STI/HIV test result disclosure between female sex workers and their primary, non-commercial male partners in two Mexico-US border cities: a prospective study

Disclosure of sexually transmitted infections (STI)/HIV diagnoses to sexual partners is not mandated by public health guidelines in Mexico. To assess the feasibility of couples-based STI/HIV testing with facilitated disclosure as a risk-reduction strategy within female sex workers' (FSW) primary partnerships, we examined STI/HIV test result disclosure patterns between FSWs and their primary, non-commercial male partners in two Mexico-US border cities.

From 2010 to 2013, 335 participants (181 FSWs and 154 primary male partners) were followed for 24 months. At semiannual visits, participants were tested for STIs/HIV and reported on their disclosure of test results from the previous visit. Multilevel logistic regression was used to identify individual-level and partnership-level predictors of cumulative (1) non-disclosure of ≥1 STI test result and (2) non-disclosure of ≥1 HIV test result within couples during follow-up.

Eighty-seven percent of participants reported disclosing all STI/HIV test results to their primary partners. Non-disclosure of ≥1 STI test result was more common among participants who reported an STI diagnosis as part of the study, while non-disclosure of ≥1 HIV test result was more common among participants in longer-duration partnerships. Drug use before/during sex within partnerships was associated with non-disclosure of both STI and HIV test results.

STI/HIV test result disclosure was highly prevalent within FSWs' primary partnerships, suggesting couples-based STI/HIV testing with facilitated disclosure may be feasible for these and potentially other high-risk, socially marginalised couples.

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By: Pines HA1, Patterson TL2, Rangel G3, Martinez G4, Bazzi AR5, Ulibarri MD2, Syvertsen JL6, Martin NK7, Strathdee SA1.

• 1Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, USA.
• 2Department of Psychiatry, University of California, San Diego, La Jolla, USA.
• 3Department of Population Studies, El Colegio de La Frontera Norte, Tijuana, Baja California, México.
• 4Federación Mexicana de Asociaciones Privadas (FEMAP), Ciudad Juárez, Chihuahua, México.
• 5Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA.
• 6Department of Anthropology, The Ohio State University, Columbus, USA.
• 7School of Social and Community Medicine, University of Bristol, Bristol, UK Social and Mathematical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.