Serostatus Disclosure Research Articles

HIV-Related Stress Experienced by Newly Diagnosed People Living with HIV in China: A 1-Year Longitudinal Study.

This study explored the HIV-related stressors that people living with HIV (PLWH) commonly experience and express as stressful at the time of diagnosis and 1 year later. The factors associated with stress levels and whether social support would moderate the negative effects of stress on psychological health (depressive and anxiety symptoms) were also investigated. Newly diagnosed PLWH were consecutively recruited in this study. Participants rated their stress with the HIV/AIDS Stress Scale at baseline and 1 year later. Social support, depression, and anxiety were also self-reported at both time points. There were significant decreases in stress levels 1 year after diagnosis. Stressors regarding confidentiality, disclosure, emotional distress, fear of infecting others, and excessive attention to physical functions were the most problematic at baseline and 1-year follow-up. A younger age, married status, not living alone, less income, presence of HIV symptoms, and lack of social support were associated with higher levels of stress. No stress-buffering effect of social support on depressive and anxiety symptoms was found in this study. Interventions to reduce stress among PLWH should take into consideration the following priority stressors: confidentiality, discrimination/stigma, serostatus disclosure, distressing emotions, fear of infecting others, and excessive attention to physical functions. More attention should be paid to PLWH with younger age, not living alone, less income, presence of HIV symptoms, and lack of social support.

“Do I need to or do I want to?” A typology of HIV status disclosure among gay, bisexual, and other men who have sex with men

ABSTRACTGay, bisexual, and other men who have sex with men (GBMSM) are a key population that is disproportionately affected by HIV. However, few studies have explored how and why disclosure of HIV status occurs in this population. To understand disclosure in the context of other socioecological factors, we conducted a qualitative study among 24 self-identified HIV-positive GBMSM, aged 21 and above, and who were Singaporean residents. Analysis of participants’ interviews revealed that disclosure of HIV status was not a binary event; rather, each type of disclosure held varying degrees of positive and negative ramifications. Disclosure and self-acknowledgement of HIV status at each time point also had different consequences for participants’ quality of life. Suggested potential interventions include increasing training for medical professionals and public awareness surrounding issues relating to HIV. Findings from this study provide a framework to describe the complexities that accompany serostatus disclosure in a setting where there are prevalent “shame-based”, negative attitudes towards HIV. As such, this framework can also be utilized in the future planning and organization of services for this target population in similar contexts.

Security amidst stigma: Exploring HIV and sexual minority stressors through an attachment-based psychotherapy group.

Despite strides in HIV prevention and lesbian, gay, bisexual, and transgender care, comprehensive care centers are of critical importance for lesbian, gay, bisexual, and transgender communities and people with HIV/AIDS who continue to contend with intersecting stigmas and chronic minority stressors. Building on the integrated attachment and sexual minority stress model, we discuss these themes by highlighting a group vignette from an urban psychiatric clinic that has provided affirmative psychotherapy to marginalized communities affected by HIV/AIDS for over 2 decades. The authors have rotated at the clinic as cofacilitators of a weekly, process-oriented group for sexual minority men who are HIV positive or are affected by HIV. In this article, we provide a theoretical foundation for HIV-affirming group psychotherapy and clinical integration of minority stress and attachment-based interventions. Group psychotherapy provides a rare opportunity to bond an often-isolated community by evoking factors of universality, cohesiveness, and catharsis. It simultaneously enables us to confront individual existential concerns with serostatus disclosure, grief, and feelings of victimization, as well as challenge internalized stigma and rejection sensitivity. We apply these issues to a verbatim clinical exchange, analyzing attachment-related themes and issues pertaining to minority stress and stigma, as well as discuss group mechanisms for attachment interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Level and determinants of postpartum adherence to antiretroviral therapy in the Eastern Cape, South Africa.

