HIV-Positive Individuals May Delay Telling Casual Sex Partners

Some people with HIV infection may not tell their sexual partners or family members until the disease has progressed. The last in line to know of a person's HIV status seem to be casual sex partners, according to a study presented at the American Public Health Association meeting in Atlanta last week.

Megan E. O'Brien of Tulane's School of Public Health and Tropical Medicine reported the findings. She and her colleagues interviewed HIV clinic attendees between June and September 2000. The majority of participants were African-American. Eighty percent had acquired HIV through sex, largely through heterosexual contact. In all, 269 men and women were interviewed.

After an average of nearly three years since diagnosis, 75 percent of interviewees had informed their main sex partner about their HIV status. However, only 25 percent of those with casual sex partners had informed them. People who did not disclose their HIV status to casual partners were less likely to use condoms than those who did reveal their status to at least one casual partner. About 70 percent of interviewees had revealed their status to family members.

The low rate of disclosure to casual partners might reflect the success of treatment with antiretroviral drugs. According to O'Brien, many HIV-positive individuals are living longer, healthier lives and some may believe that because they look and feel healthy, they are less likely to transmit the virus. "Individuals with and without HIV need to be educated about the limitations of antiretroviral therapy and the realities of HIV disease," O'Brien said. "A treatment is not a cure," she noted. Individuals who are not infected need to realize that they cannot assume a partner will volunteer their HIV status; therefore, they must protect themselves by consistently using condoms.

"HIV is still a disease which carries a social stigma," O'Brien said. "In such a setting, individuals with HIV have little incentive to disclose their HIV status. We need to address the cultural basis for stigma." In addition, however, professionals need to better counsel patients on how to tell different people about their status and how to deal with any "unpleasant reactions."

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