Unsafe Sex and HIV Disclosure: Should I disclose?

>A recent request for questions resulted in someone asking what I think is one of the MOST difficult questions in sexuality/HIV prevention. “Should I disclose HIV status when I’m having unsafe sex?”

My short answer is “yes.”

My long answer is also “yes,” but probably not for the reason one would think.

Before I go into my response, I highlight the level of fear, AIDS phobia, inaccurate knowledge, and generally rude behaviors by many negative individuals toward positive individuals. The level of discrimination by negatives toward positives is sad and disappointing given that we are 25+ years into the epidemic. I also highlight all the reasons the CDC, and other prevention workers would say yes: we all have a responsibility toward stopping the epidemic.

But, in my opinion, the reason a person should disclose his or her HIV status is the expression of the individual’s own mental health. I think it is incredibly brave and courageous when an individual stands up and says, “This is me.” When an individual discloses their HIV status, I think it represents a level of self-knowledge, self-acceptance, and overall inner strength where he or she also says, “This is me, if you don’t like it, deal with it.” I recognize this level of self-knowledge and self-acceptance is a bit utopian, but then again that’s what we psychologists move toward: helping an individual claim a level of pride and integrity in all aspects of his or her life. If you’re not at that point, I think it can be a goal. Finding someone (or many someones) who will walk with you in that journey is important.

Have a question? Or an opinion, please email or post to http://sexualhealthinstitute.blogspot.com

Resources

Web: TheBody.Com

Neither Gay Nor Bi: Understanding men who have sex with men (MSM)

I finished my second power point for a second presentation tomorrow at the University of Minnesota "Beyond the Boxes" Conference. If you would like a copy of the pdf handout, please contact nsimon@pride-institute.com.

The first power point on Internet Sexual Compulsivity is also available.

New Era of HIV prevention needed.

HIV prevention has had two previous "eras" of prevention. When HIV/AIDS first broke, the primary message was "don’t get HIV or you’ll die." This era was before the time of effective medication (pre-1996). Once the field discovered some basic medications, the second era of HIV started where prevention attempts had an implicit assumption that we would be able to eradicate the spread of HIV.

However, today we need a third era of HIV prevention and I honestly don’t have the answer on what the new era should look like. We need an approach that affirms the importance of HIV prevention without using fear as the primary motivator. We also need to acknowledge the reality that HIV is no longer considered a deadly illness but is now a chronic illness. Don’t get me wrong; HIV is extremely serious, but, we might be able to learn from other prevention programs, smoking for example, in developing better HIV prevention.

We also need to see risky sexual behaviors as a symptom rather than the problem. Co-occurring problems such as drug and alcohol use, mental health concerns, sexual compulsivity, and poverty are but a few of the related issues that need to be addressed in prevention.

Please don’t start a flame-war by attacking other respondents, but I’d like to hear from you.
How do you think our community should move forward?