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Trust and understanding vital for improving partner notification in MSM
Improving trust and understanding between healthcare providers and men who have sex with men (MSM) may be a vital element for improving partner notification of HIV among this group in the US. Partner notification is a major barrier to preventing onward HIV transmission because of the inherent complexities and sensitive nature of HIV disclosure. However researchers from Yale University in the US also showed that differences in perspectives around disclosure, transmission, and lifestyle choices between healthcare professionals and MSM in particular, are proving to be a major barrier for partner notification of HIV.
To analyse the difference in perspectives, the researchers ran focus groups and conducted in-depth interviews with MSM and healthcare providers, including disease prevention specialists and case managers, from a clinic in Connecticut. Many MSM were worried about talking about HIV and disclosure with their healthcare provider because of a perceived stigma for being both gay and HIV positive, adding that they generally mistrusted the healthcare system. Fear of openly discussing their sexual orientation in general, even outside the healthcare system, and also a fear of rejection around HIV disclosure, which might lead to risky behaviour such as drug use, were all issues highlighted by MSM. These factors that impact partner notification of HIV were not appreciated by healthcare professionals – who understood lack of disclosure and sexual promiscuity among MSM as simply a characteristic of men.
In order to overcome these barriers to partner notification of HIV, the authors state that increasing understanding, open dialogue and trust between healthcare providers and MSM may lead to improved partner notification. Lead author, Jennifer Edelman, added: "Partner notification services offered through the state health department are key for promoting timely diagnosis of HIV infection, but we need to find ways to educate providers about these services and optimize their utilization and implementation."