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5 June 2018, 05:30
Men who have sex with other men but are not open about their sexuality could be underestimating their risk of contracting HIV, researchers have warned.
A University of Edinburgh study claimed that public health messages should be targeted specifically at this "neglected" group.
According to the research team, the men tend to mix with, and acquire infection from, each other and not from openly-gay men.
Potentially fearful of stigmatisation or prejudice, they are unlikely to mix in the same social venues as openly-gay men and are not likely to disclose that they have sex with other men.
The men are thought less likely to receive prevention messages and access the same healthcare as others and, as a result, they may be less aware of their HIV risk.
Researchers at the university used a national archive of anonymous data to study patterns of HIV transmission and they analysed the genetic code of virus samples from more than 60,000 HIV-positive people in the UK.
Scientists were able to create networks of linked infections to see how the virus had spread.
Earlier work from the same group suggested that 6% of men who claimed to be heterosexual at the time of diagnosis had actually become infected through sex with men.
The current study found the group of men identified tend to have fewer sex partners and prefer to partner with each other - behaviour that may lead to them underestimating their risk, researchers said.
Little evidence was found of them spreading the infection to openly-gay men or heterosexual women.
Professor Andrew Leigh Brown, of the School of Biological Sciences, who led the research, said: "Nondisclosed men who have sex with men are more likely to be infected by each other than by openly-gay men, and less likely to be aware of their risk.
"The finding shows that public health messages should be targeted specifically at this neglected group.
"It also shows that large-scale studies of health data can be carried out without risk to individual privacy."
The study, published in The Lancet HIV, was funded by the United States National Institutes of Health.