Generationing, stealthing,  and gift giving: the intentional  transmission of HIV by  HIV-positive men to their  HIV-negative sex partners

Abstract

Gift giving is the process by which an HIV positive person purposely infects an HIV-nega tive person with HIV, usually with that person’s knowledge and consent. Little has been written about this HIV transmission practice. In this paper, two specific types of gift giving – gener ationing and stealthing – are explained and introduced to the scientific literature. Generationing is a type of gift giving in which one gift giver successfully infects a previously uninfected man with HIV, and then the two men collaborate in an effort to seroconvert another man, and so forth. Stealthing is anoth er type of gift giving in which an HIV-positive man actively tries to infect an HIV-negative man with HIV, without the latter’s knowledge or consent. The present study reports on the prevalence of gift giving (4.6%) in a population of men who use the Internet specifically to identify partners for unprotected sex. The research is based on a national random sample of 332 men who have sex with men, identified from 16 websites. Data were collected via tele phone interviews conducted between January 2008 and May 2009. The paper concludes with a discussion of the implications of these find ings for HIV prevention and intervention efforts. Most notably, to the extent that genera tioning, stealthing, and gift giving occur among MSM, they represent a very high risk of HIV transmission. More work needs to be done to understand these behaviors, the factors that underlie them, and to determine how prevalent they are in the bare-backing population of MSM.