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Nondisclosure of HIV Infection to Sex Partners and Alcohol’s Role: A Russian Experience

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Abstract

Nondisclosure of one’s HIV infection to sexual partners obviates safer sex negotiations and thus jeopardizes HIV transmission prevention. The role of alcohol use in the disclosure decision process is largely unexplored. This study assessed the association between alcohol use and recent nondisclosure of HIV serostatus to sex partners by HIV-infected risky drinkers in St. Petersburg, Russia. Approximately half (317/605; 52.4 %) reported not having disclosed their HIV serostatus to all partners since awareness of infection. Using three separate GEE logistic regression models, we found no significant association between alcohol dependence, risky alcohol use (past 30 days), or alcohol use at time of sex (past 30 days) with recent (past 3 months) nondisclosure (AOR [95 % CI] 0.81 [0.55, 1.20], 1.31 [0.79, 2.17], 0.75 [0.54, 1.05], respectively). Alcohol use at time of sex was associated with decreased odds of recent nondisclosure among seroconcordant partners and among casual partners. Factors associated with nondisclosure were relationship with a casual partner, a serodiscordant partner, multiple sex partners, awareness of HIV diagnosis less than 1 year, and a lifetime history of sexually transmitted disease. Nondisclosure of HIV status to sex partners is common among HIV-infected Russians, however alcohol does not appear to be a predictor of recent disclosure.

Resumen

La no comunicación del diagnóstico de infección por el VIH a parejas sexuales impide la negociación de sexo seguro y la prevención de su transmisión. No se conoce el impacto que el consumo de alcohol tiene en este proceso. Este estudio examinó la asociación entre el consumo de alcohol y la falta de comunicación reciente del diagnóstico de VIH a parejas sexuales en bebedores de riesgo infectados por el VIH en San Petersburgo, Rusia.Entre 605 participantes, aproximadamente la mitad (317/605,52,4 %, IC 95 %: 48,5; 56,4) no comunicó el diagnóstico de VIH a todos parejas desde la infección. Utilizando tres diferentes modelos de regresión logística GEE, no se encontró asociación entre la dependencia del alcohol, el consumo de alcohol de riesgo (últimos 30 días), o el consumo de alcohol durante el sexo (último s 30 días) con la comunicación del diagnóstico reciente de VIH (últimos 3 meses) (ORA [IC 95 %] 0,81 [0,55, 1,20] 1,31 [0,79, 2,17] 0,75 [0,54, 1,05]). El consumo de alcohol próximo al acto sexual se asoció con una menor proporción de comunicación del diagnóstico de VIH con parejas seroconcordantes y ocasionales. Los factores asociados con la falta de comunicación del diagnóstico incluyen tener pareja ocasional, serodiscordantes, múltiples parejas sexuales, un diagnóstico de VIH en el último año e historia de enfermedades de transmisión sexual. La falta de comunicación del diagnóstico de VIH a parejas sexuales es común entre infectados por el VIH en Rusia, pero el consumo de alcohol no parece ser un predictor.

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References

  1. UNAIDS. UNAIDS Russia HIV and AIDS prevalence estimates. http://www.unaids.org/en/regionscountries/countries/russianfederation/ (2011). Accessed 28 Nov 2011.

  2. Goliusov AT, Dementyeva LA, Ladnaya NN, Pshenichnaya VA. Country progress report of the Russian federation on the implementation of the declaration of commitment on HIV/AIDS. Ministry of health and social development of the Russian federation: federal service for surveillance of consumer rights protection and human well-being of the Russian federation 2010. http://www.unaids.org/en/dataanalysis/monitoringcountryprogress/2010progressreportssubmittedbycountries/russia_2010_country_progress_report_en.pdf (2010). Accessed 28 Nov 2011.

  3. Federal scientific and methodological center for prevention and control of AIDS. Distribution of risk factors for HIV in Russia from 1 Jan 2010 to 30 June 2010. http://hivrussia.ru/stat/2010.shtml (2010). Accessed 28 Nov 2011.

  4. UNODC. World Drug Report. http://www.unodc.org/unodc/en/data-and-analysis/WDR-2011.html (2011). Accessed 23 Sept 2011.

  5. Mathers BM, Degenhardt L, Phillips B, Wiessing L, Hickman M, Strathdee SA, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008;372(9651):1733–45.

    Article  PubMed  Google Scholar 

  6. Raj A, Cheng DM, Levison R, Meli S, Samet JH. Sex trade, sexual risk, and nondisclosure of HIV serostatus: findings from HIV-infected persons with a history of alcohol problems. AIDS Behav. 2006;10(2):149–57.

    Article  PubMed  Google Scholar 

  7. Ciccarone DH, Kanouse DE, Collins RL, Miu A, Chen JL, Morton SC, et al. Sex without disclosure of positive HIV serostatus in a US probability sample of persons receiving medical care for HIV infection. Am J Public Health. 2003;93(6):949–54.

