Sexual Risk Behaviors and HIV Incidence Among Men Who Have Sex with Men in Southern China: Investigating the Role of HIV Serostatus Disclosure

Abstract

Abstract Background The impact of HIV serostatus disclosure on sexual risk behaviors and HIV risk among men who have sex with men (MSM) is unclear. We aim to examine associations between receiving HIV serostatus disclosure from partners before sex and sexual risk behaviors and reveal the impact of such disclosure on HIV incidence. Methods We recruited HIV-negative MSM who had reported engaging in homosexual encounters within the previous 6 months. Participants completed questionnaires every 3 months and were tracked for 12 months. Generalized Estimation Equations (GEE) were used to evaluate factors associated with receiving HIV serostatus disclosure from partners and to examine the impact of receiving this disclosure on sexual risk behaviors. Results Among 363 participants, 350 completed at least one follow-up. On average, 50.60% (95% CI: 47.30%-53.70%) of participants received HIV serostatus disclosure from sexual partnersduring the follow-up visits.The HIV incidence was 1.47 per 100 person-years (95% CI: 0.479-3.398). Participants who had tested for HIV in the last 3 months (aOR=3.145, 95% CI: 2.109-4.691; P＜0.001) were more likely to receive HIV serostatus disclosure from partners. Conversely, Participants who have male casual partners (aOR=0.209, 95% CI: 0.127-0.346, P＜0.001) were less likely to receive such disclosure.Adjusting for potential confounders in GEE models, receiving HIV serostatus disclosure from partners is not a contributing factor to multiple partners (aOR=0.468, 95% CI: 0.347-0.632, P＜0.001). There was no significant association between receiving HIV serostatus disclosure and engaging in unprotected anal intercourse (OR=1.128, 95% CI: 0.876-1.453, P=0.351). MSM who did not consistently receive HIV serostatus disclosure from their partners appeared to have a higher seroconversion rate than those who consistently received such disclosure, though the difference was not statistically significant (IRR=0.531; 95%CI=0.060-4.699, P=1.000). Conclusion Our study found that the proportion of MSM who received HIV serostatus disclosure from their partners before sex was relatively low. HIV testing facilitates HIV serostatus disclosure. Receiving HIV serostatus disclosure from partners before sex does not increase risky sex. These findings promote regular HIV testing and encourage HIV serostatus disclosure with sexual partners.