HIV and Gay and Bisexual Men
- In the United States, gay and bisexual men are the population most affected by HIV.
- The Centers for Disease Control and Prevention (CDC) recommends that all sexually active gay and bisexual men get tested for HIV at least once a year. Some sexually active gay and bisexual men may benefit from getting tested more often, for example, every 3 to 6 months.
- Gay and bisexual men who are HIV negative but at risk of getting HIV should consider pre-exposure prophylaxis (PrEP). PrEP is when people who do not have HIV but who are at risk of getting HIV take HIV medicine every day to reduce their chances of HIV infection.
Does HIV affect gay and bisexual men?
In the United States, gay and bisexual men are the population most affected by HIV. According to the Centers for Disease Control and Prevention (CDC), in 2019, adult and adolescent gay and bisexual men accounted for 69% of the new HIV diagnoses in the United States and dependent areas.
What factors put gay and bisexual men at risk for HIV infection?
The high percentage of gay and bisexual men who are living with HIV means that, as a group, they have a greater risk of being exposed to HIV.
Other factors may also put gay and bisexual men at risk for HIV infection:
- Anal sex. Most gay and bisexual men get HIV from having anal sex without using condoms or without taking medicines to prevent or treat HIV. Anal sex is the riskiest type of sex for getting HIV or passing it on to others (called HIV transmission).
- 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:
Choose less risky sexual behaviors.
Receptive anal sex is the riskiest type of sex for getting HIV. Insertive anal sex (topping) is less risky for getting HIV than receptive anal sex (bottoming). In general, there is little to no risk of getting or transmitting HIV from oral sex.
Limit your number of sex partners.
The more partners you have, the more likely you are to have a partner with poorly controlled HIV or to have a partner with a sexually transmitted disease (STD). Both factors can increase the risk of HIV transmission.
Use condoms correctly every time you have sex.
Read this CDC fact sheet: External (sometimes called Male) Condom Use.
Consider pre-exposure prophylaxis (PrEP).
Pre-exposure prophylaxis (PrEP) is when people who do not have HIV but who are at risk of getting HIV take HIV medicine every day to reduce their chances of HIV infection. PrEP can be combined with other prevention methods, such as condoms, to reduce the risk of HIV even further. To learn more, read the HIVinfo fact sheet on Pre-Exposure Prophylaxis (PrEP).
Consider post-exposure prophylaxis (PEP).
Post-exposure prophylaxis (PEP) is the use of HIV medicines soon after a possible exposure to HIV to prevent becoming infected with HIV. For example, a person who is HIV negative may use PEP after having sex without a condom with a person who is HIV positive. To be effective, PEP must be started within 72 hours after the possible exposure to HIV. To learn more, read the HIVinfo fact sheet on Post-Exposure Prophylaxis (PEP).
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. Some sexually active gay and bisexual men (including those who have more than one partner or have had casual sex with people they do not 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: Let’s Stop HIV Together.
How should a gay man living with HIV protect his 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 cannot cure HIV infection, but it can reduce the amount of HIV in the body (called the viral load).
A main goal of ART is to reduce a person’s viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV whose viral load stays undetectable have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Maintaining an undetectable viral load is also the best way to stay healthy.
Other steps you can take include using condoms during sex and talking to your partner about taking PrEP.
This fact sheet is based on information from the following sources:
- Gay and Bisexual Men's Health: For Your Health: Recommendations for a Healthier You
- HIV and Gay and Bisexual Men
- Pre-Exposure Prophylaxis (PrEP)
- Post-Exposure Prophylaxis (PEP)
- HIV Prevention
Also see the HIV Source collection of HIV links and resources.