Adherence to antiretroviral therapy (ART), especially during the postpartum period, remains a major challenge in the efforts towards eliminating mother-to-child transmission of HIV. This study examined the levels and determinants of postpartum adherence to ART among mothers with HIV in the Eastern Cape, South Africa. In this cross-sectional analytical study, we interviewed 495 postpartum women with HIV between January and May 2018. We measured postpartum adherence using six questions probing participants' adherence behaviours since child birth. We categorised the adherence behaviours into complete adherence (mothers who reported no missed episode(s) of ART since child birth) and suboptimal adherence (mothers with any missed episode(s) of ART). Adjusted and unadjusted logistic regression models were used to examine the determinants of postpartum adherence to ART. Overall, 63.9% reported complete adherence during the postpartum period but the rates varied by socio-demographic and behavioural characteristics. The adjusted logistic regression analysis showed that younger mothers were 70% less likely to report complete adherence to ART compared to mothers aged 40 and above. Likewise, mothers who currently use alcohol were 53% less likely to report complete postpartum adherence to ART compared to those who did not use alcohol. However, mothers who knew their partner's status were twice more likely to report complete postpartum adherence compared to those who did not. There was no statistically significant relationship between ART adherence and breastfeeding durations. Postpartum adherence to ART is suboptimal in the study setting, and younger mothers and those who use alcohol have a lower odds of complete adherence. Knowing a partner's status improves adherence, but infant feeding practices did not influence postpartum adherence behaviours. It is critical to design and strengthen interventions which target young mothers and alcohol users. Also, HIV sero-status disclosure should be encouraged among mothers to facilitate partner support.

Economic vulnerability and non-initiation of antiretroviral therapy in India: a qualitative study

ABSTRACT In India, many people living with HIV (PLHIV) do not successfully initiate antiretroviral therapy (ART) after diagnosis. We conducted a clinic-based qualitative study at the Y.R. Gaitonde Centre for AIDS Research in Chennai, Tamil Nadu to explore factors that influence ART non-initiation. We interviewed 22 men and 15 women; median age was 42 (IQR, 36-48) and median CD4+ was 395 (IQR, 227-601). Participants were distrustful of HIV care freely available at nearby government facilities. Faced with the perceived need to access the private sector and therefore pay for medications and transportation costs, non-initiators with high CD4+ counts often decided to postpone ART until they experienced symptoms whereas non-initiators with low CD4+ counts often started ART but defaulted quickly after experiencing financial stressors or side effects. Improving perceptions of quality of care in the public sector, encouraging safe serostatus disclosure to facilitate stronger social support, and alleviating economic hardship may be important in encouraging ART initiation in India.

Factors affecting disclosure of HIV-positive serostatus among people living with HIV/AIDS attending an antiretroviral therapy center of Eastern India.

HIV serostatus disclosure plays an important role in reducing the risk of HIV transmission. However, its negative effects may include rejection, assault, separation, divorce, stigma, and discrimination. This study was undertaken to find out the proportion of HIV-positive serostatus disclosure to any family member and different factors influencing disclosure among people living with HIV/AIDS (PLWHA). A cross-sectional study was conducted among all patients aged 18-49 years with confirmed HIV infection registered at the antiretroviral therapy center of a tertiary care hospital in eastern part of Uttar Pradesh, India, for the duration of 1 year, from July 2017 to June 2018. Most of the respondents were aged 30-49 years (79.9%), male (63.2%), married (85.4%), rural residents (60.4%), Hindu (96.5%), literate (84%), employed/driver (61.8%), and belonged to lower/lower middle class (62.6%). The rate of disclosure of HIV-positive status to any family member was quite high in this study (238/288 or 82.6%), among which 92.9% (221/238) to the spouse only. The number of sexual partners before disclosure, educational status, and socioeconomic status of the respondents were found to be independent predictors of disclosure of HIV-positive status to any family member (P < 0.05). This study indicates the need of giving more emphasis on creating awareness regarding the importance of HIV serostatus disclosure to any family member, especially to spouse, and encourage all PLWHA in the community to disclose their status. Effective strategies also need to be evolved that will target those not likely to disclose their status to anybody.

How Follow-Up Counselling Increases Linkage to Care Among HIV-Positive Persons Identified Through Home-Based HIV Counselling and Testing: A Qualitative Study in Uganda

