A new study by researchers at Rand Health, a national health policy research center, shows that although many HIV-positive gay and bisexual men tell their sex partners about their infection, 42% do not always inform their sex partners before having unprotected sex. Overall, about 19% of HIV-positive men and women fail to consistently disclose their serostatus. Heterosexual women were the most likely to inform their sex partners that they are HIV-positive, while gay and bisexual men were the least likely. The study found that for gay and bisexual men, nondisclosure was most common in nonexclusive sexual relationships, particularly casual or anonymous encounters.
"Our results suggest that many HIV-infected gay and bisexual men tailor their sexual activity to reduce the risk that they will transmit HIV to casual partners to whom they do not disclose," said researcher David E. Kanouse, a behavioral scientist at Rand Health, in a news release. "Public-health messages have urged all gay men to 'act as if every partner is HIV-positive.' Such measures may have had the unintended consequence of making disclosure seem optional and nondisclosure acceptable in some encounters."
Health experts say the study indicates that programs are needed to urge HIV-positive people to disclose their serostatus to their sex partners and to begin practicing safer sex to keep from transmitting HIV to others. "The most effective mechanisms are likely to be through promoting community norms that robustly say 'do ask, do tell,'" said Daniel Ciccarone of the University of California, San Francisco, in a press release.
The full study appears in the June issue of the American Journal of Public Health.