticut and Yale University and received board approval from APT Foundation Inc. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Shrestha, R., Altice, F.L., Sibilio, B. et al. HIV Sero-Status Non-disclosure Among HIV-Infected Opioid-Dependent Individuals: The Roles of HIV-Related Stigma, Risk Behavior, and Social Support. J Community Health 44, 112–120 (2019). https://doi.org/10.1007/s10900-018-0560-7

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