Background:
Many quantitative studies have been conducted on HIV disclosure, but few studies have explored what respondents are actually saying to their sex partners. Additionally, few studies have explored disclosure of other STIs besides HIV.

Objective:
To explore, through qualitative methods, the context and content of STI/HIV
disclosure among men who have sex with men (MSM).

Method:
A mixed methods study was conducted among online and offline samples of
MSM to explore Internet-related risk and preventive behaviors. Subjects were recruited from 3 venues (STD clinic, bath houses, or online) and first
completed a quantitative survey (N=158) after which some were invited to participate in the qualitative portion of the study (n=38).

Result:
Only 21% of men reported discussing STI status with sex partners each and every time within the last 12 months. The majority of men (31%) reported never discussing STI status with sex partners in last 12 months. Disclosure discussions were broad and lack important details, such as type of HIV or STI test or when testing occurred. Also, discussion of status does not equate with safer sexual behaviors. Further, HIV was discussed much more often than STIs, if STIs were even discussed at all.

Conclusion:
In light of the increasing STI incidence among MSM (particularly syphilis and gonorrhea), the re-emergence of certain STIs (lymphogranuloma venereum), as well as the potential for HIV super infection of those already infected with HIV, it is important to consider ways to improve the consistency and quality of HIV/STI disclosure among potential sex partners and increase disclosure of STIs among potential sex partners.

Implications:
More qualitative research is needed on the specifics of disclosure among MSM, and programs need to be developed that not only promote disclosure, but include skill building on how to talk about status of HIV and STIs, including specific STIs and dates of last tests.