- Among all gay and bisexual men, African American gay and bisexual men are most affected by HIV.
- Diagnoses among all African American gay and bisexual men increased 22% in the last decade but have leveled off since 2010.
- Diagnoses among young African American gay and bisexual men increased 87% in the last decade but actually declined 2% in the last 5 years.
In the United States, gay, bisexual, and other men who have sex with men1 are disproportionately affected by HIV. Among gay and bisexual men, black/African American2 men -- especially those who are younger -- are the group most affected by HIV. While the number of new diagnoses declined for African Americans as a whole in recent years, diagnoses among African American gay and bisexual men increased between 2005 and 2014. However, that upward trend has stabilized since 2010.
HIV and AIDS Diagnoses3
- Among all gay and bisexual men diagnosed with HIV in the United States in 2014, African Americans accounted for the highest number (estimated 11,201; 38%), followed by whites (estimated 9,008; 31%) and Hispanics/Latinos4 (estimated 7,552; 26%).
- In 2014, an estimated 39% (4,321) of African American gay and bisexual men diagnosed with HIV were aged 13-24. An estimated 36% (3,995) were aged 25-34; 13% (1,413) were aged 35-44; 9% (989) were aged 45-54; and 4% (486) were aged 55 or older.
- From 2005 to 2014, the number of new HIV diagnoses among African American gay and bisexual men increased 22%. But that number stabilized in recent years, increasing less than 1% between 2010 and 2014.
- From 2005 to 2014, the number of new HIV diagnoses among young African American gay and bisexual men (aged 13 to 24) increased 87%. But that trend has leveled off, with the number declining 2% between 2010 and 2014.
- Among all gay and bisexual men diagnosed with AIDS in the United States in 2014, African Americans accounted for the highest number (estimated 4,343; 39%), followed by whites (estimated 3,564; 32%) and Hispanics/Latinos (estimated 2,665; 24%).
Living With HIV
- By the end of 2013, an estimated 493,543 gay and bisexual men were living with diagnosed HIV infection. Of those, 152,303 (31%) were African American, 210,299 (43%) were white, and 104,529 (21%) were Hispanic/Latino.
In addition to risk factors affecting all gay and bisexual men (a larger percentage of men with HIV in sexual networks, sexual risk factors such as anal sex, more sex partners compared to other men), several factors are specific to African American gay and bisexual men. These include:
- Socioeconomic factors. African Americans are more likely than men of some other races/ethnicities to experience socioeconomic factors -- such as limited access to and use of quality health care, lower income and educational levels, and higher rates of unemployment and incarceration -- that place them at higher risk for HIV infection. These factors may help explain why African Americans have not made greater gains on the HIV continuum of care. Of African Americans living with HIV infection at the end of 2012, 86% had been diagnosed, but only 37% had been prescribed antiretroviral therapy (medicines to treat HIV) and only 29% had achieved viral suppression.5
- Smaller and more exclusive sexual networks. African American gay and bisexual men are a small subset of all gay and bisexual men, and their partners tend to be of the same race. Because of the small population size and the higher prevalence of HIV in that population relative to other races/ethnicities, African American gay and bisexual men are at greater risk of being exposed to HIV within their sexual networks.
- Sexual relationships with older men. Having sexual relationships with older men, who are more likely to have HIV, may increase risk for exposure among some young African American gay and bisexual men.
- Lack of awareness of HIV status. Though African American gay and bisexual men report higher HIV testing in the past year than Hispanic/Latino or white gay and bisexual men, they are also more likely to be HIV-positive and not know it because of the higher prevalence of HIV in the population.6 People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others.
Stigma, homophobia, and discrimination put gay and bisexual men of all races/ethnicities at risk for multiple physical and mental health problems and may affect whether they seek and are able to receive high-quality health services, including HIV testing, treatment, and other prevention services.
What CDC Is Doing
CDC is addressing HIV among African American gay and bisexual men with three areas of commitment:
- Engaging African American gay and bisexual communities and strategic partners.
