1. P Murphy 1, D Hevey 1, S O’Dea 2, N Ní Rathaille 2, F Mulcahy 2 1. Research Centre for Psychological Health, School of Psychology, Trinity College Dublin 2. Department of GU Medicine and Infectious Diseases, St James’s Hospital Optimism, Community Attachment, and Serostatus Disclosure among HIV-Positive MSM in Ireland

2. Study Aims Investigate the how serostatus disclosure by MSM to casual partners is influenced by… …HIV-related Optimism …Community Attachment

3. HIV-related Optimism HIV-related optimism: “favourable feelings about the multiple outcomes from the use of HIV treatments (e.g., beliefs regarding less severity of AIDS, reduced risks of HIV transmission, and less need to use condoms)”

4. HIV-related Optimism Forms of HIV-related optimism… …HIV Transmission Optimism …HIV Health Optimism

5. HIV-Related Optimism and Disclosure? HIV Transmission Optimism and Disclosure? H1: Greater HIV Transmission Optimism will be associated with greater levels of serostatus disclosure. HIV Health Optimism and Disclosure? H2: Greater HIV Health Optimism will be associated with greater levels of serostatus disclosure.

6. Community Attachment Community Attachment: a sense of belonging or rootedness in a community. Often symbolic rather than geographic.

7. Community Attachment and Disclosure? HIV Community Attachment and Disclosure? H3: Greater HIV Community Attachment will be associated with greater levels of serostatus disclosure.

8. Community Attachment and Disclosure? Gay Community Attachment and Disclosure? H4: Greater Gay Community Attachment will be associated with lower levels of serostatus disclosure.

9. Methodology Quantitative survey data, analysed using multinomial logistic regression. Eligibility Criteria: 18 years of age or older Diagnosis of HIV/AIDS Self-identification as MSM At least 1 casual partner in the 6 months prior to participation

10. Recruitment 97 participants recruited from the GUIDE clinic at St James’s Hospital between February 2013 and June 2013 Participants classified as consistent disclosers, inconsistent disclosers, and non-disclosers.

11. Results H1: Greater HIV transmission optimism will be associated with greater levels of serostatus disclosure ?

12. Results H2: Greater HIV Health Optimism will be associated with greater levels of serostatus disclosure.

13. Results H3: Greater HIV Community Attachment will be associated with greater levels of serostatus disclosure.

14. Results H4: Greater Gay Community Attachment will be associated with lower levels of serostatus disclosure.

15. Implications Health optimism is a good thing, but it’s impact on disclosure may lead to less than optimal outcomes for HIV+ MSM. Those highly affiliated with the HIV community may be disclosing when it is not actually beneficial. HIV-related stigma within the gay community does inhibit disclosure of HIV status and needs to be addressed.

16. Limitations Relationship between HIV Transmission Optimism and serostatus disclosure could not be tested. Identity salience and stigma, or community norms? Cannot establish causality. Self-selection and response biases.

17. Acknowledgements The Society for the Study of Sexually Transmitted Diseases. All of the staff and patients at the GUIDE clinic. Professor Fiona Mulcahy, Siobhán O’Dea, Neans Ní Rathaille.

18. Questions ?