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HIV Prevention Q&As

Start talking. Stop HIV.

Q1. What are some of the reasons why gay and bisexual men are at higher risk for HIV?

There are complex reasons why gay and bisexual men are at higher risk for HIV. Some of the reasons are listed below.

HIV severely affects gay and bisexual men–more than any other group in the United States. Gay and bisexual men make up about 2% of the overall population, but account for approximately two-thirds of all new HIV infections each year. Data included in CDC’s 2013 National HIV Prevention Progress Report show that there was a 12% increase in new infections among gay and bisexual men overall between 2008 and 2010, and a 22% increase among young gay and bisexual men aged 13-24. Gay and bisexual men also account for over half of the 1.1 million people living with HIV in the United States. A 2011 study in 20 U.S. cities found that 18% of gay or bisexual men had HIV. That’s about 1 in 6 men. Of these men, 33% did not know they had HIV. Those who are unaware that they have HIV may infect others without knowing it. Also, those who do not know they are HIV-positive are not able to get HIV treatment that can protect their health and reduce the chance of transmitting HIV to their partners.

Learn more about HIV among gay and bisexual men.

Q2. I’m HIV-negative. How can I avoid getting HIV?

Your life matters and staying healthy is important. It’s important for you, the people who care about you, and your community. Knowing your HIV status gives you powerful information to help you take steps to keep you and your partners healthy. You should get tested for HIV, and encourage your partners to get tested too. If you test positive, you can get on treatment to stay healthy for many years and reduce the chance of transmitting HIV to your sex partners. If you test negative and are sexually active, continue to get tested at least once a year—some men may benefit from more frequent testing (e.g., every 3-6 months). To find a testing site near you, call 1-800-CDC-INFO (232-4636), visit hivtest.cdc.gov, text your ZIP code to KNOW IT (566948), or use a home testing kit.

For people who are sexually active, there are more tools available today to prevent HIV than ever before. The list below provides a number of ways that you can lower your chances of getting HIV. The more of these actions you take, the safer you can be.

  • If your partner is HIV-positive, encourage your partner to get and stay on treatment. ART reduces the amount of HIV virus (viral load) in blood and body fluids. ART can keep people with HIV healthy for many years, and greatly reduce the chance of transmitting HIV to sex partners if taken consistently and correctly.

Q3. My boyfriend and I are exclusive and we are both HIV-negative. How can we stay that way?

Being with one partner and agreeing to be sexually active only with each other, decreases your chance of getting HIV and other sexually transmitted diseases (STDs). But being in a relationship doesn’t automatically protect you from HIV.

It is important that you and your partner get tested for HIV and other STDs and share your test results with one another or get tested together as a couple. The only way to know your HIV status for sure is to get tested, and do it at least once a year.

It is estimated that between 30% to 70% of HIV infections among gay men are acquired from their main sexual partner. Many of these infections can happen early in a relationship, because men may not have accurate knowledge about their own or their partner’s HIV status and they stop using condoms or other prevention strategies as the relationship becomes more serious. In addition, while you and your partner may never have sex outside of your relationship, some men do. While you may know your partner’s status today, you may not always know if your partner is having sex outside of the relationship or doing other things to increase the chance for getting HIV, such as injecting drugs.

Some people choose to keep using condoms when they are in an exclusive relationship for further protection from HIV and other STDs. In fact, because many STDs show no symptoms, you or your partner could have an STD from an earlier relationship and not even know it.

It is important that you and your partner have ongoing conversations about these issues to stay healthy, and protect you both from HIV. 

Q4. My boyfriend is living with HIV and I am not. What is the best way for us to keep me from getting HIV?

There are more options available today than ever before to keep your partner healthy and to reduce your chance of getting HIV. But it is important to know that your overall chance of getting HIV increases the more times you have sex with someone who is living with HIV. So, while any of these actions alone can lower your chance of getting HIV, you can lower your chances even more by taking multiple actions. The more actions you take, the safer you can be.

