Abstinence in people with HIV

Another population that - in some cases - appears to be practising abstinence as an HIV prevention method is HIV-positive people. Whether this is a conscious choice not to have sex or due to isolation, illness, low self-esteem, rejection or lack of confidence following an HIV diagnosis is a different matter.

One US survey, for instance¹ found that 18.5% of gay men and 26% of heterosexual men and women living with HIV had not had sex in the three months prior to the survey. This appears to be particularly the case with women. The Padare Project, for instance, in a survey of HIV-positive Africans living in London,² found that while only 10% of men had not had sex in the previous four weeks, among women the proportion rose to one-third.

Although much of this lack of a sex life will be due to factors cited above, some individuals with HIV have taken a conscious choice to be sexually abstinent in order not to pass on their HIV. Another survey, in 2006,³ looked at the sex lives of people with HIV from the US HIV Cost and Services Utilization Study (HCSUS) and asked people specifically about elective abstinence.

Of the 1339 HCSUS respondents whose data were analysed, 415 participants reported being sexually inactive in the previous six months. Of those, 201 were deliberately abstinent. The likelihood of elective abstinence was higher among women and heterosexual men, older participants, and those with a stronger sense of responsibility according to questionnaire measures. It was lower among those with a primary relationship partner/spouse, those on antiretroviral therapy, subjects with CD4 counts of 50 or higher, and drinkers. Among gay men, higher perceived responsibility for limiting disease transmission and non-drinking status were related to deliberate abstinence.