There was no significant difference in the percentage of gay and bisexual
men, heterosexual men and women engaging in undisclosed, unprotected sex
specifically with an HIV-negative partner. However, gay or bisexual men were
more likely
to have any instances of undisclosed or unprotected sex, regardless of their
partner’s HIV status.
“The results of this study indicate that sex without disclosure of HIV
status is relatively common among persons living with HIV,” say Daniel
H. Ciccarone, M.D., M.P.H., of the University of California San Francisco
and colleagues.
“The numbers are large enough to suggest that substantial numbers of
new HIV infections could occur among partners of HIV-positive persons who do
not disclose their status,” he adds.
The study surveyed 1,421 adults age 18 and older receiving medical treatment
for HIV infection. Participants were asked about partner HIV status, whether
they were in exclusive relationships with those partners, how often they engaged
in oral, anal and vaginal sex and whether they disclosed their HIV status to
their sexual partners.
Overall, 42 percent of gay or bisexual men, 19 percent of heterosexual men
and 17 percent of women say that they had sex without disclosing their HIV
status to a partner in the six months previous to the study.
Ciccarone and colleagues say that gay or bisexual men with HIV may be less
likely to tell partners about their HIV status because prevalence and awareness
of HIV are relatively higher in the gay community, perhaps leading to a situation
where HIV-positive men assume their partners are already aware of HIV risks.
The researchers also suggest that the stigma of being HIV-positive has not
decreased over the past 20 years of the HIV/AIDS epidemic, which may help explain
why so many people do not tell their partners about their HIV status.
“Disclosure is undoubtedly complicated by perceived fears of rejection,
discrimination and violence from partners and others,” Ciccarone says.
The study was supported by the National Institute of Child Health and Human
Development and the Agency for Healthcare Research and Quality.
