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The Prevalence of Undiagnosed HIV Serodiscordance Among Male Couples Presenting for HIV Testing

  • Special Section: Sexual Health in Gay and Bisexual Male Couples
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Abstract

In the United States, a substantial proportion of HIV transmissions among men who have sex with men (MSM) arise from main sex partners. Couples voluntary HIV testing and counseling (CHTC) is used in many parts of the world with male–female couples, but CHTC has historically not been available in the U.S. and few data exist about the extent of HIV serodiscordance among U.S. male couples. We tested partners in 95 Atlanta male couples (190 men) for HIV. Eligible men were in a relationship for ≥3 months and were not known to be HIV-positive. We calculated the prevalence of couples that were seroconcordant HIV-negative, seroconcordant HIV-positive, or HIV serodiscordant. We evaluated differences in the prevalence of HIV serodiscordance by several dyadic characteristics (e.g., duration of relationship, sexual agreements, and history of anal intercourse in the relationship). Overall, among 190 men tested for HIV, 11 % (n = 20) were newly identified as HIV-positive. Among the 95 couples, 81 % (n = 77) were concordant HIV-negative, 17 % (n = 16) were HIV serodiscordant, and 2 % (n = 2) were concordant HIV-positive. Serodiscordance was not significantly associated with any evaluated dyadic characteristic. The prevalence of undiagnosed HIV serodiscordance among male couples in Atlanta is high. Offering testing to male couples may attract men with a high HIV seropositivity rate to utilize testing services. Based on the global evidence base for CHTC with heterosexual couples and the current evidence of substantial undiagnosed HIV serodiscordance among U.S. MSM, we recommend scale-up of CHTC services for MSM, with ongoing evaluation of acceptability and couples’ serostatus outcomes.

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Notes

  1. Although not related to the current analysis, additional eligibility and exclusion criteria related to willingness and availability to complete a 3-month follow-up assessment: for eligibility, both were willing to complete a follow-up study visit in 3 months; for exclusion, either partner planning to move from the Atlanta area within 3 months of the initial study visit.

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Acknowledgments

This research was supported by the National Institutes of Mental Health (R34-MH086331), the Emory Center for AIDS Research (P30 AI050409), and the MAC AIDS Fund. The authors acknowledge Adam Carpenter for his expert editorial assistance and support.

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Authors and Affiliations

  1. Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, 4th Floor GCR, Atlanta, GA, 30322, USA

    Patrick S. Sullivan, Kristin M. Wall, Brandon O’Hara, Jeb Jones, Jasper Barnes, Travis Sanchez & Darcy White

  2. Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Ralph DiClemente & Gina Wingood

  3. Center for Research and Education on Gender and Sexuality, San Francisco State University, San Francisco, CA, USA

    Colleen Hoff

  4. AID Atlanta, Atlanta, GA, USA

    Lamont Scales

  5. Department of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA, USA

    Laura F. Salazar

  6. Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, USA

    Susan Allen

  7. Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Rob Stephenson

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  1. Patrick S. Sullivan
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  2. Kristin M. Wall
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  8. Lamont Scales
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  9. Laura F. Salazar
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  10. Travis Sanchez
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  12. Gina Wingood
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  13. Susan Allen
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  14. Rob Stephenson
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Correspondence to Patrick S. Sullivan.

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Sullivan, P.S., Wall, K.M., O’Hara, B. et al. The Prevalence of Undiagnosed HIV Serodiscordance Among Male Couples Presenting for HIV Testing. Arch Sex Behav 43, 173–180 (2014). https://doi.org/10.1007/s10508-013-0214-x

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  • DOI: https://doi.org/10.1007/s10508-013-0214-x

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