    Article  PubMed  Google Scholar 

  8. Kumarasamy N, Venkatesh K, Srikrishnan A, Prasad L, Balakrishnan P, Thamburaj E, et al. Risk factors for HIV transmission among heterosexual discordant couples in South India. HIV Med. 2010;11(3):178–86.

    Google Scholar 

  9. Kalichman SC, Rompa D, Cage M, DiFonzo K, Simpson D, Austin J, et al. Effectiveness of an intervention to reduce HIV transmission risks in HIV-positive people. Am J Prev Med. 2001;21(2):84–92.

    Article  PubMed  CAS  Google Scholar 

  10. CDC. Public health service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR Morb Mortal Wkly Rep. 1987;36(31):509–15.

  11. Chaudoir SR, Fisher JD, Simoni JM. Understanding HIV disclosure: a review and application of the Disclosure Processes Model. Soc Sci Med. 2011;72(10):1618–29.

    Article  PubMed  Google Scholar 

  12. Mohammed H, Kissinger P. Disclosure of HIV serostatus to sex partners in rural Louisiana. AIDS Care. 2006;18(Suppl 1):S62–9.

    Article  PubMed  Google Scholar 

  13. Stein MD, Freedberg KA, Sullivan LM, Savetsky J, Levenson SM, Hingson R, et al. Sexual ethics. Disclosure of HIV-positive status to partners. Arch Intern Med. 1998;158(3):253–7.

    Article  PubMed  CAS  Google Scholar 

  14. Kalichman SC, Nachimson D. Self-efficacy and disclosure of HIV-positive serostatus to sex partners. Health Psychol. 1999;18(3):281–7.

    Article  PubMed  CAS  Google Scholar 

  15. Niccolai LM, King E, D’Entremont D, Pritchett EN. Disclosure of HIV serostatus to sex partners: a new approach to measurement. Sex Transm Dis. 2006;33(2):102–5.

    Article  PubMed  Google Scholar 

  16. Obermeyer CM, Baijal P, Pegurri E. Facilitating HIV disclosure across diverse settings: a review. Am J Public Health. 2011;101(6):1011–23.

    Article  PubMed  Google Scholar 

  17. Eisele TP, Mathews C, Chopra M, Brown L, Silvestre E, Daries V, et al. High levels of risk behavior among people living with HIV Initiating and waiting to start antiretroviral therapy in Cape Town South Africa. AIDS Behav. 2008;12(4):570–7.

    Article  PubMed  Google Scholar 

  18. Olley BO, Seedat S, Stein DJ. Self-disclosure of HIV serostatus in recently diagnosed patients with HIV in South Africa. Afr J Reprod Health. 2004;8(2):71–6.

    Article  PubMed  CAS  Google Scholar 

  19. Bouillon K, Lert F, Sitta R, Schmaus A, Spire B, Dray-Spira R. Factors correlated with disclosure of HIV infection in the French Antilles and French Guiana: results from the ANRS-EN13-VESPA-DFA Study. AIDS. 2007;21(Suppl 1):S89–94.

    Article  PubMed  Google Scholar 

  20. Tunthanathip P, Lolekha R, Bollen LJ, Chaovavanich A, Siangphoe U, Nandavisai C, et al. Indicators for sexual HIV transmission risk among people in Thailand attending HIV care: the importance of positive prevention. Sex Transm Infect. 2009;85(1):36–41.

    Article  PubMed  CAS  Google Scholar 

  21. Grau LE, White E, Niccolai LM, Toussova OV, Verevochkin SV, Kozlov AP, et al. HIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg: Russian Federation. AIDS Behav; 2011.

    Google Scholar 

  22. Zaridze D, Brennan P, Boreham J, Boroda A, Karpov R, Lazarev A, et al. Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths. Lancet. 2009;373(9682):2201–14.

    Article  PubMed  CAS  Google Scholar 

  23. Krupitsky EM, Horton NJ, Williams EC, Lioznov D, Kuznetsova M, Zvartau E, et al. Alcohol use and HIV risk behaviors among HIV-infected hospitalized patients in St. Petersburg, Russia. Drug Alcohol Depend. 2005;79(2):251–6.

    Article  PubMed  Google Scholar 

  24. Galvan FH, Bing EG, Fleishman JA, London AS, Caetano R, Burnam MA, et al. The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study. J Stud Alcohol. 2002;63(2):179–86.

    PubMed  Google Scholar 

  25. Hahn JA, Woolf-King SE, Muyindike W. Adding Fuel to the Fire: Alcohol’s Effect on the HIV Epidemic in Sub-Saharan Africa. Curr HIV/AIDS Rep. 2011;8(3):172–80.

