Self-Disclosure of HIV Status to Sexual Partners: A Qualitative Study of Issues Faced by Gay Men

Objective:This study aimed to explore the range of issues faced by HIV-positive and HIV-negative gay men concerning HIV serostatus self-disclosure to sexual partners. Methods: In-depth semistructured interviews of 1–2 hr each were conducted with 26 HIV-positive and 15 HIV-negative gay men who were recruited from a larger cohort of gay men followed longitudinally for several years at a major medical center. Interviews were audiotaped, transcribed, and content-analyzed by two independent raters. Results: Several themes emerged concerning how disclosure was viewed, who and what was told, why disclosure occurred, and how disclosure decisions related to sexual behavior. Variations occurred in when and why men disclosed, and in the contents and definitions of their disclosures. Men disclosed using codes and indirect hints. Various rationalizations arose for not telling as well. Many men adopted the position that they do not tell, but practice safer sex, yet definitions of safer sex varied such that what some men consider safe, others do not. Conclusion: Recognition thus needs to be increased among clinicians, researchers, patients, and others that definitions of disclosure and of safer sex can vary significantly. The data have critical implications for designing appropriate interventions to limit the further spread of HIV