Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention

AIDS Care. 2019 Aug;31(8):1011-1018. doi: 10.1080/09540121.2018.1548753. Epub 2018 Nov 18.

Abstract

Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006-2009 identified individual and social network characteristics of Black MSM (n = 226) that are associated with disclosure that may be leveraged to increase disclosure. Over two-thirds (68.1%) of the sample had ever disclosed to HCPs. Part-time employment (AOR = 0.32, 95% CI = 0.11-0.95), bisexual identity (AOR = 0.29, 95% CI = 0.12-0.70), and meeting criteria for alcohol use disorders (AOR = 0.32, 95% CI = 0.14-0.75) were negatively associated with disclosure. Disclosers were more likely to self-report being HIV-positive (AOR = 4.47, 95% CI = 1.54-12.98), having more frequent network socialization (AOR = 2.15, 95% CI = 1.24-3.73), and having a social network where all members knew the participant had sex with men (AOR = 4.94, 95% CI = 2.06-11.86). These associations were not moderated by self-reported HIV status. Future interventions to help MSM identify social network members to safely disclose their same-sex behavior may also help disclosure of same-sex behavior to HCPs among Black MSM.

Keywords: HIV; disclosure; health care providers; men who have sex with men.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome
  • Adult
  • Black or African American / psychology*
  • Black or African American / statistics & numerical data
  • Disclosure
  • HIV Infections / ethnology
  • HIV Infections / prevention & control*
  • HIV Seropositivity
  • Health Personnel / psychology*
  • Homosexuality, Male / ethnology*
  • Homosexuality, Male / psychology
  • Humans
  • Male
  • Self Disclosure*
  • Sexual Behavior / statistics & numerical data
  • United States