We investigated how follow-up counselling had increased linkage to HIV care in a trial of referral to care and follow-up counseling, compared to referral to care only, for participants diagnosed as HIV-positive through home-based HIV counseling and testing. We carried out a cross-sectional qualitative study. Using random stratified sampling, we selected 43 trial participants (26 [60%] in the intervention arm). Sample stratification was by sex, distance to an ART facility, linkage, and nonlinkage to HIV care. Twenty-six in-depth interviews were conducted with participants in the intervention arm: 17 people who had linked to HIV care and 9 who had not linked after 6 months of follow-up. Home-based follow-up counseling helped to overcome worries resulting from an HIV-positive test result. In addition, the counseling offered an opportunity to address questions on HIV treatment side effects, share experiences of intimate partner violence or threats, and general problems linking to care. The counselling encouraged early linkage to HIV care and use of biomedical medicines, discouraging alternative medicine usage. Home-based follow-up counseling also helped to promote HIV sero-status disclosure, facilitating linkage to, retention in and adherence to HIV care and treatment. This study successfully demonstrated that home-based follow-up counselling increased linkage to care through encouragement to seek care, provision of accurate information about HIV care services and supporting the person living with HIV to disclose and manage stigma.

Substance Use, HIV Serostatus Disclosure, and Sexual Risk Behavior in People Living with HIV: An Event-Level Analysis.

People living with HIV (PLWH) face difficult decisions about disclosing their HIV status to new sexual partners. Alcohol and other drug use could impact these decision-making processes and subsequent sexual risk behavior. We sought to examine the event-level relationships between substance use, HIV disclosure, and condom use in PLWH and their first-time HIV-negative or unknown status sexual partners. Adult PLWH were recruited from care settings in a southeastern U.S. city. Participants reported their sexual behavior for 28 consecutive days via text message prompts. We employed multilevel covariation in a causal system to examine the event-level relations between substance use and condom use. We proposed that this relationship would be mediated by HIV disclosure and moderated by viral suppression status. A total of 243 participants (83% male, 93% Black) reported 509 sexual events with first-time HIV-negative/unknown status sexual partners. Substance use at the time of sex was negatively associated with disclosure in PLWH with suppressed viral load (OR 0.29, β = -1.22, 95% CI [-2.42, -0.03], p = .045), but differentially associated with condom use in PLWH with detectable versus undetectable viral load. In PLWH with viral suppression, participants who always disclosed versus who never disclosed their HIV status were more likely to use condoms (β = 1.84, 95% CI [0.35, 3.53], p = .017), but inconsistent disclosers were less likely to use a condom after disclosing (OR 0.22, 95% CI [0.07, 0.68], p = .008). Event-level analysis offers a more nuanced understanding of the proximal (substance use, HIV disclosure) and person-level (substance use, viral load) determinants of HIV transmission risk behavior in PLWH.

Determinants of HIV serostatus disclosure and assessment of the competence of health care personnel in HIV serostatus disclosure

Background: Disclosure of HIV serostatus is essential for the care and eradication of HIV infection. The World Health Organization recommends disclosure to school-age children and younger children but this practice is commonly hindered by stigmatization and other presumed psychosocial effects of the disease. Objective: To identify limitations to the disclosure of serostatus in HIV-infected children, outcomes of disclosure as well as compare the outcomes of disclosure by either parents/caregiver only with the involvement of health care personnel. Methods: A questionnaire-based study of primary caregivers of children aged 6 years to 18 years with HIV infection who were enrolled at two government-owned tertiary institutions in Lagos State, Nigeria. The healthcare personnel directly involved in the care of these children also participated in the study. Results: A total of 190 primary caregivers participated in the study. In all, 29 health care personnel completely filled the questionnaires. Disclosure (partial and full) was recorded among 31.0%. Older children and children with single parents were more likely to know their HIV status. Similar positive and negative impacts of disclosure were observed irrespective of the individuals involved in the processes. In all, 62.1% of healthcare personnel have had training on disclosure. Conclusion: Disclosure rate in HIV-infected children was low. There is a need for more training of health personnel and education of caregivers on the benefits of disclosure as well as the introduction of effective measures to tackle the barriers to disclosure.

The impact of serostatus disclosure on spousal relationships between wives and HIV-positive husbands who have sex with men in China

ABSTRACT This study explored the impact of serostatus disclosure on the spousal relationship between wives and their HIV-positive husbands who have had sex with men. A qualitative study using semi-structured interviews was conducted in Sichuan, China in 2017 with wives (n = 31) who had known their husbands’ HIV-positive status. Participants were identified by local governmental and non-governmental organizations that provide routine services for people living with HIV and their family members. Qualitative data underwent a detailed content analysis. Both positive and negative impacts on the spousal relationship were expressed by wives. Six themes were identified: (1) reduced sexual activities; (2) changes in intimacy; (3) limited communication on HIV-related issues but improved communication on other topics; (4) increased instrumental support but decreased emotional support; (5) improved resilience in the spousal relationship; and (6) shared privacy management rules regarding HIV-positive status. Moreover, the acknowledgment of the husband’s homosexual behavior hurt the spousal relationship more seriously than the disclosure of the husband’s HIV-positive status, and irremediable marriages were observed among wives who knew both. Disclosure of HIV-positive status had a great impact on the spousal relationship, though such impact varied across individuals.

