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HIV and Gay and Bisexual Men

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 is a lower risk than anal sex.

Last updated 4/26/2016; last reviewed 4/26/2016)

 

Key Points

  • In the United States, gay, bisexual, and other men who have sex with men (MSM) are the population most affected by HIV. Among all gay and bisexual men, African Americans are the racial/ethnic group most affected by HIV.
  • CDC recommends that all gay and bisexual men get tested for HIV at least once a year. Sexually active gay and bisexual men should consider getting tested more often, for example, every 3 to 6 months.
  • Pre-exposure prophylaxis (PrEP) is an HIV prevention option for people who are HIV negative and at high risk of getting HIV. People on PrEP take a specific HIV medicine every day. HIV-negative gay and bisexual men at high risk of getting HIV should consider PrEP.

 

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), at the end of 2011, about 57% of people living with diagnosed HIV in the United States were gay and bisexual men, or gay and bisexual men who also inject drugs.

Among all gay and bisexual men, African Americans are the racial/ethnic group most affected by HIV. CDC reports that in 2010, African-American gay and bisexual men accounted for almost as many new HIV infections as white gay and bisexual men, although the African-American gay and bisexual male population is much smaller than the white gay and bisexual male population.

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 anal sex. Anal sex is the riskiest type of sex for getting or spreading HIV.
  • Many sex partners. Having more sex partners than other men increases the risk of HIV infection among gay and bisexual men.
  • Homophobia, stigma, and discrimination. Negative attitudes about homosexuality may prevent 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 is 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 infection (STI). 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 are HIV negative and:

  • 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 STI in the past 6 months; or
  • you have injected drugs in the past 6 months and have shared needles or works or been in a drug treatment program in the past 6 months.

To learn more, read this CDC fact sheet on PrEP.

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 gay and bisexual men get tested for HIV at least once a year. Recently, CDC has recommended that all sexually active gay and bisexual men should consider 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 infected with HIV. ART can’t cure HIV infection, but it reduces the amount of HIV in the body (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:

 

Source: AIDSinfo

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