Abstract
Dear Editor,
Partner notification (PN) for human immunodeficiency virus (HIV) in men who have sex with men (MSM) potentially reduces undiagnosed HIV and reduces onward transmission. PN can be challenging for both MSM and clinical services at the time of diagnosis, as this can be an emotionally and psychologically difficult time. PN can take the form of both partner referral, driven by MSM, or provider referral where services contact MSM sexual contacts anonymously. Some other issues for MSM are stigma and criminalisation, which need to be handled sensitively during PN. Some MSM may face other barriers including social, cultural or ethnic issues around their PN, for example disclosure of sexual behaviour outside relationships or within cultures where same sex relationships are less acceptable. More innovative PN strategies using social media are currently evolving which will hopefully underpin and streamline this process. Clinical services therefore need to tailor PN for each MSM diagnosed using resources available; MSM may require additional emotional and psychological support through this process either through statutory or third sector (e.g. charity) services. Understanding the experiences of MSM who have undergone HIV PN may inform future public health strategy.
We consented and conducted semi-structured interviews in 10 MSM diagnosed recently with HIV. Eight MSM identified as White British, one Asian and one Black British. Interviews were transcribed and coded and emerging themes were developed using framework analysis. The MSM lived in the South East, UK, median age 39.5 years (range 23–50), had been diagnosed with HIV for seven months (range 3–12) and 8/10 identified as White British. Data were analysed using framework analysis. MSM expressed an understanding and acceptance of the immediacy of PN given the potential for onward transmission and felt a ‘social duty’ to disclose their HIV status to recent partners. A clear difference in preference of disclosure of status was expressed: face-to-face contact for regular sexual partners and provider referral for non-regular partners. MSM self-selected which sexual partners should be informed using an assessment of recalled sexual risk: MSM targeted those who they felt needed to be informed and were also able to accurately trace the potential route of infection. MSM have significant concerns around stigmatisation and criminalisation as part of the PN process: they valued the support received from sexual healthcare workers when addressing disclosure.
This study was a convenience sample and only included two non-White British MSM; other harder-to-reach MSM such as those who struggle with disclosure of their sexual behaviour due to socio-cultural reasons may face other challenges and barriers to PN not identified within the scope of this study.
HIV PN is valued and acceptable to MSM diagnosed recently with HIV: support from healthcare workers is important to MSM in this process; however, MSM may not objectively recognise all partners who require notification and may leave some partners untested.