- Expanding and focusing on the prevention strategies and programs with the greatest impact.
- Evaluating and disseminating information on prevention strategies and programs.
CDC funds state and local health departments and community-based organizations (CBOs) to support HIV prevention services for gay and bisexual men. In 2015, CDC added two new funding opportunities (FOAs) to help health departments reduce HIV infections and improve HIV medical care among gay and bisexual men of color. These FOAs will increase gay and bisexual men's access to pre-exposure prophylaxis (PrEP), increase health departments' surveillance capacity, and support effective models of prevention and care for gay and bisexual men of color.
CDC is also supporting Capacity Building Assistance for High-Impact HIV Prevention, a national program that addresses gaps in each step of the HIV care continuum by providing training and technical assistance for staff of health departments, CBOs, and health care organizations. The estimated annual funding is $22 million.
CDC awarded $55 million over 5 years to 34 CBOs to provide HIV testing to more than 90,000 young gay and bisexual men of color, with the goals of identifying more than 3,500 previously unrecognized HIV infections and linking those who have HIV to care and prevention services.
Through its Act Against AIDS campaigns, CDC provides African American gay and bisexual men with effective and culturally appropriate messages about HIV prevention and treatment. For example,
- Doing It, a new national HIV testing and prevention campaign, encourages all adults to know their HIV status and protect themselves and their community by making HIV testing a part of their regular health routine.
- Start Talking. Stop HIV. helps gay and bisexual men communicate about safer sex, testing, and other HIV prevention issues.
- HIV Treatment Works shows how people living with HIV have overcome barriers to stay in care and provides resources on how to live well with HIV.
- Partnering and Communicating Together (PACT) to Act Against AIDS, a new 5-year partnership with organizations such as the National Black Justice Coalition and the Black Men's Xchange, is raising awareness about testing, prevention, and retention in care among populations disproportionately affected by HIV, including African Americans.
To learn more, visit the CDC Gay and Bisexual Men's Health site.
- The term men who have sex with men is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This fact sheet uses the term gay and bisexual men.
- Referred to as African American in this fact sheet.
- HIV and AIDS diagnoses indicate when a person is diagnosed with HIV infection or AIDS, not when the person was infected.
- Hispanics/Latinos can be of any race.
- A person with a suppressed viral load has a very low level of the virus. That person can stay healthy and has a dramatically reduced risk of transmitting the virus to others.
- Based on CDC's National HIV Behavioral Surveillance, which conducts behavioral surveys among populations at increased risk of HIV infection.
- CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2015;26. Accessed January 20, 2016.
- CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data -- United States and 6 dependent areas -- 2013. HIV Surveillance Supplemental Report 2015;20(2). Accessed January 20, 2016.
- CDC. HIV infection risk, prevention, and testing behaviors among men who have sex with men -- National HIV Behavioral Surveillance, 20 U.S. cities, 2014. HIV Surveillance Special Report 2016;15. Accessed February 1, 2016.
- CDC. High-impact HIV prevention: CDC's approach to reducing HIV infections in the United States. Accessed January 20, 2016.
- CDC. Progress along the continuum of HIV care among blacks with diagnosed HIV -- United States, 2010. MMWR 2014;63(5):85-9.
- Millett GA, Peterson JL, Flores SA, et al. Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis. Lancet 2012;380(9839):341-8. PubMed abstract.
- CDC. Prevalence and awareness of HIV infection among men who have sex with men -- 21 cities, United States, 2008. MMWR 2010;59(37):1201-7.
- Ford CL, Whetten KD, Hall SA, Kaufman JS, Thrasher AD. Black sexuality, social construction, and research targeting "The Down Low" ("The DL"). Ann Epidemiol 2007;17(3):209-16. PubMed abstract.
- Wolitski RJ, Fenton KA. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav 2011;Suppl 15:S9-17. PubMed abstract.