Washington Blade - October 10, 2003
Stephen Fallon

A FORMER SAN Francisco health commissioner was recently jailed for hiding his HIV status from his boyfriend, who became infected with the AIDS virus.

Ronald Hill's arrest has already triggered debates about who is to "blame" for HIV rates, which have risen among gay and bisexual men by 17 percent in the past three years, more than for any other group.

For months now, the mainstream press has paid disproportionate attention to supposedly pathological HIV-negative gay men who are said to haunt chat rooms and sex parties in a perverse quest to become "pozzed up."

Publicity about a former public health official who deliberately withheld his status will only give the media new gay demons.

In the early days of AIDS, gay activists chanted "Silence = Death." Well, too many gay men still aren't talking much today.

More HIV-positive gay men (42 percent) fail to disclose their HIV status to sex partners than do members of any other group. Two large studies have found that 13 to 16 percent even fail to disclose before having unprotected sex.

Non-disclosure rates with casual sex partners are six times higher than with primary partners, according to the Centers for Disease Control; in casual encounters, straights fail to disclose at similar rates.

HIV-positive men sometimes ask why they should have to shoulder the responsibility for bringing up HIV, when they're already forced to live with its negative consequences every day. They say that any guy who has sex without asking his partner's status (or without insisting on condoms even after asking) has willingly entered a risk arena. Caveat emptor.

I don't buy it. An HIV-negative man's duty to ask is not equal to an HIV-positive man's duty to disclose. Consider the odds.

The guy who doesn't ask is gambling that his partner is probably HIV-negative. It may be a foolish gamble, but even in most urban gay ghettos, the chances are pretty good that he'll be correct.

On the other hand, the diagnosed HIV-positive man knows with 100-percent certainty that he's infected. So not disclosing amounts to failing to protect a fellow human being.

Someone else's foolishness does not negate the universal human responsibility each of us has to protect one another. If someone steps off a curb without looking first, we don't watch the approaching bus knock him down and say, "Tough luck; he should have looked." We pull him back to the curb.

HIV-POSITIVE MEN have their reasons; they recognize that their desire to protect partners can come back to bite them. HIV-negative guys, including me, are notoriously hypocritical in dealing with positive guys.

When someone discloses that he's HIV-positive, too often we smile, say it doesn't matter, and then politely extricate ourselves from the sexual encounter, relationship, or even friendship. Until we stop imposing social excommunication on men who disclose, they will continue to hide their status.

Somewhere between full disclosure and premeditated denial, many HIV-positive men admit to non-disclosure by omission, rather than by commission. In one early study, men said that they wouldn't lie, but that if a partner does not ask their status, they felt no obligation to disclose because "in this day and age, they should know."

Others described giving hints to partners, but not declaring their status outright. The location for sex also influences non-disclosure. Guys told one researcher they feel less responsible if they go to a sauna, "because people go there to have sex so they should know."

How HIV-positive men perceive responsibility dictates how they will act. University of Washington researcher Rosemary Ryan asked 325 poz guys about their perceived responsibility for protecting a partner from HIV and other STDs.

Those who felt high levels of responsibility were highly unlikely to put a partner at risk. Those expressing medium responsibility were eight times more likely to have unprotected sex. Guys who felt low responsibility - who believed that it was up to the other partner to protect himself - were 59 times more likely to put their partner at risk through unprotected sex without disclosure.

Somehow, in rejecting the narrow and punitive moral laws that constrict mainstream America, we seem to have forgotten to build our own standards of conduct to guide us through gay life. Disclosure should be expected, and people who bravely disclose their status deserve respect.

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