The following actions can lower your chance of getting HIV:

It is also important for you to get tested for HIV at least once a year, so you are sure about your HIV status. You may benefit from more frequent testing (e.g., every 3-6 months). Knowing your HIV status gives you powerful information to help you take steps to keep you and your partners healthy (see Q7. When should I get tested for HIV and other STDs?). To find a testing site near you, call 1-800-CDC-INFO (232-4636), visit hivtest.cdc.gov, text your ZIP code to KNOW IT (566948), or use a home testing kit.

Q5. I am living with HIV. What should I do to keep my partners from getting HIV?

Photo of two men lying on a blanket, facing each other, talking.Taking care of yourself and staying healthy is important. Your life matters.

Talk about your HIV status with all of your sexual partners and take steps to protect your health and your partners' health.

The following actions can reduce your risk of transmitting HIV:

You should also encourage your partners who are HIV-negative to get tested for HIV at least once a year so they are sure about their HIV status and can take action to keep them healthy. They may benefit from more frequent testing (e.g., every 3-6 months). (see Q7. When should I get tested for HIV and other STDs?). To find a testing site near them, they can call 1-800-CDC-INFO (232-4636), visit hivtest.cdc.gov, text their ZIP code to KNOW IT (566948), or use a home testing kit.

Q6. My partner and I are living with HIV, and want to stay healthy. What can we do?

 Photo of two men talking in front of a steamy bathroom mirror. One man is shirtless with shaving cream on his face. Taking care of each other and keeping you both healthy is important.

You and your partner should take steps to protect your health—for yourselves, for each other, and for those who care about both of you.

If either of you have other sex partners who are HIV-negative or whose status you don’t know, the following strategies can reduce your risk of transmitting HIV:

You may also want to encourage your partners who are HIV-negative to get tested for HIV at least once a year, so they are sure about their HIV status.

Q7. When should I get tested for HIV and other sexually transmitted diseases (STDs)?

All sexually active gay and bisexual men should be regularly tested for STDs. The only way to know your STD status is to get tested. Having an STD (like gonorrhea) makes it easier to get HIV, so it’s important to get tested to protect your health and the health of your partner. CDC recommends sexually active gay and bisexual men test for:

Your health care provider can offer you the best care if you discuss your sexual history openly. Talk with your provider about getting vaccinations for hepatitis A and B, and HPV. You should have a provider you are comfortable with. CDC’s Lesbian, Gay, Bisexual and Transgender Health Services page has resources that can help you find health services that are gay-friendly.

Q8. What types of sexually transmitted disease (STD) tests do I need to ask my doctor about?

All sexually active gay and bisexual men should be regularly tested for STDs. The only way to know your STD status is to get tested (you can search for a testing site). Having an STD (like gonorrhea) makes it easier to get HIV, so it’s important to get tested to protect your health and the health of your partner. CDC recommends sexually active gay and bisexual men test for:

Your health care provider can offer you the best care if you discuss your sexual history openly. Talk with your provider about getting vaccinations for hepatitis A and B, and HPV. You should have a provider you are comfortable with. CDC’s Lesbian, Gay, Bisexual and Transgender Health Services page has resources that can help you find health services that are gay-friendly.

Q9. How can I keep from getting HIV from oral sex?

Oral sex involves giving or receiving oral stimulation to the penis (fellatio), the vagina (cunnilingus), or the anus (anilingus or rimming). Most types of oral sex carry little to no risk of HIV. Your highest oral sex risk is performing oral sex (fellatio) with ejaculation in your mouth. However, the risk is still low, and much lower than anal or vaginal sex. Factors that may increase the risk of transmitting HIV through oral sex are oral ulcers, bleeding gums, genital sores, and the presence of other sexually transmitted diseases (STDs) (which may or may not be visible).

The following things can reduce your risk of getting HIV through oral sex:

In addition, your chance of getting HIV from oral sex is lower if you are already taking pre-exposure prophylaxis (PrEP) consistently and correctly or if your partner is living with HIV and is taking antiretroviral therapy (ART) consistently and correctly.

Keep in mind that barrier methods are the only way to protect you from some STDs, including gonorrhea of the throat. And although the chance of getting or transmitting HIV from anilingus (rimming) is small, there is a big chance of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming. There are effective vaccines that protect against hepatitis A and B and human papillomavirus infections. Talk to your health care provider to see if these are right for you, if you have not already been vaccinated.

