Non-Disclosure of HIV Status Common in U.S.

NEW YORK (Reuters Health) – More than 10 percent of American men and women who are HIV-positive and sexually active — gay, straight and bisexual — fail to disclose their status before engaging in unprotected high-risk sex with partners whose HIV status is unknown or negative, according to a new study.

NEW YORK (Reuters Health) – More than 10 percent of American men and women who are HIV-positive and sexually active — gay, straight and bisexual — fail to disclose their status before engaging in unprotected high-risk sex with partners whose HIV status is unknown or negative, according to a new study.”It’s not uncommon that people reported that with certain partners there was no disclosure,” said lead author Dr. Daniel H. Ciccarone of the University of California at San Francisco. “(And) from a public health point of view this is where transmission could happen — these are the relationships we’re most concerned about.”The researchers stressed that although the disclosure of HIV status has not been conclusively linked to an increase in condom use, prevention efforts that stress the importance of disclosure for anyone who is sexually active might promote safer sex.”Most HIV-positive people are doing right,” Ciccarone told Reuters Health. “But it’s not just on the HIV-positive person. It’s also their partners who need to be asking and sharing.”In 1998, Ciccarone and his research team interviewed nearly 1,400 HIV-positive men and women from across the U.S. who were at least 18 years old. The researchers asked the participants about their sexual behavior during the previous six months — oral, anal and vaginal sex as well as abstinence.In the June issue of the American Journal of Public Health, the authors report that abstinence rates were high among all HIV-positive individuals — ranging from 28 percent among gay and bisexual men to 39 percent among heterosexual men. Women of all orientations reported a 34 percent abstinence rate.The survey showed that approximately half of all the sexually active HIV-positive men and women regardless of sexual orientation reported having sex with a partner whose status was either unknown or negative. About 13 percent of people who had sex with a partner who was HIV-negative or of unknown status had unprotected vaginal or anal intercourse.Ciccarone and his colleagues also noted that for all HIV-positive individuals most such unprotected sex without disclosure appeared to involve mutual non-disclosure — namely neither partner revealed his or her status to the other.Among HIV-positive individuals who were sexually active, gay and bisexual men were much more likely to have any sex — either with or without a condom — without disclosing their status to their partner. Forty-two percent of gay and bisexual men reported having sex without disclosure, compared to 19 percent of heterosexual men and 17 percent of all women.The survey also found that among those HIV-positive individuals having sex without disclosure, gay and bisexual men were much more likely to do so in casual relationships than in monogamous relationships, whereas heterosexual men and women of all orientations were equally likely to do so in either an monogamous or non-monogamous relationship.However, the researchers found little difference among all HIV-positive individuals regarding the likelihood of having sex with a partner whose status was either unknown or negative.(SOURCE: American Journal of Public Health 2003;93, Wed May 28, 2003 05:30 PM ET, Alan Mozes)