A new report from the UK suggests what many of us have been arguing for years now: HIV stigma drives some HIV-positive men to engage in riskier sex practices.

Here's the meat of the findings, with quotes from the news article:

1. Rejection and Stigma Shape Risk Management: "The researchers argue that men’s concerns about rejection and stigma shape the way they manage risk. Disclosure leaves men vulnerable to significant harm, including violent reactions and anxiety about ex-partners using police investigations as retribution, as well as rejection leading to emotional upset and problems finding sexual partners. In a community that often remains hostile to people with HIV, men’s instinct for self-preservation often leads them to choose behaviours where disclosure is felt to be unnecessary."

2. Poz Men Rely on Saunas, 'Poz Spaces,' to Obviate Need for Disclosure:: "For example, many men used saunas, not just because sex was readily available, but also because the men assumed that almost all other sauna users were HIV-positive. Like online chat rooms or HIV support group meetings, saunas were thought to be ‘HIV-positive spaces’ where men had implicitly announced their HIV status simply by being there. This allowed men to have unprotected sex there without an explicit discussion of HIV status, but leaving them with their sense of personal integrity intact."

3. Some Men Suggest Condoms Instead of Disclosing Status:"In some settings, some men tried to avoid disclosure but maintain their sense of moral integrity by suggesting to sexual partners that it would be a good idea to use a condom. Nonetheless one man described how these suggestions prompted one sexual partner to ask directly whether he had HIV. When he said yes, the man became angry and left."

4. Some Tick 'Safer Sex Needs Discussion' Box on Online Profile Instead of Disclosing: Another form of implicit disclosure that men tried was ticking ‘safer sex needs discussion’ on a Gaydar internet profile. Few men explicitly advertised their HIV status on their profile, but might mention it during private instant messaging. The respondents described ambiguities and misunderstandings in disclosure on the internet, but generally found that the internet enabled them to screen potential partners with less fear of disappointment or reprisal."

5. Behavioral Risk Reduction Strategies Limited: "Nonetheless, the researchers found that men used risk reduction strategies to quite a limited extent. No respondents mentioned reducing the duration of anal intercourse or the impact that viral load or a sexually transmitted infection could have on the risk of transmission. Just a few men discussed the greater risk of infection for the receptive partner or the possible benefit of withdrawing before ejaculation."

6. Some Serosort, But Highly Controversial Topic: "Some men did practice some form of serosorting (seeking partners of the same HIV status) and respondents said that it allowed them to have uninhibited sex where HIV status did not remain the most salient concern throughout. Nonetheless the researchers stress that very few men exclusively practiced serosorting in a way that could guarantee that both partners had the same HIV status. Disclosure was often implicit (by being in a sauna, for example) or was not reciprocal... However, the majority of men actually rejected the idea of serosorting. It was associated in their minds with high-risk, esoteric practices, and in the words of one respondent, men who are “going spreading it round because they are shagging willy-nilly”. Many men were at pains to distance themselves from this behaviour. They were appalled by the idea that unprotected sex could ever be a regular or planned activity, and so rejected serosorting, strategic positioning, withdrawal before ejaculation and other risk-reduction strategies."

7. Many Aspire to Use Condom Everytime -- But Lack Self-Confidence, Skills to Implement Goal: "Nonetheless these same men had all had some unprotected sex. It tended to be described as an exceptional event, explained by circumstances such as substance use or a partner’s insistence. The researchers make it clear that a number of men lacked the self-confidence or negotiation skills to manage such situations. Many men aspired to use a condom every time, but were not able to fall back on risk-reduction strategies when, for whatever reason, condoms weren’t used."

Thus, we need stigma interventions. Now.

(Via Lifelube)