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Fact Sheet: Men's Fear of Stigma -- Denial of Risk

December 1, 2000

In the U.S., as in most cultures, there is a social stigma in being identified as homosexual. Fear of being stigmatized as gay is so powerful that it causes some men who have sex with men to deny the reality of their sexual orientation and to identify themselves as heterosexual. As a consequence, they do not perceive themselves as being at high risk for HIV, even though having unprotected sex with men is one of the highest risk behaviors for HIV infection. This causes many heterosexual and bisexual men to discount warning messages that they perceive to apply only to "gay" men.

Heterosexual Sex

HIV among heterosexuals is on the rise in the United States, yet this fact remains largely hidden. Denial of risk is a major factor among heterosexuals who perceive that risk of HIV is of concern only to bisexuals and homosexuals.

HIV-positive heterosexual men tend to experience their disease in relative isolation. Frequently they hide their disease from family and friends for fear of rejection and humiliation.

  • Heterosexual men are most likely to contract HIV from casual sex partners and/or infection from injecting drug use.

  • Over 70% of HIV infections worldwide occur through sex between men and women.


  • 15% of all AIDS cases reported in the U.S. last year occurred through heterosexual contact.

  • 9% of all U.S. males diagnosed with HIV last year were infected through heterosexual contact.

  • Studies have shown that HIV-positive heterosexuals are less likely than gay men . . .

    • to have had a viral load test and to be taking anti-viral treatments

    • to be interested in taking a proactive role in their care and treatment

    • to know other HIV-positive people, including HIV-positive heterosexuals

    • to have a support network

Greater awareness of HIV/AIDS among heterosexuals will encourage safer sex, stimulate greater research in this population and motivate more support programs for HIV-positive heterosexuals.

Bisexual Sex

Bisexuality is the potential to feel sexual attraction to both men and women. Because bisexuality is often hidden, denied or ignored, it has received little research attention.

We do know, however, that sexual activity with multiple partners of both genders does increase the possibility of transmitting HIV and other STDs, especially to women. Studies also indicate that, on average, bisexual men are less likely to practice safe sex and less likely to seek medical help than are heterosexual men.

  • Research among bisexual and gay men suggests that some are now less concerned about becoming infected than in the past and may be inclined to take more risks.

  • Data suggests that younger bisexual and gay men in particular continue to place themselves at considerable risk for infection with HIV and other STDs.

Sex Between Men

Although sex between men has been recorded in almost every human society, in most cultures it is repressed and even denied. In some cultures, homosexual behavior may be condemned among adults but permitted as play among adolescent boys. Or men may be permitted to have discreet relationships with other men as long as they also marry and have children.

Some men who identify themselves as heterosexual also have sex with men; their female partners are often unaware of this.

  • In the U.S., 10%-14% of boys and men report having sex with other boys and men.

  • 44% of U.S. men diagnosed with AIDS are men who have sex with men.

  • Young men who have sex with men account for 3 out of 4 HIV infections among young men, according to estimates.

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This article was provided by American Association for World Health. It is a part of the publication AIDS: All Men -- Make a Difference!.