"Demand what you prefer": the role of sexual assertiveness among HIV-infected women

Aim: This study was conducted to evaluate sexual assertiveness among HIV-infected women, and to address the relationship between sexual assertiveness, sociodemographic characteristics, sexual and fertility profile, and HIV-related variables in this population. Design: A cross sectional study. Methods: The research was conducted with a sample of 93 eligible HIV-infected women referred to Imam Khomeini hospital between September 2016 and January 2018. The Hurlbert Index of Sexual Assertiveness was used to assess sexual assertiveness. Results: Mean and standard deviation of sexual assertiveness was 51.33 (20.16). We found a significant relationship between age (p = 0.04), education (p = 0.03), pregnancy experience (p = 0.003), age at the time of first sexual contact (p = 0.005), and disclosure of HIV sero-status to sexual partners (p = 0.05) and sexual assertiveness. Binary logistic regression results showed that age (p = 0.04), having live children (p = 0.003), and disclosure of HIV sero-status to sexual partners (p = 0.04) could significantly predict sexual assertiveness score. Conclusion: Our findings showed that level of sexual assertiveness in HIV sero-positive women deserves more attention. In addition, consideration should be given to sexual health related issues and sexual assertiveness skills during routine HIV care appointments.

Status and associated characteristics of HIV disclosure among people living with HIV/AIDS in Liangshan, China: A cross-sectional study.

Human immunodeficiency virus (HIV) disclosure is a prerequisite to get access to antiretroviral therapy (ART) and social support. Increased disclosure of HIV status has been shown to reduce mother-to-child transmission and high-risk sexual behaviors. Limited studies were conducted to get an insight into HIV disclosure among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA) in Liangshan.Our study aimed to investigate the status and associated characteristics of HIV disclosure among PLWHA in Liangshan.We conducted a cross-sectional study using a stratified, convenience sampling method from August to December in 2017. All of the participants were from Liangshan, a typical impoverished mountainous area which also has a long history of drug production and drug trade. Each participant completed a structured questionnaire including HIV disclosure status, demographic and HIV-related characteristics, social support, and perceived HIV-related stigma. We performed a binary regression analysis to detect associated characteristics of HIV disclosure among PLWHA in Liangshan.A final sample size of 318 participants was included in this study. The overall prevalence of HIV disclosure was 83.6% (266/318). In binary logistic regression analysis, PLWHA who had higher educational levels, and got infected by sexual transmission were less likely to disclose their HIV status (both P < .05). HIV nondisclosure was correlated with a higher level of perceived HIV-related stigma (P < .01).The prevalence of HIV disclosure was relatively low in Liangshan. Healthcare workers are suggested to conduct more counseling and education to promote safe sexual behaviors and reduce perceived stigma among PLWHA, then enhance HIV serostatus disclosure.

HIV-Related Stigmatization and Medication Adherence: Indirect Effects of Disclosure Concerns and Depression.

Stigmatization due to HIV status may interfere with disease management among persons living with HIV (PLWHA) by heightening serostatus disclosure concerns and vulnerability to depressive symptoms. In this cross-sectional study, indirect effects of disclosure concerns and depressive symptoms were examined for the association of stigma to treatment adherence (medication and clinic appointment adherence) in an outpatient sample of PLWHA. Participants (N = 179; 47% White, 41% African-American; 35% MSM) completed measures of stigma-related experiences, concerns about disclosing HIV status, depression, and medication adherence; clinic appointment attendance was obtained from chart data. Stigma had an indirect effect on medication adherence (but not clinic attendance) via disclosure concerns. Stigma had indirect effects on both medication adherence and clinic attendance via depressive symptoms. In path analyses including both disclosure concerns and depressive symptoms, combined indirect effects emerged for both medication adherence and clinic attendance. There was a significant indirect pathway from stigma to disclosure concerns to depression to clinic attendance, whereas the positioning of the mediators was swapped for the significant indirect pathway from stigma to medication adherence. These analyses provide evidence that stigmatizing experiences negatively affect treatment adherence through the indirect effects of disclosure concerns and depressive symptoms. Disclosure concerns and depressive symptoms are two mechanisms worthy of further research to enhance understanding of the association between stigma and treatment adherence difficulties.

