Intervention to Assist MSM Disclose HIV Status to Casual Sex Partners

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 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, the investigators
will test how treatment engagement, retention and expectations predict subsequent disclosure
and risky sexual outcomes.