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Disclosure of HIV Status and HIV Sexual Transmission Behaviors among HIV-Positive Black Men Who Have Sex with Men in the BROTHERS (HPTN 061) Study

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Abstract

We assessed whether disclosure of HIV status is significantly associated with reported HIV sexual risk behaviors among HIV positive Black/African American men who have sex with men (MSM) (Black MSM) in six cities in the USA. Participants from the BROTHERS (HIV Prevention Trials Network [HPTN 061]) study focused on assessing the feasibility and acceptability of a multifaceted HIV prevention intervention to reduce HIV infections among Black MSM enrolled between July 2009 and October 2010. All participants completed a behavioral assessment using an audio computer-assisted self-interview that included questions about HIV status disclosure, HIV sexual risk behaviors, and other behaviors. Biological samples were also collected. This analysis focused on baseline data of HIV-positive Black MSM in the HPTN 061 study. Of the 143 HIV-positive Black MSM (majority ≥ 35 years of age) included in this analysis, 58% reported disclosing their HIV status to their last male anal sex partner. Forty-three percent and 42% reported condomless insertive and receptive anal intercourse respectively with their last male partner; whereas, 17% and 18% of the sample engaged in condomless insertive and receptive anal intercourse with a serodiscordant/unknown status partner, respectively. In multivariable logistic regression models, there was no statistically significant association between HIV status disclosure and condomless insertive anal intercourse (aOR = 0.35, 95% CI 0.11, 1.08; p = 0.30), condomless receptive anal intercourse (aOR = 2.48, 95% CI 0.94, 6.52; p = 0.20), or condomless receptive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.55, 95% CI 0.20, 1.49; p = 0.45). However, HIV status disclosure was significantly associated with lower odds of reporting condomless insertive anal intercourse with a serodiscordant/unknown status partner (aOR = 0.19, 95% CI 0.06, 0.68; p ≤ 0.01). Among this multi-city sample of HIV-positive Black MSM, disclosure of HIV status was common and associated with lower HIV sexual risk behaviors. These findings should motivate and guide research to develop prevention messages to increase HIV status disclosures.

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Acknowledgments

We thank the men who participated in the HPTN 061 (BROTHERS study). Overall support for the HIV Prevention Trials Network (HPTN) is provided by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) under Award Numbers UM1AI068619 (HPTN Leadership and Operations Center), UM1AI068617 (HPTN Statistical and Data Management Center), and UM1AI068613 (HPTN Laboratory Center). The primary author of this manuscript was also supported by the HPTN Scholars Program. Steve Shoptaw was supported by the National Institute of Mental Health (Center for HIV Identification, Prevention, and Treatment Services [P30MH058107]) The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health.

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Authors and Affiliations

  1. Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, USA

    Chukwuemeka N. Okafor & Michael J. Li

  2. Center for Behavioral and Addiction Medicine, Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA

    Chukwuemeka N. Okafor, Michael J. Li & Steve Shoptaw

  3. Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA

    Chukwuemeka N. Okafor, Michael J. Li & Steve Shoptaw

  4. CommonSpirit Health, Dignity Health, CARE Clinic, St. Mary Medical Center, Long Beach, CA, USA

    Christopher Hucks-Ortiz

  5. The Fenway Institute, Fenway Health, Boston, MA, USA

    Kenneth H. Mayer

  6. Division of Infectious Disease, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Kenneth H. Mayer

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  1. Chukwuemeka N. Okafor
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Correspondence to Chukwuemeka N. Okafor.

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Okafor, C.N., Li, M.J., Hucks-Ortiz, C. et al. Disclosure of HIV Status and HIV Sexual Transmission Behaviors among HIV-Positive Black Men Who Have Sex with Men in the BROTHERS (HPTN 061) Study. J Urban Health 97, 692–703 (2020). https://doi.org/10.1007/s11524-020-00419-9

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