"Closeted" Men May Play Key Role in STD Spread: CDC
February 7, 2003
Young black men who have sex with other men are more likely than their peers to have not disclosed their sexual orientation to others, according to a new CDC report. And while such "closeted" men do not have a higher risk of HIV and other STDs than "out" gay and bisexual men, "nondisclosers" are less likely to know that they have HIV and are more likely to have recently had sex with a woman, the CDC survey suggests. The full report, "HIV/STD Risks in Young Men Who Have Sex with Men Who Do Not Disclose Their Sexual Orientation -- Six Cities, 1994-2000," was published in the Feb. 7 issue of CDC's Morbidity and Mortality Weekly Report (2003;52(5):81-86).Adapted from:
Researchers evaluated a survey examining the sexual practices and attitudes of 5,589 MSM ages 15 to 29, all of whom underwent testing for HIV and hepatitis B. In all, 637 men reported that they were "not out to anyone" about the fact that they had sex with men. Of this group, 55 percent were ages 15 to 22. Overall, 8 percent of the closeted men tested HIV-positive, compared to 11 percent of men who were open about their sexuality.
HIV prevalence was 14 percent among closeted blacks compared to 24 percent of openly gay or bisexual blacks. About 18 percent of blacks said they had not disclosed their sexual orientation, compared with 8 percent of whites. Fourteen percent of black nondisclosers were HIV-infected compared with 5 percent of nondisclosers of other ethnicities.
Among HIV-positive men, those who were closeted were less likely than out men to be aware of the infection. Of those with HIV, 98 percent of nondisclosers were unaware of the infection compared with 75 percent of those who were openly gay.
While the study did not find nondisclosers faced higher HIV risk, "the data suggest that a substantial portion of nondisclosers are infected with HIV and other STDs and are at high risk for transmitting these infections to their male and female sex partners," CDC stated in an accompanying editorial. The survey finding that more than one in three closeted men reported having had sex with women recently suggests such nondisclosers may play a major role in spreading HIV and STDs to women, according to CDC. This might be particularly true for closeted black men, CDC said, as about one in five were positive for hepatitis B and about one in seven were HIV-positive.
"The findings in this report suggest that public-awareness and prevention programs should be developed" for closeted men "to reduce internalized homophobia and other factors that influence nondisclosure," the report concludes.