Community beliefs, HIV stigma, and depression among adolescents living with HIV in rural Uganda

The availability of and increased access to antiretroviral therapy (ART) has significantly reduced the morbidity and mortality associated with HIV. As a result, perinatally infected youth are increasingly able to reach adolescence. There is limited information about the psychosocial challenges facing adolescents living with HIV (ALWH) in rural settings of sub-Saharan Africa. We sought to understand psychosocial challenges facing ALWH in rural Uganda and their effects on mental health and HIV treatment outcomes. We conducted 5 focus group discussions and 40 one-on-one in-depth interviews in Mbarara, Uganda with adolescents (aged 13–17 years) and adult women caregivers. All interviews were audio-recorded, transcribed directly into English, and coded using thematic analysis to identify themes related to psychosocial adversities and mental health. Adversities faced by adolescents included negative community perceptions (perceived aggression, presumed early mortality), HIV stigma (enacted and internalized), vulnerability factors (loss of parents, poverty), and health challenges (depression, ART non-adherence). In the conceptual model that emerged from the findings, negative community perceptions (about perceived aggression or presumed early mortality) predisposed ALWH to experience enactments and internalization of stigma that led to depression and ART non-adherence. The data also identified several protective factors, including counselling, family and religious support, and timely serostatus disclosure. Interventions to correct community misperceptions about HIV can potentially reduce stigma and thereby improve physical and mental health outcomes of ALWH.

Family acceptance, peer support, and HIV serostatus disclosure of MSM-PLWHA in Medan, Indonesia

This study was conducted to determine the correlation between family acceptance and HIV serostatus disclosure, and the correlation between peer support and HIV serostatus disclosure. This was a quantitative study with a cross-sectional design involving 176 MSM-PLWHA (Men who have sex with men-people living with HIV and AIDS). Instruments used in this study is Brief Scale of HIV disclosure, perceived acceptance scale, and peer group caring interaction scale. The analysis showed a significant correlation between peer support and HIV serostatus disclosure (p-value 0.011), but there was no significant correlation between family acceptance and HIV serostatus disclosure (p-value 0.979). Peer support affects HIV serostatus disclosure in MSM-PLWHA. Peer group interventions need to be improved. Providing systematic peer group support for MSM-PLWHA and integrating intervention with peer support might need to be done for the next care plan for MSM-PLWHA in Medan, Indonesia.

Behavioral interventions promoting HIV serostatus disclosure to sex partners among HIV-positive men who have sex with men: a systematic review.

This review aimed to identify intervention components which were effective to promote disclosure of HIV status among men have sex with men (MSM) living with HIV, particularly from a theoretical perspective. A systematic review was performed through searching electronic databases, HIV-related conferences websites, and registered ongoing randomized controlled trials. Studies were included if they reported intervention evaluation results related to HIV disclosure and published before December 31, 2017. Two independent reviewers collected studies and extracted data. Eight studies met the inclusion criteria and were summarized. Interventions appeared effective in promoting HIV disclosure to their sex partners among MSM living with HIV if they were theory based (e.g., consequence theory and social cognitive theory). Key elements of effective interventions consisted of increasing disclosure self-efficacy, highlighting disclosure benefits, assisting risk assessment, developing disclosure strategy, and using messages under social influence. Findings of this review imply that future interventions are more likely to succeed if they apply consequence theory, social cognitive theory, and trans-theoretical model of behavior change and include multiple key intervention components.