Q10. How well do condoms prevent HIV?

Male Condoms

Female Condoms

Although highly effective when used consistently and correctly, there is still a chance of getting HIV if you only use condoms, so adding other prevention methods can further reduce your risk (see Q2. I’m HIV-negative. How can I avoid getting HIV? and Q5. I am living with HIV, what should I do to keep my partners from getting HIV?)

Q11. I’m negative–can I take medicines to prevent getting HIV?

Yes. If you are HIV-negative there are two different ways you can take medicines to prevent HIV: pre-exposure prophylaxis (PrEP) pre-exposure prophylaxis (PrEP) and Post-exposure prophylaxis (PEP).

You should consider PREP if you’re in an ongoing sexual relationship with an HIV-positive partner. PrEP should also be considered if you have had a sexually transmitted disease (STD) or any anal sex (receptive or insertive) with a male partner without condoms in the past 6 months, and are not in an exclusive relationship with a recently tested, HIV-negative partner.

PrEP involves taking a pill (brand name Truvada) every day. You and your health care provider should consider the following factors in deciding whether PrEP is right for you:

Even when you use PrEP consistently and correctly, there still may be a chance that you can get HIV. Taking other actions, like using condoms consistently and correctly, can lower your chances of getting HIV even more.

PEP is medicine that is used to prevent HIV after a possible exposure. An example of a possible exposure is if you have anal sex without a condom with someone who is HIV-positive or whose HIV status you don’t know. You take PEP for 4 weeks if you may have been recently exposed to HIV and are not on PrEP. PEP keeps HIV from making copies of itself and turning into infection. To be effective, PEP must begin as soon as possible, but always within 72 hours (3 days) of a possible exposure. Keep in mind that PEP should only be used in situations right after a potential exposure. PEP is not intended for long-term use. It is not a substitute for other proven HIV prevention methods, such as correct and consistent condom use.

You should continue to use condoms with sex partners while taking PEP. If you have repeated exposures to HIV, you should consider PrEP.

Q12. Can I transmit HIV if I have an undetectable viral load?

Yes, it is possible that you could still transmit HIV. However, having an undetectable viral load greatly lowers the chance of transmitting the virus to your sexual partners who are HIV-negative. Having an undetectable viral load is also good for your overall health.

Viral load refers to the amount of HIV in the blood. An undetectable viral load is when the amount of HIV in the blood is so low that it can’t be measured. Antiretroviral therapy (ART) reduces viral load, ideally to an undetectable level, when taken consistently and correctly. If a person’s viral load goes down after starting ART, then the treatment is working. However, people with an undetectable viral load still have HIV in their body, which means there is a chance that they can transmit HIV through sex. An HIV-positive person can still potentially infect a partner even if they have an undetectable viral load, because of the reasons listed below.

Researchers are studying how much you can lower your chances of transmitting HIV when your viral load is undetectable, and we should know more when these studies are complete. 

If you are taking ART, follow your health care provider’s advice. Visit your health care provider regularly and always take your medicine as directed. This will give you the greatest chance of having an undetectable viral load. Taking other actions, like using a condom consistently and correctly, can lower your chances of transmitting HIV even more.

Q13. I am much more into talking about things than my partner is. I can’t always tell where things stand. Is it normal to want to have “check-in” conversations about HIV prevention?

Yes! It’s normal and important to talk about keeping healthy. The key to a good relationship is being able to talk about important but uncomfortable topics like sexual health, even if it seems awkward and you feel uneasy. Not talking about HIV can have serious consequences. It is important to talk openly and honestly with your partner about protecting your health and his. Get tips on how to start the conversation.

Q14. I’ve been with my partner for a couple of years now. Early on, we agreed to only be with one another, but lately I get the sense he might be messing around. What should I do?

 Photo of two men walking down the street while talking. The men are facing each other. Even when it’s awkward and/or difficult, finding a way to talk openly about difficult topics is important. Not talking about what is going on can have serious consequences. It is not uncommon for men to need to revisit earlier conversations as their relationship matures. You should also always take steps to keep you both healthy. Get tested and treated for HIV and other sexually transmitted diseases (STDs) and encourage your partner to do the same. Protect yourself from HIV and other STDs. HIV prevention strategies include using condoms correctly and consistently, as well as medicines to prevent HIV infection (see PrEP and PEP).

