‘Closeted’ Men Who Have Sex With Men Less Likely to Be HIV-Positive, Aware of HIV, Hepatitis B Status

Men who have sex with men but who have not disclosed their sexual orientation to others are less likely to be HIV-positive than men who are "out," according to a CDC study published in the Feb. 7 issue of Morbidity and Mortality Weekly Report, Reuters reports. However, "closeted" men, or "nondisclosers," are also less aware of their HIV or hepatitis B status than men who have disclosed. In addition, nondisclosers are more likely to have recently had sex with a woman, prompting the CDC to recommend that efforts to test nondisclosers and their partners should be increased (Reuters, 2/6). The study surveyed 5,589 men between the ages of 15 and 29 who visited MSM-identified venues in six U.S. cities -- Baltimore, Dallas, Los Angeles, Miami, New York and Seattle -- between 1994 and 2000. Participants were asked about the degree to which they considered themselves to be "out"; were tested for HIV and hepatitis B; and were provided with HIV/STD preventative counseling and care referral (Shehan et. al, MMWR, 2/7). While nondisclosers are "thought to be at a particularly high risk for HIV infection because of low self-esteem, depression or lack of peer support and prevention services that are available" to "out" men, the actual risks of HIV and STDs for such groups are "unknown," according to Reuters. The study found that 8% of "closeted" men were HIV-positive, compared to 11% of "out" men. The study also found that young black MSM are more likely than their peers to be "closeted" and that 14% of "closeted" black men were HIV-positive, versus 24% of "out" black MSM. Fourteen percent of black nondisclosers were HIV-positive, compared with 5% of other ethnicities. Also, 98% of nondisclosers were unaware of their HIV status, compared with 75% of men who are open about their sexuality, making nondisclosers more likely to transmit infections to both male and female sex partners. The study concludes that "public-awareness and prevention programs should be developed [for nondisclosers] to reduce internalized homophobia and other factors that influence nondisclosure" (Reuters, 2/6).