Closeted Men May Have Increased HIV Risks

A new study, published in the June issue of The Lancet, focused on HIV transmission rates among closeted men in the United Kingdom. With funding from The National Institutes of Health, a team of scientists and researchers from The University of Edinburgh studied participants' behavorial patterns, and now have growing concerns.

HIV prevention programs need to shift their focus to “neglected” populations of men who have sex with men (MSM) but do not identify as gay or bi, because they are more likely to be at risk of dangerous practices, study investigators said.

The same team conducted earlier work suggesting six percent of men who identified as straight at the time of their HIV diagnosis had in fact acquired the virus through sex with men. The new study indicates that this group of MSM also underestimated their risk of HIV and were less likely to be educated about the risks.

The study refers to this specific sub-group as  “potential non-disclosed MSM,” or pnMSM, in its findings. Analyzing previously available data, investigators observed samples from 14,405 subjects — including 8,452 MSM, 1,743 heterosexual women, and 1,341 heterosexual men. A total of 249 pnMSM were identified in the network of subjects.

According to the The Times, the team used a national archive of anonymous data to study patterns of HIV transmission, analyzing the genetic code of HIV samples from over 60,000 people living with HIV in the U.K. The team was able to create networks of linked transmissions to piece together how the virus spreads.

“We found that self-reported heterosexual men were more likely to link MSM and heterosexual women than heterosexual women were to link MSM and heterosexual men,” investigators found, “but the number of such transmission chains was small.”

The study states that pnMSM “are a subgroup distinct from both MSM and from heterosexual men.” Overall, researchers found that the group of men identified tended to have fewer sex partners and preferred to partner with each other — behaviors that could contribute to underestimating their risk. While pnMSM were generally good at using condoms consistently, the study showed they commonly avoided getting tested for HIV for long periods of time. There little evidence connecting this population to transmitting the virus to out gay men or heterosexual women.

Andrew Leigh Brown, of the School of Biological Sciences and the lead inestigator of the study told The Times, “Non-disclosed men who have sex with men are more likely to [contract HIV] by each other than by openly gay men and less likely to be aware of their risk.”

“The finding shows that public health messages should be targeted specifically at this neglected group. It also shows that large-scale studies of health data can be carried out without risk to individual privacy,” added Brown.

Men who identify as gay are half as likely as straight men to acknowledge their own sexuality on social media, which makes finding the accurate percentage of gay men today difficult.

Since this group of men are likely to distance themselves from the gay community, they also unknowingly distancing themselves from HIV awareness programs and testing facilities. HIV is now a treatable condition, but early detection and getting proper care is key to living a long, healthy life.