Disclosure Rates

Published in the Fall 2008 issue of SSA Magazine

When and why do African-American men who have sex with men talk about HIV?

-Gordon Mayer

The HIV/AIDS crisis affects blacks more than other Americans, and black men having sex with men (MSM) the most of any other subgroup. Nearly half of the 139,000 African-American men living with AIDS in 2005 carried the disease as a result of male-to-male sexual contact, according to the Centers for Disease Control and Prevention.

SSA doctoral student Jason Bird is investigating one potent prevention vector: whether and how these men disclose their HIV status to a potential partner prior to sex. The roots of Bird's research come from his experience doing prevention work among HIV –positive individuals. A man who reveals his status risks stigma, especially in the black community, due to cultural factors from family structures to religious strictures. Bird realized that unspoken assumptions made by both HIV -negative and HIV –positive MSM about each other could lead to misunderstandings and miscommunications.

"The positive guys said their assumptions were that someone willing to engage in sexual risk must be positive, so anybody who was willing to take a risk they assumed to be positive," Bird explains. "But the negative guys thought a partner willing to engage in risk must be negative, because how would someone who's positive put someone at risk?"

To date, Bird has interviewed 20 MSM to examine how they balance thoughts, feelings, and experiences about their HIV –positive identity during sexual encounters. Using a grounded-theory approach, which focuses on the meanings individuals attach to phenomenon, he hopes to build a theory about how these men calculate the costs and benefits of disclosing their HIV -positive status.

Bird says that, at first, he expected the men might wish to avoid the subject of disclosure, feel defensive about their choices, or find his questions judgmental. The opposite turned out to be the case: Interviews he hoped would run two hours each ended up lasting closer to two and a half. "Even though they'd not talked about disclosure, it was clearly not the first time they had thought about what it meant to disclose or not to disclose," he says. "This is something they deal with every day."