Men who have sex with men (MSM) remain disproportionately represented in the national HIV/AIDS statistics. Little progress has been made in understanding the nuances of MSM sexual behavior or communication that may be perpetuating the spread of HIV. Non- disclosure of an HIV-positive status may be a key factor responsible for male-male HIV transmission. There are no known intervention programs whose primary focus is to help MSM develop requisite skills to disclose their status to casual sexual partners. The development of such interventions is essential because of the numerous repercussions for not disclosing when one is knowingly HIV-positive such as legal prosecution and the transmission of HIV. In a previous intervention development study (R21MH067494) the research team created and tested a 4 session intervention found to be promising for increasing disclosure to casual sexual partners. The purpose of the proposed research is to further refine and enhance our HIV disclosure intervention (DI) designed to increase disclosure to casual sexual partners and reduce sexual risk taking behaviors among HIV- positive MSM;assess the relative effectiveness of a disclosure intervention to an attention control case management group (ACCM) for HIV-positive MSM;examine the effects of the intervention over time;explore differential treatment responses to the disclosure intervention and ACCM on the basis of ethnicity, age, and education level as well as examine the mediating effect of baseline frequency of sexual activity, severity of substance abuse at baseline, and stigmatized fear on the relationship between intervention type and the outcome. Finally we will test how treatment engagement, retention and expectations predict subsequent disclosure and risky sexual outcomes.
Reducing the spread of HIV is a national public health priority, and understanding HIV disclosure patterns and theory-driven interventions to enhance disclosure is necessary for HIV prevention efforts. The purpose of this project is to compare the relative effectiveness of our disclosure intervention to case management for HIV-positive MSM. There are no known interventions focusing on facilitating HIV disclosure to sexual partners. The development of such an intervention is essential because of the numerous repercussions, including transmission of HIV, for not disclosing HIV positive status.