How Does HIV Affect Gay and Bisexual Men?
In the United States, gay, bisexual, and other men who have sex with men (MSM) are the population most affected by HIV. According to the Centers for Disease Control and Prevention (CDC), about 67% of people diagnosed with HIV in 2015 in the United States were gay and bisexual men.
Among all gay and bisexual men, African Americans are the racial/ethnic group most affected by HIV. CDC reports that in 2015, more African-American gay and bisexual men were newly diagnosed with HIV than white or Hispanic/Latino gay and bisexual men.
What Factors Put Gay and Bisexual Men at Risk for HIV Infection?
Because of the high percentage of gay and bisexual men who are living with HIV, the risk of being exposed to HIV is increased for a gay or bisexual man.
Other factors may also put gay and bisexual men at risk for HIV infection:
- Anal sex. Most gay and bisexual men get HIV through having anal sex without using condoms or without taking medicines to prevent HIV (known as pre-exposure prophylaxis or PrEP). Anal sex is the riskiest type of sex for getting or spreading HIV.
- Homophobia, stigma, and discrimination. Negative attitudes about homosexuality may discourage gay and bisexual men from getting tested for HIV and finding health care to prevent and treat HIV.
What Steps Can Gay and Bisexual Men Take to Prevent HIV Infection?
Gay and bisexual men can take the following steps to reduce their risk of HIV infection:
Have less risky sex.
Unprotected anal sex is the highest-risk sexual activity for HIV transmission. Insertive anal sex (topping) is less risky for getting HIV than receptive anal sex (bottoming). Unprotected oral sex can also be a risk factor for HIV transmission, but it carries a lower risk than anal sex.
Limit the number of sex partners.
The more partners you have, the more likely you are to have a partner with HIV whose HIV is not well controlled or to have a partner with a sexually transmitted disease (STD). Both of these factors can increase the risk of HIV transmission.
Use condoms correctly.
Read this CDC fact sheet: The Right Way to Use a Male Condom.
Consider pre-exposure prophylaxis (PrEP).
PrEP is an HIV prevention option for people who don't have HIV but who are at high risk of becoming infected with HIV. People on PrEP take a specific HIV medicine every day. PrEP should always be combined with other prevention options, such as condoms.
Consider PrEP if you do not have HIV and:
- you are in an ongoing sexual relationship with an HIV-positive partner; or
- you are sexually active but not in an exclusive relationship with a recently tested, HIV-negative partner, and you have had anal sex without a condom or you have been diagnosed with an STD in the past 6 months; or
- you have injected drugs in the past 6 months and have shared needles or injection drug equipment ("works") or been in a drug treatment program in the past 6 months.
To learn more, read the AIDSinfo fact sheet on PrEP.
Consider post-exposure prophylaxis (PEP).
PEP is the use of HIV medicines to reduce the risk of HIV infection soon after a possible exposure to HIV. PEP may be used, for example, after a person who does not have HIV has sex without a condom with a person who has HIV. To be effective, PEP must be started within 3 days after the possible exposure to HIV. PEP involves taking HIV medicines each day for 28 days. PEP is intended for emergency situations. It is not meant for regular use by people who may be exposed to HIV frequently.
Get tested for HIV.
Whether you test HIV positive or HIV negative, you can take action to protect your health and prevent HIV transmission.
How Often Is HIV Testing Recommended for Gay and Bisexual Men?
CDC recommends that all sexually active gay and bisexual men get tested for HIV at least once a year. However, some sexually active gay and bisexual men (including people who have more than one partner or have had casual sex with people they don't know) may benefit from getting tested more often, for example, every 3 to 6 months.
Visit this CDC webpage to learn more about HIV testing and to find a testing location near you: Start Talking. Stop HIV.
I Am a Gay Man Living With HIV. How Can I Protect My Partner From HIV?
Take HIV medicines every day. Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone who has HIV. ART can't cure HIV infection, but it reduces the amount of HIV in the body (called the viral load). Having less HIV in your body will improve your health and also reduce your risk of passing HIV to your partner during sex, but will not eliminate the risk completely.
In addition, remember to always use condoms during sex. And for added protection, talk to your partner about using PrEP.
Where Can I Find More Information About HIV and Gay and Bisexual Men?
Browse the following CDC webpages to find more information. This fact sheet is based on information from these sources:
- Gay and Bisexual Men's Health: For Your Health: Recommendations for a Healthier You
- HIV Among Gay and Bisexual Men
- HIV Among African American Gay and Bisexual Men
- Pre-Exposure Prophylaxis (PrEP)
[Note from TheBody: This article was created by AIDSinfo, who last updated it on Apr. 5, 2018. We have cross-posted it with their permission.]