Miami Herald - Monday, April 06, 2009
Daniel Shoer Roth

Tom Edwards prefers to "get it over with" on the first date. If he is immediately rejected, it won't hurt as much as if he had been emotionally involved.

Ernesto Carvalho prefers not to tell until some time has passed. He wants his partner to get to know him before he shares such personal information, even if it's heartbreaking to be rejected then.

The two were at odds during a group therapy session last week at the Miami Beach Community Health Center, where gay men living with HIV/AIDS can share their fears and be better understood. Disclosure is a dilemma, the men agreed, because rejection is painful when it comes from a potential partner.

Society commonly rejects these men -- for being gay and for being infected. A study released on Wednesday by Gay Men's Health Crisis in New York says half of Americans surveyed believe HIV/AIDS contributes to anti-gay bias -- the same proportion as in 1986.

Yet, little is said about the discrimination suffered by gays who are HIV-positive from other gay men, perhaps because the gay community wants to protect itself from the bad publicity.

"Gay people as a minority complain that they are discriminated against, but within a large part of the gay community they discriminate against those of us who have HIV, so there is a double standard," argues Hernando Hernandez, 44, who has lived with the virus for 24 years.

This stigma sometimes leads irresponsible individuals with the virus to not disclose it to their sex partners.

"Non-disclosure is one of the challenges of HIV prevention," noted Spencer Lieb, senior epidemiologist with the Florida Department of Health Bureau of HIV/AIDS.

Among the overall population of gay men and those who do not identify themselves as gay but have occasional sex with men, the rate of new infections has steadily increased since 1990, according to the U.S. Centers for Disease Control (CDC). In Miami-Dade, a 2005 research study conducted by the CDC and the state's health agency found that about one in six of men who have sex with men are HIV-infected.

Recent Florida figures show an increase of 48 percent in newly reported HIV cases in Miami-Dade County from 2006 to 2008 and 74 percent in Broward County. This might have occurred because of an enhanced reporting system, said Lieb. Yet, some of the gay population have increased HIV/AIDS complacency, which can lead to riskier sexual behaviors.

In group therapy, Felix Gonzalez shared an incident that provoked his ire and made him feel awful. He had met a man one recent night and they agreed to have lunch the next day. When Gonzalez, 39, disclosed his status, "he automatically lost all enthusiasm of continuing the conversation."

For Gonzalez it is important to be honest upfront. However, other men with HIV believe that if the person doesn't ask their status, it is because he would rather not know.

"It is a struggle for them, because on the one hand they want to be responsible, but on the other they want to protect themselves from breaching confidentiality and rejection," said Linda Simon, the Miami Beach program's psychotherapist.

Sure, everyone enjoys the freedom to not get involved in a relationship with a person with HIV/AIDS.

But it's also true that some in the gay community should be more sensitive when responding to these situations and not shut out a potential friendship.

It is dreadful that from fear of rejection, someone might place another at risk, just as it is to not show compassion.
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