Researchers from Boston University School of Medicine (BUSM) in partnership with Indian researchers and HIV positive networks groups, have found that in India, non-disclosure of HIV serostatus to sex partners among both HIV-infected female sex workers (FSWs) and HIV-infected clients of FSWs is exceedingly common. These findings currently appear online in the journal AIDS and Behavior.
No previous studies in India specifically, and few internationally, have assessed FSWs' and male clients' disclosure of HIV status to sex partners. Disclosure of HIV serostatus to sex partners is viewed as a social and legal responsibility for HIV-infected individuals, particularly in the absence of condom use. In many developing countries, high prevalence of non-disclosure, ranging from 17 to 86 percent, is considered to be an important factor promoting transmission of HIV to sex partners. Disclosure to sex partners, on average, occurs less in developing countries than in the developed world (49 vs. 79 percent respectively).
Results were based on surveys conducted with HIV-infected FSW and infected male clients regarding HIV knowledge, awareness of sex partners' HIV serostatus, alcohol use, transactional sex involvement, post-HIV diagnosis and non-disclosure of HIV serostatus. Non-disclosure of one's serostatus to all sex partners was reported by almost three-fifths of females and two-fifths of males according to the researchers. Predictors of non-disclosure included lack of correct knowledge about HIV and no knowledge of sex partners' HIV serostatus. Among females, recent alcohol consumption also predicted non-disclosure. Among males, having ten (or more) paid sexual partners in the year following HIV diagnosis predicted non-disclosure.
"Disclosure is a complex decision for HIV- infected persons in India as in many other countries in the world and it may be influenced by a fear of losing clients or sex in paid or unpaid relationships," explained lead author Niranjan Saggurti, PhD, Co-Investigator of Alcohol Use and Sexual Risk in HIV-Infected Persons with Transactional Sex study at BUSM.
Saggurti believes that HIV prevention programs in India that seek to increase disclosure of HIV serostatus to sex partners may benefit from several factors including improving basic HIV knowledge, reducing alcohol consumption, reducing the number of different sex partners and seeking knowledge about the serostatus of one's partner as a means to increase disclosure of HIV serostatus to sex partners.