Bay Area Reporter - June 8, 2006
Matthew S. Bajko, m.bajko@ebar.com

The health department is launching a new disclosure initiative tonight (Thursday, June 8) with a community forum designed to teach people not only how to ask the right questions about a sex partner's HIV status but how to disclose their own status. The idea is that educating people on how to talk about HIV prior to having sex with someone will allow them to make better choices on what kind of sexual activities they engage in with their partners.

"We do know from talking to both providers and men throughout the community that disclosure is a huge issue for people still and it is not just positive guys. People don't have the tools to really bring it up. There is still a lot of fear and stigma," said Doug Sebesta, director of the disclosure initiative. "A lot of it is feeling awkward and not knowing when to do it or not knowing how to bring it up, or what to say or what the reaction is going to be."

Disclosure of one's HIV status has been a key part of the city's HIV prevention strategies for years. With the advent of the Internet and men using it to find sexual partners, health officials pushed online sites like www.Manhunt.net and www.Gay.com to add HIV status to people's profiles. More recently, negative men have begun adding when they took their last HIV test to their online profiles as a way to show the information is up to date.

In San Francisco, disclosing one's HIV status has also been driven by the many gay men who have turned to serosorting, where they only have sex with someone of the same HIV status. It is increasingly common to see HIV-positive men, as well as negative men, disclose their status in their profiles and seek out men of similar status, though there are still a large number of men who do not disclose their status, either leaving the question blank or stating they do not know if they are positive or negative.

The aim of the disclosure initiative is to bring the ease of disclosing one's status online into gay men's day-to-day lives, so no matter where they meet their sexual partners, they feel comfortable discussing HIV status before they get into bed. Such pre-sex disclosures are important, argue health officials, because it allows men to make better choices when it comes to the type of sex they engage in and protect themselves or their partners from contracting HIV.

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Disclosing can be difficult for HIV-positive men, who fear being rejected despite the fact they can engage in sexual behaviors that reduce the risk of passing HIV on to their partners. Negative men also fear a positive man will reject them if they disclose their status, or both positive and negative men will avoid the topic all together if they are having sex with a condom.

"Disclosure used to be a stressful thing for me. I know now that the longer I wait to disclose my HIV status to a potential partner, the harder it gets. I also know now that by not telling my HIV status to a potential partner, it does me more harm emotionally than the rejection that could result from it," wrote Alejandro, a spokesman for the HIV Stops With Me campaign, on the social marketing campaign's Web site. "I always find a way to talk about HIV ... I know it can be frightening at times. I just remind myself that the power within me is much greater than the fear before me. And trust me when I say it gets easier the more you do it."

Sebesta said he hopes the new initiative will lessen the fear and stigma around disclosing one's HIV status so it becomes routine practice for gay men, even if they use condoms.

"One thing the initiative is hoping to do is change community norms around HIV and normalize it as an everyday, unstigmatized part of our lives," he said. "It is each person's responsibility to take care of each other and negotiate what type of behaviors they are going to do that takes care of both of them. For a lot of people that is difficult. They haven't thought it out."

To help people learn the tools they need to disclose their HIV status, the AIDS Office has launched a new hotline (415) 820-1590 and e-mail address at ask.tell@sfdph.org staffed by four employees assigned to provide answers and guidance. A Web site www.hivdisclosure.com is under development and will launch in July and a social marketing campaign will be unveiled in late August or early September.

"We have heard from so many people that people don't hear HIV being spoken about anymore and they keep getting into situations where it doesn't come up," said Sebesta. "It doesn't come up at the larger community level. You don't hear people talking about it and it should still be in the forefront."

The disclosure initiative will present a town hall meeting tonight from 7 to 9 p.m. at the LGBT Community Center, fourth floor Ceremonial Room, 1800 Market Street in San Francisco.

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Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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