Objectives: To examine gay men's patterns of self-disclosure of HIV seropositivity to friends, lovers, relatives and colleagues; to assess the effects of disclosure; and to identify reasons for not disclosing to particular individuals.Design: Longitudinal questionnaire survey of gay men.Methods: A total of 163 HIV-positive men participating in the AIDS Behavioral Research Project, a longitudinal study of San Francisco gay men, completed questionnaires about their self-disclosure patterns, health status, and psychological well-being.Results: HIV-positive men were most likely to disclose their status to lovers and closest gay friends. Asymptomatic men were less likely to disclose to relatives and colleagues than symptomatic men. Friends and lovers were rated as responding more helpfully than relatives and colleagues. Men who perceived their significant others as responding more helpfully were less depressed and anxious currently and 1 year later. A variety of reasons were given for not disclosing, including not wanting to worry others, fear of discrimination, fear of disrupting relationships, and emotional self-protection.Conclusion: While disclosure can have advantages for both HIV-positive individuals and their significant others, HIV-positive individuals must be assured that the benefits of doing so will outweigh the potential costs.

Predictors of unprotected anal intercourse were examined among 508 gay men in San Francisco. The cohort was recruited in 1983-84 at which time 49.8 percent of non-monogamous men (N = 435) and 71.2 percent of monogamous men (N = 73) reported practicing unprotected anal intercourse. Only 12 percent of non-monogamous and 27.4 percent of monogamous men reported these practices in 1988. The non-monogamous men who practiced unprotected anal intercourse in 1984 were more likely to be younger, to report that unprotected anal intercourse was their favorite sexual activity, to be low in perceived efficacy to change sexual behavior, to report that friends were more likely to engage in high-risk behaviors, to have less knowledge of health guidelines, and to be less depressed at that time. Non-monogamous individuals who in 1984 reported that unprotected anal intercourse was their favorite sexual activity were more likely to practice that behavior in 1988. Those who knew their serostatus as positive were less likely to report unprotected anal intercourse in 1988. These data infer that in order to modify AIDS-related high-risk behaviors, community risk-reduction programs be differentially aimed at young persons so as to increase personal efficacy about risk reduction, challenge peer norms, promote antibody testing, and eroticize safer sexual activities.