AEGiS-APPJ: High-Risk Sexual Behavior and Failure to Disclose HIV Infection to Sex Partners: How Do We Respond?

Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date.

High-Risk Sexual Behavior and Failure to Disclose HIV Infection to Sex Partners: How Do We Respond?

AIDS & Public Policy Journal 19, no. 1/2 (Spring/Summer 2004) 11-36
Daniel Bruner

Advocates for persons living with HIV/AIDS need to pay more attention to the troubling fact that unsafe sexual behavior (penetrative anal and vaginal sex without condoms) persists among significant numbers of persons who know that they are HIV positive and who do not disclose this to their sex partners. Such behavior appears to have been increasing over the past few years, and may be fueling an upsurge in HIV infections in men who have sex with men. The "code of the condom"-the message that everyone should always use condoms and that condom use makes disclosure of one's HIV status unnecessary-is inadequate to address this problem.

HIV-prevention thinking should face up to the moral and ethical dimensions of sexuality. Specifically, we need to reinvigorate moral dialog around sexual behavior and sexual risk by emphasizing the fundamental moral value, and the virtue, of taking care of ourselves and of each other. This value requires us to envision ourselves as all belonging to the same moral community.

Remembering the fundamental importance of taking care may require us to rethink the "code of the condom" and place a new emphasis on disclosure of one's HIV status to one's sex partners, casual as well as committed. It also may have a number of implications for lawyers and other advocates for persons living with HIV/AIDS. I suggest that advocates place primary emphasis on issues that reinforce our membership in a single moral community and our obligations to treat each other with care and respect, such as vigorous enforcement of nondiscrimination laws and principles, harm-reduction campaigns, and honest sex education. On issues such as criminal sanctions for unsafe sexual behavior and confidentiality of HIV status, we should avoid positions that may undermine our moral credibility and reinforce the atomistic individualism that corrodes our society.
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