    Article  PubMed  Google Scholar 

  26. Duru OK, Collins RL, Ciccarone DH, Morton SC, Stall R, Beckman R, et al. Correlates of sex without serostatus disclosure among a national probability sample of HIV patients. AIDS Behav. 2006;10(5):495–507.

    Article  PubMed  Google Scholar 

  27. Kessler RC, Andrews G, Mroczek D, Ustun B, Wittchen H. The World Health Organization composite international diagnostic interview short-form (CIDI-SF). Intl J Methods Psych Res. 1998;7(4):15.

    Google Scholar 

  28. Sobell LC, Sobell MB. Timeline Follow-back: a technique for assessing self-reported ethanol consumption. In: Allen J, Litten RZ, editors. Measuring alcohol consumption: psychosocial and biological methods Totowa. NJ: Humana Press; 1992. p. 41–72.

    Chapter  Google Scholar 

  29. Beck AT. Depression inventory. Beck. Russian translation Aaron T. Beck: Pearson education, Inc; 1996. 2007.

    Google Scholar 

  30. Wright K, Naar-King S, Lam P, Templin T, Frey M. Stigma scale revised: reliability and validity of a brief measure of stigma for HIV + youth. J Adolesc Health. 2007;40(1):96–8.

    Article  PubMed  Google Scholar 

  31. WHO. Gender dimensions of HIV status disclosure to sexual partners: rates, barriers and outcomes. http://www.who.int/gender/documents/en/VCTinformationsheet_%5b92%20KB%5d.pdf (2004). Accessed 23 Sept 2011.

  32. Simoni JM, Pantalone DW. Secrets and safety in the age of AIDS: does HIV disclosure lead to safer sex? Top HIV Med. 2004;12(4):109–18.

    PubMed  Google Scholar 

  33. Sullivan KM. Male self-disclosure of HIV-positive serostatus to sex partners: a review of the literature. J Assoc Nurses AIDS Care. 2005;16(6):33–47.

    Article  PubMed  Google Scholar 

  34. George WH, Stoner SA. Understanding acute alcohol effects on sexual behavior. Annu Rev Sex Res. 2000;11:92–124.

    PubMed  CAS  Google Scholar 

  35. Lancet Editorial. Alcohol and harm reduction in Russia. Lancet. 2009;373(9682):2171.

    Google Scholar 

  36. Leon DA, Saburova L, Tomkins S, Andreev E, Kiryanov N, McKee M, et al. Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. Lancet. 2007;369(9578):2001–9.

    Article  PubMed  Google Scholar 

  37. Bobak M, McKee M, Rose R, Marmot M. Alcohol consumption in a national sample of the Russian population. Addiction. 1999;94(6):857–66.

    Article  PubMed  CAS  Google Scholar 

  38. Perlman FJ. Drinking in transition: trends in alcohol consumption in Russia 1994–2004. BMC Public Health. 2010;10:691.

    Article  PubMed  Google Scholar 

  39. Tomkins S, Collier T, Oralov A, Saburova L, McKee M, Shkolnikov V, et al. Hazardous alcohol consumption is a major factor in male premature mortality in a typical Russian city: prospective cohort study 2003–2009. PLoS ONE. 2012;7(2):e30274.

    Article  PubMed  CAS  Google Scholar 

  40. Nilssen O, Averina M, Brenn T, Brox J, Kalinin A, Archipovski V. Alcohol consumption and its relation to risk factors for cardiovascular disease in the north-west of Russia: the Arkhangelsk study. Int J Epidemiol. 2005;34(4):781–8.

    Article  PubMed  Google Scholar 

  41. Kalichman SC, Rompa D, Luke W, Austin J. HIV transmission risk behaviours among HIV-positive persons in serodiscordant relationships. Int J STD AIDS. 2002;13(10):677–82.

    Article  PubMed  Google Scholar 

  42. D’Angelo LJ, Abdalian SE, Sarr M, Hoffman N, Belzer M. Disclosure of serostatus by HIV infected youth: the experience of the REACH study. Reaching for excellence in adolescent care and health. J Adolesc Health. 2001;29(3 Suppl):72–9.

    Article  PubMed  Google Scholar 

  43. Wolitski RJ, Rietmeijer CA, Goldbaum GM, Wilson RM. HIV serostatus disclosure among gay and bisexual men in four American cities: general patterns and relation to sexual practices. AIDS Care. 1998;10(5):599–610.

    Article  PubMed  CAS  Google Scholar 

  44. Marks G, Richardson JL, Maldonado N. Self-disclosure of HIV infection to sexual partners. Am J Public Health. 1991;81(10):1321–2.

    Article  PubMed  CAS  Google Scholar 

  45. Simon Rosser BR, Horvath KJ, Hatfield LA, Peterson JL, Jacoby S, Stately A. Predictors of HIV disclosure to secondary partners and sexual risk behavior among a high-risk sample of HIV-positive MSM: results from six epicenters in the US. AIDS Care. 2008;20(8):925–30.

