Examining correlates of serostatus disclosure and sexual transmission risk behaviors among people living with HIV in North Carolina Public Deposited

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  • March 20, 2019
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  • Przybyla, Sarahmona Marie
    • Affiliation: Gillings School of Global Public Health, Department of Health Behavior
Abstract
  • Prevention programs targeting people living with HIV/AIDS (PLWHA) are critical in reducing the spread of the virus. Prevention efforts include promotion of risk reduction behaviors as well as disclosure of one's serostatus to sex partners. A substantial body of literature on HIV serostatus disclosure exists. However, most studies have focused solely on gay or bisexual men or among urban populations. A better understanding of the mechanisms through which PLWHA disclose their serostatus and practice safer sex behaviors is necessary to inform the development of interventions to facilitate disclosure and to meet the needs of a diverse population of PLWHA to help reduce HIV transmission. The data for these secondary analyses come from SAFETALK, a motivational interviewing-based, safer sex intervention for HIV-positive patients in North Carolina (n=490). Predictors of interest were informed by behavioral theory and previous research on serostatus disclosure and sexual transmission risk behaviors. Descriptive statistics and logistic regression were used to assess study aims. Serostatus disclosure and transmission risk behaviors were assessed at baseline. Overall, 78.9% of respondents disclosed to sexual partners. Multinomial logistic regression found that participants who had casual partners, unknown serostatus partners, and experienced stigma related to their HIV were more likely to withhold disclosure to partners. Only 16% of the sample reported engaging in unprotected vaginal or anal sex with an at-risk partner. Overall, serostatus disclosure was associated with transmission risk behavior as those who disclosed their status were less likely to engage in unprotected sex with an at-risk partner than those who withheld disclosure. Clarifying the relationship between serostatus disclosure and transmission risk behavior remains a critical public health priority as researchers need to better understand the strategies people employ to decide whether or not to disclose and how the dyad ultimately decides to engage in protected or unprotected sexual activity. While the majority of the sample did not engage in transmission risk behaviors, the fact that unprotected sex with at-risk partners was found provides a rationale for continuing Prevention with Positives programs in HIV clinical care settings where PLWHA can discuss their experiences with disclosure and risk behavior with their health care providers.
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  • Golin, Carol E.
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