RAND Study Finds Some HIV-Positive People Deliberately Choose Sexual Abstinence

Eleven percent of gay or bisexual men, 18 percent of heterosexual men and 18 percent of women being treated for the virus that causes AIDS deliberately chose to be sexually abstinent, according to a survey by the RAND Corporation.

The RAND Health study, published in the June edition of the American Journal of Public Health, was the first to examine the issue among a representative group of people being treated for HIV (the Human Immunodeficiency Virus).

“We really haven't had a good estimate of how many people who are HIV-positive have deliberately chosen to be sexually inactive,” said Laura Bogart, a RAND psychologist and lead author of the study. “This information may be useful to those who create HIV education and prevention programs.”

RAND researchers analyzed information from 1,339 people who took part in the RAND-based HIV Cost and Services Utilization Study, the only study to date of a nationally representative group of HIV-positive patients. Researchers found that 415 of study participants were sexually inactive, but just 201 said they had deliberately chosen to be abstinent.

Participants were asked if they had engaged in oral, anal or vaginal sexual intercourse over the previous six months. Those who had not were asked questions about the reason for their inactivity, in order to distinguish those who were deliberately abstinent from those who were abstinent for other reasons.

The survey was conducted in 1998, but researchers say they believe the findings remain valid because there have been no major changes in the treatment of HIV since that time that would prompt HIV patients to alter their behavior.

Gay and bisexual men who chose to be sexually inactive were most likely to do so out of a perceived responsibility to protect others, according to the study. Heterosexual men and women more often chose to be sexually inactive if they were in poor health.

In the study, gay and bisexual men, heterosexual men, and women were all less likely to be deliberately sexually inactive if they had a spouse or partner.

Researchers say that fewer HIV-positive gay men may choose abstinence, compared to other groups living with the virus, because being HIV-positive creates less stigma in the gay community than it does in the rest of society. At the same time, this community seems to forge a link between personal responsibility and sexual behavior.

“HIV-positive gay men may be more informed about less risky sexual practices,” Bogart said. “We should increase education about safer sexual practices among other groups of HIV-positive patients.”

Previous studies had estimated that more than 30 percent of HIV-positive patients were sexually inactive, but those studies had not examined whether that abstinence was deliberate or not.

Funding for the study was provided by the National Institute of Child Health and Human Development, and the U.S. Agency for Healthcare Research and Quality.

Other authors of the study are Rebecca L. Collins, David E. Kanouse, Robin Beckman, Daniela Golinelli and Chloe E. Bird, all of RAND; and William Cunningham of UCLA's David Geffen School of Medicine and the UCLA School of Public Health.

RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care quality, costs and delivery, among other topics.