Heterosexual HIV transmission: ethics of disinformation and the importance of adhering to an evidence-based approach in psychotherapeutic practice

Abstract

For a quarter of a century the threat of HIV has been the predominant public health message to the heterosexual community. Despite an ever-increasing quantity of research that has cast doubt on the ease of penile-vaginal sexual transmission and despite the discredited nature of the message in the public domain, it continues unabated. Whilst condom use continues at a very low level and sexually transmitted infections other than HIV have increased very markedly over recent years, research evidence shows that HIV is not readily transmitted through unprotected penile-vaginal sex, unless genital epithelial tissues are already unhealthy or become so due to concomitant bacterial transmission. Further, the broad sweep heterosexual HIV message serves to threaten the safety of our clients because it concentrates on advocating condom use but does not emphasize the benefits of frequent STI testing and, most significantly, it fails to specifically target increasingly common sexual behaviours that do pose major risks of HIV infection for heterosexual individuals. As psychotherapeutic practitioners we have an ethical duty to present the full facts to our clients. If we do not familiarise ourselves with evidence-based research and challenge status quo viewpoints, we are acting unethically and not in the best interests of individual client self-determination.

Keywords:

• heterosexual HIV
• HIV
• STI
• risk factors
• ethical issues