Online Survey Examines HIV Status Disclosure Among MSM in Asia
HIV rates among men who have sex with men (MSM) in Asia, which are as high as 30 percent in Bangkok, Thailand, have led to the prioritization of MSM as a target group for prevention and treatment interventions. One prevention approach— known as "Prevention with positives"—helps HIV-positive individuals reduce the risk of transmission to their HIV-negative partners, including by disclosing their HIV infection status. Researchers used an online survey to assess HIV disclosure in the MSM community in Asia.1
The "Asian Internet MSM Sex Survey" was conducted between January and February of 2010 and offered in nine Asian languages as well as English. Of the 13,883 people who completed the survey, 416 self-identified as HIV-positive MSM and were included in the analysis. Sixty-eight percent of these HIV-positive MSM reported having unprotected anal sex in the past six months.
However, 67 percent did not disclose their HIV status to any of their partners, and only seven percent disclosed to all partners. Participants who did not disclose their status were more likely to have partners who also did not disclose their own status, have only casual partners, use drugs before sex on a weekly basis, have been diagnosed between one and five years before, and not know their current HIV viral load. Notably, less than half of the survey participants who identified as HIV-negative had ever had an HIV test.
The researchers commented that stigma and discrimination are critical barriers to disclosure. Structural policies such as criminalization of HIV transmission or exposure, lack of employment protections, and personal fears of rejection or social isolation can all contribute to non-disclosure. Although these results may not apply to MSM who would not participate in an online survey or are within different social and demographic groups from the study participants, the study emphasizes the need for greater support for prevention activities that engage HIV-positive MSM and link them to care and treatment. HIV-negative partners should also be encouraged to receive HIV testing and disclose their own status to promote shared sexual responsibility.1.
Wei C, Lim SH, Guadamuz TE, Koe S. HIV Disclosure and Sexual Transmission Behaviors among an Internet Sample of HIV-positive Men Who Have Sex with Men in Asia: Implications for Prevention with Positives. AIDS Behav
. 2011 Dec 25. [Epub ahead of print]