    Article  PubMed  CAS  Google Scholar 

  46. Simbayi LC, Kalichman SC, Strebel A, Cloete A, Henda N, Mqeketo A. Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa. Sex Transm Infect. 2007;83(1):29–34.

    Article  PubMed  CAS  Google Scholar 

  47. Rietmeijer CA, Lloyd LV, McLean C. Discussing HIV serostatus with prospective sex partners: a potential HIV prevention strategy among high-risk men who have sex with men. Sex Transm Dis. 2007;34(4):215–9.

    Article  PubMed  Google Scholar 

  48. Marks G, Ruiz MS, Richardson JL, Reed D, Mason HR, Sotelo M, et al. Anal intercourse and disclosure of HIV infection among seropositive gay and bisexual men. J Acquir Immune Defic Syndr. 1994;7(8):866–9.

    PubMed  CAS  Google Scholar 

  49. McKay T, Mutchler MG. The effect of partner sex: nondisclosure of HIV status to male and female partners among men who have sex with men and women (MSMW). AIDS Behav. 2010;6:1140–52.

    Google Scholar 

  50. Emlet CA. A comparison of HIV stigma and disclosure patterns between older and younger adults living with HIV/AIDS. AIDS Patient Care STDS. 2006;20(5):350–8.

    Article  PubMed  Google Scholar 

  51. Mansergh G, Marks G, Simoni JM. Self-disclosure of HIV infection among men who vary in time since seropositive diagnosis and symptomatic status. AIDS. 1995;9(6):639–44.

    Article  PubMed  CAS  Google Scholar 

  52. Krupitsky E, Zvartau E, Karandashova G, Horton NJ, Schoolwerth KR, Bryant K, et al. The onset of HIV infection in the Leningrad region of Russia: a focus on drug and alcohol dependence. HIV Med. 2004;5(1):30–3.

    Article  PubMed  CAS  Google Scholar 

  53. Samet JH. Russia and human immunodeficiency virus-beyond crime and punishment. Addiction. 2011;106:1883–5.

    Article  PubMed  Google Scholar 

  54. De Rosa CJ, Marks G. Preventive counseling of HIV-positive men and self-disclosure of serostatus to sex partners: new opportunities for prevention. Health Psychol. 1998;17(3):224–31.

    Article  PubMed  Google Scholar 

  55. Vlahov D, Robertson AM, Strathdee SA. Prevention of HIV infection among injection drug users in resource-limited settings. Clin Infect Dis. 2010;50(Suppl 3):S114–21.

    Article  PubMed  Google Scholar 

  56. Cohen J. Late for the epidemic: HIV/AIDS in eastern Europe. Science. 2010;9(329):3.

    Google Scholar 

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Acknowledgments

All authors contributed to the design of the study. DL and EB oversaw data collection and management. KL, DC, EQ, CC, AR, AW, CB, and JS drafted the analytical plan and conducted the analysis. KL drafted the article. All authors provided feedbacks on drafts and approved of its final version. We thank all HERMITAGE subjects for their participation, and our colleagues at Boston University and Pavlov State Medical University for their support, namely Sharon Coleman and Michael Winter for statistical help and Natalia Gnatienko for critical review of the manuscript. Support for this work came from the National Institute of Alcohol Abuse and Alcoholism (NIAAA; R01AA016059 and K24-AA015674) and from the Boston University Preventive Medicine Residency Program directed by Jane Liebschutz MD, MPH. There are no conflicts of interest.

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Authors and Affiliations

  1. Boston Medical Center, Department of Medicine, Boston University, 801 Massachusetts Ave., Boston, MA, 02118, USA

    Karsten Lunze, Anita Raj, Alexander Y. Walley, Carly Bridden & Jeffrey H. Samet

  2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA

    Debbie M. Cheng

  3. Bekhterev Research Psychoneurological Institute, St. Petersburg, 192019, Russia

    Evgeny Krupitsky

  4. St. Petersburg Pavlov State Medical University, St. Petersburg, 197022, Russia

    Evgeny Krupitsky, Dmitry Lioznov & Elena Blokhina

  5. Division of Global Public Health, Department of Medicine, UCSD, La Jolla, CA, 92093, USA

    Anita Raj

  6. Data Coordinating Center, Boston University School of Public Health, Boston, MA, 02118, USA

    Emily Quinn & Christine Chaisson

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  1. Karsten Lunze
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Lunze, K., Cheng, D.M., Quinn, E. et al. Nondisclosure of HIV Infection to Sex Partners and Alcohol’s Role: A Russian Experience. AIDS Behav 17, 390–398 (2013). https://doi.org/10.1007/s10461-012-0216-z

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