Consistent, inconsistent, and non-disclosure to casual sexual partners among HIV-seropositive gay and bisexual men

OBJECTIVE: This study examined the disclosure of HIV status to casual sex partners, factors related to disclosure, and the relationship between disclosure and HIV sexual risk behaviors among a sample of HIV-positive gay and bisexual men in New York City and San Francisco. Comparisons were made particularly among men who reported consistent disclosure, inconsistent disclosure, and non-disclosure. METHOD: The data from a baseline assessment of 1168 HIV-positive gay and bisexual men in the two cities were utilized. Men were recruited from a variety of community-based venues, through advertising, and other techniques. RESULTS: Consistent disclosers reported greater self-efficacy for disclosing and more intentions to disclose than other men. They also reported less drug use, lower incomes, and more perceived viral consequences resulting from unsafe sex than did inconsistent disclosers. Overall, sexual risk behaviors were greater among inconsistent disclosers, followed by non-disclosers, with consistent disclosers reporting the fewest HIV sexual risk behaviors. CONCLUSION: Disclosure is not an all-or-nothing process, as evidenced by the 38% of men in the sample who reported disclosing to some, but not all, of their casual sexual partners. These inconsistent disclosers, who reported the most sexual risk practices, seem to lack strategies to deal with disclosure and risky sex. Some men who never disclose appear to have been able to adopt strategies by which they do not engage in sexual risk with casual partners. Interventions to improve self-efficacy for disclosure and help HIV-positive gay and bisexual men to identify and adopt specific strategies to address disclosure and safe sex are needed.