Washington Blade - October 3, 2003
Laurel Faust

Seventy-four percent of the study participants told their main partner about their positive status; 70 percent told someone in their immediate family; 27 percent told a relative other than their immediate family; and 26 percent told a friend. Eighteen percent of the respondents didn't tell anyone.

People who were older were more likely to disclose the news, as were those who had progressed further along in their illness.

The results of the study by the Tulane University School of Public Health & Tropical Medicine and the Centers for Disease Control & Prevention were published in the September issue of "Sexually Transmitted Diseases."

The researchers surveyed 269 people in two HIV out-patient clinics serving predominantly urban, low-income populations in New Orleans.

Principal author Dr. Patricia Kissinger said the results are consistent with other studies conducted on populations in Los Angeles and San Francisco. She noted that this study is unique because it targets a segment of the population that more accurately reflects the growing face of the HIV epidemic.

Eighty-four percent of the Tulane study participants were African-American. There were an almost equal number of men and women surveyed.

Forty-nine percent of the sample reported in face-to-face interviews that they had contracted the virus through heterosexual contact, while 31 percent were males who reported they had acquired HIV through sex with other men. Eleven percent said they contracted the virus through IV drug use.

Kissinger said she has data on the numbers of the participants who engaged in risky sexual behavior and is compiling the information for another study. She estimated the number at between 60-70 percent.

"This was really dramatic. We didn't expect the numbers to be quite this high," Kissinger said.

She said she believes her data is representative of urban populations in the United States.

Both sex partners responsible for disclosure

Shana Krochmal, director of communications and public affairs for the STOP AIDS Project in San Francisco, insisted that the responsibility for disclosure of HIV status does not rest on the HIV-positive partner alone.

"HIV-negatives really have a shared responsibility of asking and insisting on condom usage regardless," she said. STOP AIDS Project staff work with gay, bisexual and transgendered men to prevent the transmission of HIV.

Krochmal said it's important to realize how strong the stigma is for people who are HIV-positive.

She said those who are HIV-positive feel like it doesn't matter how wonderful their personality may be ù there's still a sense that relationships won't go any further if they reveal their status to their potential partners.

Ron Simmons, president of Us Helping Us, said it's important not to "get all up in arms" about the numbers. He said that people who adopt a "holier than thou" attitude aren't addressing the problem.

Us Helping Us specializes in HIV/AIDS prevention and care services for gay and bisexual black men.

Simmons said the stigma against gay people and HIV-positive people in particular is strong enough already.

He said he recommends that HIV-positive sex partners reveal their status right away, but he said that coming out as positive is an intensely personal matter and that people have to get there in their own time.

Simmons said often times HIV-positive people engage in non-risky sexual behaviors such as mutual masturbation. He said it's important to look at the instances when HIV-positive people do go ahead with risky behaviors, so that the problem can be addressed with effective risk reduction programs.

Stephen McDonnell, director of G-NET, said that it's important that people feel comfortable not only having sex but also talking about it. G-NET is a Whitman-Walker Clinic HIV-prevention program for gay and bisexual men.

"We live in a culture that doesn't reward loving gay relationships," McDonnell said.

He said many gay men have low self-esteem, abuse drugs and alcohol, and have few healthy places to meet.

"Therefore, sometimes we engage in anonymous sex," McDonnell said.

He noted the CDC strategy for the next five years is to focus on HIV prevention in people who are positive.

"We have to be careful that we're not stigmatizing people who are HIV-positive as if it's only their responsibility to have low risk sexual activity, when in fact it is the responsibility of everyone having sex," McDonnell said.

The report notes that knowledge of a person's HIV status can be a motivating factor in safer sex behavior.

Jail, fines for failing to disclose HIV

Ronald Gene Hill, a former health commissioner in San Francisco last week pleaded innocent to charges that he knowingly and intentionally infected two people, including his boyfriend, with HIV. Hill remains jailed with bail set at $10,000.

His boyfriend, Thomas Lister, sued Hill and was awarded $5 million in 2001 after he discovered Hill taking HIV medications while they were on a cruise together, the Associated Press reported. Lister alleged that Hill had never revealed that he was carrying the AIDS virus.

A Florida man, Louis Cecil Sanders, this week was sentenced to 10 years in prison after he admitted he had intercourse with a woman without telling her of his positive HIV status, AP also reported.

Dan Bruner, associate director for litigation and advocacy for the Whitman-Walker Clinic, said that there are very few cases involving intentional infection with HIV. He said D.C. has no law on the books that specifically addresses exposing someone to HIV with or without disclosure. Bruner said a person would have to be charged with assault with a deadly weapon, reckless endangerment, attempted murder or some other general criminal law charge.

Bruner said it's a misdemeanor in Maryland to knowingly transfer or attempt to transfer the virus to another person, with a fine of up to $2,500 or imprisonment of up to three years. The law has been in effect since 1989.

Virginia enacted in 2000 a law called "infected sexual battery," which makes it a felony for a person who knows they are HIV-positive to engage in sexual activity with the intent to transmit HIV to another person. Someone convicted of the crime faces one to five years imprisonment and a fine of up to $2,500.

"In order to have criminal intent, you must have knowledge," Bruner said.

He said that this is a murky area of the law, because it may involve more than just the knowledge of positive HIV status. A person could be misinformed about how the virus is spread; he could be under the influence of drugs or alcohol; he could be seriously distressed or carried away with passion.

"Would that preclude a conviction?" Bruner said, "I don't know, There's no court I'm aware of in either state that's ruled.

"I think the real question is what is the best way to get people to behave responsibly and to practice safe sex. Some people argue that by criminalizing this behavior, all you're doing is driving people underground or giving them an incentive to not know that they're HIV-positive."

Bruner said the legislature often passes laws because it looks good politically, but the laws are very rarely used.

"The same legislative bodies that pass these laws don't give funding for HIV education and prevention," Bruner said.

He said there are no civil statutes regarding intentional transmission of HIV in D.C., Maryland or Virginia. He said cases are considered on a case-by-case basis under personal injury law.

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