The association between HIV disclosure, spousal testing and unprotected vaginal intercourse within marriage among HIV positive married MSM in China

Disclosure of HIV status can encourage spouses of people diagnosed with HIV to prioritize HIV prevention. However, few studies have reported the HIV disclosure status of married men who have sex with men (MSM) and their female spouses. The purpose of this study was to describe the prevalence of HIV disclosure, and whether it was associated with spouses' HIV testing uptake and unprotected vaginal intercourse within marriage for MSM living with HIV (HIV + MSM) in China. A cross-sectional study was conducted in three Chinese cities. Of 309 participants, only 31.1% of men had disclosed their HIV status to spouses. About 80% of participants reported that their spouses had been tested for HIV. A small proportion of men (9.1%) had unprotected sex with their spouse after HIV diagnosis. Multivariate analyses indicated HIV disclosure was positively associated with HIV testing uptake of spouses, but there was no significant association between HIV disclosure and unprotected marital sexual behaviors for HIV + MSM. The findings indicated that HIV disclosure to spouses is uncommon among married HIV + MSM in China, and HIV disclosure is associated with increased uptake of HIV testing among spouses of MSM, but it does not decrease the unprotected sexual behaviors in marriage.