The effect of disclosure on adherence to antiretroviral therapy among adults living with HIV in Ethiopia: a systematic review and meta-analysis

BackgroundSeveral factors have been identified as being associated with increased adherence to antiretroviral therapy, including sero-status disclosure; however, studies examining the effect of disclosure on ART adherence in Ethiopia have had inconsistent findings. This systematic review and meta-analysis therefore aims to estimate the pooled effect of disclosure on adherence to ART among adults living with HIV in Ethiopia.MethodsWe performed a systematic search for articles reporting on peer-reviewed, quantitative, English-language observational studies of reporting the association between self sero-status disclosure and good ART adherence in adults living with HIV/AIDS in Ethiopia during published from 2010 to 2015. We searched four electronic databases: PubMed/Medline, the World Health Organization’s Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) for studies from December 1, 2017 to January 30, 2018. We also searched university repositories and conference abstracts for unpublished studies. We conducted a meta-analysis for the pooled effect of adherence using a random effects model in Stata version 14 and assessed publication bias using the Egger’s test for funnel plot asymmetry.ResultsOur search returned in 179 studies, of which seven (3.9%), were eligible and included in the final meta-analysis. The seven included studies were conducted from 2010 to 2015. Our analysis found that disclosure had a significant effect on the adherence to ART in adult patients living with HIV. Patients who disclosed were 1.64 times more likely to have good adherence to ART compared with those who did not (OR: 1.64, 95% CI: 1.11, 2.42). The small number of studies eligible for review and differences in study definitions of adherence and disclosure were the main limitations of this study.ConclusionThis review found a statistically significant positive effect of disclosure status on the adherence to ART in adult patients living with HIV in Ethiopia. This suggests that Ethiopia’s national treatment and prevention programs should redouble efforts to encourage self-disclosure among people living with HIV/AIDS. Encouraging supportive social environments for disclosure, and promoting partner notification and partner disclosure support initiatives might be particularly helpful in this regard.

Disclosure of Human Immunodeficiency Virus Serostatus to the Patient; Issues for Laboratory Staff

Background: The disclosure of positive HIV status to a patient is not an easy task. In the developed world with established protocols for doing this, it becomes relatively simpler to present the results to the patient. In underdeveloped countries like Pakistan, it is not easy for the laboratory personnel in particular to convey such results to the patient. Case Presentation: The problem has been discussed in the light of two cases presenting to Shalamar Teaching Hospital. The first case is an example of “Provider referral” and the second one the “Self-referral”. At the end, recommendations are made to effectively handle the situation in an underdeveloped setup like Pakistan. Discussion: Complete knowledge of the disease is an essential requirement for anybody from the pathology department contemplating this responsibility. In addition, all communications should be in the local language and the counselor must be able to address all the questions/concerns raised by the patients and/or their families. The counselor learns the skill more through supervised training rather than a taught course. Conclusion: This responsibility should be accepted only if the laboratory staff has no other option.

Validation of the Outcome Expectancy Scale for HIV Serostatus Disclosure to Female Sex Partners Among Men Who Have Sex with Men and Women Living with HIV in China

The study aimed to develop an instrument, Outcome Expectancy Scale (OES), to assess outcome expectancies regarding disclosing HIV-positive status to the regular female sex partner (i.e. girlfriend, wife) based on a cross-sectional survey among 217 men who have sex with men and women living with HIV. We developed the positive OES and negative OES, and five factors were identified for each of them by the Exploratory Factor Analysis, respectively. The psychometric properties were satisfactory. This 30-item OES was valid and reliable in assessing outcome expectancies, and it could be used to inform intervention design and theory development.

Prevalence and associated factors of HIV serostatus disclosure to regular female sex partners among HIV-positive men who have sex with both men and women in China

ABSTRACTHIV-positive men who have sex with men and women (MSMW) may transmit HIV to regular female sexual partners (FSPs, including girlfriend and wife) through unprotected sex. FSPs’ awareness of the HIV serostatus of the MSMW promotes them to access services. However, the prevalence of HIV disclosure among MSMW was low, and factors associated with this disclosure are largely unknown. This study aimed to examine factors associated with HIV disclosure to regular FSPs among HIV-positive MSMW. We recruited 432 HIV-positive MSMW from three provinces of China and collected information on participants’ individual characteristics and interpersonal relationships with their FSPs using individualized structured questionnaire. Univariate and multivariate logistic regression were used for data analysis. The prevalence of HIV disclosure to their most recent FSPs was 49.8%. Facilitators of HIV disclosure included the presence of HIV/AIDS symptoms, perceiving this partner’s HIV status as positive, exposure to counseling favoring disclosure, inconsistent condom use, and this partner’s acknowledgment of MSM identity. Barriers against HIV disclosure included unknown HIV serostatus of this partner and an instrumental relationship to hide MSM identity. HIV disclosure to regular FSPs was low. Programs should target priority subgroups. Services in counseling favoring disclosure and partner HIV testing should be enhanced.