Serosorting, disclosure stigma, and physical/mental health outcomes among HIV-positive adults

Background: For individuals living with HIV, decisions about sexuality and sexual behavior are among the most important and difficult aspects of chronic illness management. This pilot project examined the interaction between sersorting behavior and disclosure stigma in determining physical, mental health, and behavioral outcomes.

Methods: Participants were 38 HIV+ adults (36% women; 80% persons of color) who reported anal or vaginal intercourse in the past 30 days. Participants completed a time-line follow-back (TLFB) protocol and a quantitative assessment battery administered via ACASI. Factorial ANOVA was used to examine the extent to which disclosure stigma scores (median split: high/low) moderated the impact of serosorting behavior (all concordant sexual partners: yes/no) on dependent measures.

Results: 47% of participants reported serosorting (i.e. having only seroconcordant partners in the survey period). There was no main effect of serosorting or disclosure stigma on any of the dependent variables. However, disclosure stigma moderated the relationship between serosorting and: number of symptoms reported (p = .02); pain (p < .05); quality of life (p < .05); anxiety (p = .01); illness intrusiveness (p < .01); and role-functioning (p <.01). Low-stigma serosorters reported no club drug use and no STIs in the previous three months, while 25% of high-stigma serosorters reported club drug use and 50% reported a recent STI. Only 13% of low-stigma serosorters reported unprotected sex with HIV+ partners compared to 63% of high-stigma serosorters.

Conclusions: Understanding the interaction between disclosure stigma and serosorting is critical to the provision of comprehensive HIV care and prevention.