HIV-AIDS non-disclosure should be a crime, study of gay and bisexual men finds

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Two-thirds of men who have sex with men believe that people with HIV-AIDS should face criminal charges if they fail to disclose their status to a sexual partner.

But that number varied a lot depending on circumstance, with 83 per cent saying non-disclosure before anal sex should be a crime, and 42 per cent saying failure to disclose HIV status before oral sex was a criminal act. Only 17 per cent said failing to disclose should never be criminalized.

Those are just a couple of the eye-opening findings in a ground-breaking poll that is billed as the largest-ever survey of gay and bisexual men in Canada.

"The consensus is there should be legal measures in place related to disclosure," Dan Allman, an assistant professor in the Dalla Lana School of Public Health at the University of Toronto, said in an interview.

"At the same time, there is a feeling that legal measures won't have an impact. There's an innate understanding that disclosing your HIV status is hard and criminal laws aren't going to make it easier," he said.

The survey, dubbed Male Call involved 1,235 detailed interviews with men who have sex with men.

The research is being presented Thursday at the Canadian Association for HIV Research conference in Vancouver. The data have also been packaged in graphic form in the hope the material will be posted in health clinics, community centres and high schools.

The research shows that 26.2 per cent of respondents did not know their HIV status because they had not been tested recently; that number jumped to 50.6 per cent among bisexual men. Overall, 67.2 per cent of the men surveyed were HIV-negative, and 6.6 per cent HIV-positive.

Most of those who had not been tested said they were confident they were HIV-negative because their sexual practices put them at low risk. But a significant minority, 17 per cent, said they did not want to know their status, either because they could not deal with being infected or out of fear it could cause legal problems.

The fear associated with being HIV-positive was pervasive. The poll showed that 83 per cent of men worry about being stigmatized because of HIV, while 68 per cent fear being rejected by other gay/bisexual men, and 51 per cent fear being prosecuted for not disclosing their HIV status.

"The HIV epidemic has profoundly affected this population," said Ted Myers, head of the HIV Social, Behavioural and Epidemiological Studies Unit at the University of Toronto, and co-investigator on the study.

The survey shows that there is a diverse population of men who have sex with men in Canada: 54.6 per cent described themselves as gay, 35.6 per cent as bisexual, 4.1 per cent as straight, and 5.7 per cent as "other."

Of those polled, 61.3 per cent were single, 19.5 per cent were married or partnered with another man, and 19.2 per cent were married or partnered with a woman.

"This isn't surprising really. Kinsey said that the world is not divided into sheep and goats, that sexuality is a continuum," Allman said. "Our survey shows there are 51 shades of grey – at least."

The respondents ranged in age from 16 to 89. The majority of men who have sex with men, 68 per cent, said they live in urban areas, principally Toronto, Vancouver and Montreal, but 32 per cent live in rural and remote parts of Canada. Men in rural and remote areas were far more likely to identify as bisexual. Men in urban areas were far more likely to describe themselves as "out."

Almost all respondents said they had experienced homophobia, and it influenced their decision to be open about their sexual orientation.

One in five men said they had moved away from friends or family because of their sexual orientation, while two in five said they had been told to seek professional help because they were sexually attracted to men, including being told to consult clergy or a mental-health professional.

The gay/bisexual community is aging, like the rest of Canada. That is reflected in the survey findings that show far more men suffer from chronic health conditions like high blood pressure (18 per cent), arthritis (16 per cent), respiratory illness (14 per cent) and diabetes (9 per cent) than HIV-AIDS (6.6 per cent).