Background:
The relationship between HIV disclosure and sexual risk among MSM who use the internet to meet sex partners has not been the focus of many research endeavors.

Objective:
To assess HIV disclosure and non-disclosure discussion patterns and related risk behaviors among MSM who use the internet to meet sex partners.

Method:
Twenty-eight semi-structured qualitative interviews from the Seattle Area MSM Study were reviewed. Themes and behavior patterns related to HIV disclosure and risk among MSM who met a sex partner online were analyzed using grounded theory methods.

Result:
Nineteen MSM (68%) discussed HIV status with sex partners and 13 discussed HIV status with a sex partner on the internet. Preliminary analysis indicated factors that facilitated disclosure discussions included online profiles with HIV status, internet chatting, discussions initiated by a sex partner, and fear of HIV. Identified hindrances to HIV disclosure included being influenced by substances, not wanting to offend a sex partner or “spoil the moment” and concern about sex partner dishonesty about status.
Thirteen MSM had unprotected anal intercourse (UAI) after discussing status, including all 5 with an HIV-positive sex partner (3 of whom believed they were themselves HIV positive) and 8 of the 14 with an HIV-negative sex partner. Nine MSM did not discuss HIV status and six of them (67%) had UAI.


Conclusion:
The relationship between HIV disclosure and risk behaviors was complex. Internet chatting and online profiles facilitated HIV status discussions on which some based their sexual behaviors. Of note, high risk activities were practiced by many MSM.

Implications:
Messages regarding the benefits of HIV disclosure discussions through the internet need to be addressed through further research and public health HIV prevention messages.