"I Assumed that He Knows Because He's Seen My Profile": HIV Status Disclosure and Condom Use Decisions Among Men who have Sex with Men (MSM) Using Hookup Apps and Websites

AIDS Behav. 2023 Dec;27(12):3992-4009. doi: 10.1007/s10461-023-04114-z. Epub 2023 Jul 1.

Abstract

In the present study, we sought to better understand how MSM make decisions about HIV disclosure when using hook-up apps/websites and how these decisions relate to condom use during app/website-facilitated sexual encounters. Semi-structured interviews were conducted with 60 MSM (30% living with HIV) who had used hook-up apps and websites to meet sexual partners within the past three months. Results demonstrated a variety of approaches to HIV status disclosure. Some men reported usually discussing HIV status, but others discussed HIV status selectively (e.g., only when asked, when a relationship became more serious). Some men reported that listing one's status in a profile precluded the need to discuss it further. Others noted that leaving an HIV status blank "hinted" at their own or others' HIV positive or negative status. These approaches were closely linked to decisions about condom use. Many men reported serosorting based on inferences or assumptions about partners' HIV status. Together, results highlighted potential gaps in communication that can lead to faulty assumptions about HIV status and subsequent serodiscordant condomless sex and suggest that interventions that promote HIV status disclosure address these potential faulty assumptions.

Keywords: Apps; Condom use; HIV disclosure; Hook-ups; MSM; Qualitative research.