In the era of the Internet and Oprah, in which formerly taboo
information is readily available or freely confided, secrecy and
privacy have in many ways given way to an onslaught of confession.
Yet for those who are HIV positive, decisions about disclosure of
their diagnosis force them to confront intimate, fundamental, and
rarely discussed questions about truth, lies, sex, and trust.
Drawing from interviews with over seventy gay men and women,
intravenous drug users, sex workers, bisexual men, and heterosexual
men and women, the authors provide a detailed portrait of moral,
social, and psychological decision making. The interviews convey
the complex emotions of love, lust, longing, hope, despair, and
fear that shape individual dilemmas about whether to disclose to,
deceive, or trust others concerning this disease. Some of those
interviewed revealed their diagnosis widely; others told no one.
Some struggled and ultimately told their partners; others spoke in
codes or half-truths. One woman discovered her husband's diagnosis
in a diary; when confronted, he denied it.
Each year in the United States, 40,000 new cases of HIV arise,
yet approximately one-third of the 900,000 Americans who are
infected do not know it. As treatments have improved, unsafe sexual
behavior has increased and efforts at prevention have stalled. Many
of those infected continue to fear and experience rejection and
discrimination. Addressing broad debates about the nature of
secrecy, morality, and silence, this book explores public policy
questions in the light of the nuanced, private decisions that are
shaping the course of an epidemic and have broader indications for
all.
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