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

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.