Just a quick follow-up on the “Jump the Shark” post about sexual ethics from last week. Read that first, or this post will make even less sense. I tried to stop thinking about this topic but over the weekend This American Life dedicated an entire segment of their most recent show to young men practicing unsafe sex and getting tested for HIV. So much for moving on.
One of HaifischGeweint’s major points of rebuttal is that anyone would be unreasonable to assume that their sexual partners are “clear” rather than “poz” as opposed to asking them outright. I’d like to try to quantify his intuition using the most relevant state level data for the case which I wrote about last time. According to the report, the prevalence rate among Kansas men stood at 132 per 100,000 during the time period just after the events described in the criminal case. In other words, those two women who had supposed Rob to be HIV negative had a 99.87% chance of guessing correctly, and only a .13% chance of guessing wrongly, as they did. (We could also use the background information of Rob’s race and his age cohort, but they tend to cancel each other out in this case, as he is in the lowest risk group in the former category and the highest risk group in the latter.)
Of course, these women probably thought that their chances were even better than the tables would indicate, because a decent fraction of the HIV+ population could be counted upon to disclose, in compliance with the generally accepted ethical obligation to let people know that you might be transmitting a potentially lethal virus on to them prior to any consensual exchange of bodily fluids, not to mention state law.
Now perhaps these women were indeed being somewhat unreasonable to assume that their new partner was HIV negative, as HG contends, but given the background probability of infection in the relevant patient population, they weren’t being all that unreasonable. More to the point, though, we should hold people to a duty to disclose rather than blame the victim for failing to inquire, whenever someone is found to be recklessly “pozzing up negs,” as the kids say.
The moral duty to disclose must rest upon those who can disclose, rather than those who can only inquire and hope for an honest response. Informational asymmetry is a form of power, and Rob took advantage of that power for the sake of gaining sexual access that would otherwise have been withheld. This is an expression of selfishness so extreme as to make even a Nietzschean Randroid blush, a complete disregard for any consequences beyond one’s own immediate pleasure.
In summary: Testing without disclosure is worthless, and disclosure without testing is pointless. We need to combine an ethos of regular testing with a stronger mutual obligation to disclose, or else we can expect HIV prevalence rates to continue their upward march.