Get tips on how to start the conversation.

Q15. My partner and I have been together for years. We had these conversations back when we first started dating. Why do we need to keep talking about this stuff?

 Photo of two men standing back to back in a nightclub. Each man is looking down at his cell phone seemingly texting. The key to a healthy relationship is talking–and talking often, even about challenging topics! In the time you’ve been together, you both may have changed or grown in many ways. A check-in provides an opportunity to get a pulse check on your relationship, and discuss related issues, such as sexual health. 

Get tips on how to start the conversation.

Q16. My partner and I are talking about an agreement for our relationship. What are some of the things we should consider to prevent HIV and sexually transmitted diseases (STDs)?

You should talk about the nature of your relationship, HIV, and STDs, and agree on something that works for both of you.

Some people may have agreements about if, when, and with whom it is okay to have sex outside the relationship. A common agreement is to be in an exclusive relationship (i.e., you and your partner only have sex with each other). Other agreements focus on the kind of sex that is allowed inside and outside of the relationship or what types of methods are used to decrease the chances of getting or transmitting HIV.

Negotiated safety is a term for one type of agreement. Negotiated safety is a way for HIV-negative couples who are in committed relationships to reduce their chance of getting HIV. Negotiating safety involves these steps:

It is important for you and your partner to get tested for HIV and other STDs at least once a year. (Please see When should I get tested for HIV and other STDs?)

If all of the conditions of negotiated safety are met between partners, it can reduce the chance of getting HIV. However, there still may be a chance of getting HIV, so taking other preventive actions can further reduce your risk (See Q2. I’m HIV-negative. How can I avoid getting HIV?).

*The time or window period between when people get HIV and when most HIV tests can detect it. Most HIV tests measure the antibodies that the human body makes to fight HIV. It takes time for a person’s body to produce enough antibodies for an HIV test to show that a person has HIV. The window period may be different depending upon the HIV test you take. You can ask your health care provider about the window period for the HIV test you are taking. If you are using a home test, you can get that information from the materials included in the packaging of the test.

Q17. What is a good way to bring up HIV status with a new partner?

You could start with a general conversation about sexual health. Ask about the last time your partner got tested for HIV and other sexually transmitted diseases (STDs) and ask about the results of those tests. Get other tips on how to start the conversation.

Q18. A friend has confided in me that he’s HIV-positive. What’s the best way to show him I’m supportive?

Listen. Talk. Support.

Q19. I’m afraid that if I tell my new partners that I am HIV-positive they will reject me. What should I do?

Feeling uncertain about disclosing your HIV status is very common, especially if you’re still adjusting to being HIV-positive and feeling anxious about your health and your future. Even if you’ve been living with HIV for some time, you may continue to find yourself in situations where it’s hard to disclose your status because of how people might react.

You will find that plenty of men will be accepting of your status–and you may even find out that your partner(s) is positive, as well.

But the reality is, there may be times when a partner is less accepting of your HIV status. When disclosing to your partner(s), encourage them to learn more about HIV to help dispel some of the myths and any potential fears that they might have. Try explaining that your status is just one part of who you are and that you are doing all you can to take care of your health and theirs. Discuss how you can work together to keep them safe and you healthy. Even if the conversation doesn't go the way you'd hoped and you’re unable to change how they feel immediately, it may help them be better informed.

If a partner cannot accept you, or chooses not to be with you, that can be difficult. Many people living with HIV have dealt with this situation and have found their way through it though—you will get through it, too. Disclosing your status is the right thing to do, and you should feel good about having taken a major step in keeping you and your partner(s) safe and healthy. You have to know that there are others out there who will respect and accept you.

It’s important to keep in mind that many states have laws that require you to tell your sexual partners if you are HIV-positive before you have sex (anal, vaginal, or oral) or share drugs or needles to inject drugs. In some states, you can be charged with a crime if you don’t tell your partner your HIV status, even if your partner doesn’t become infected. So again, telling your partner is the right thing to do. Learn more about state HIV-specific criminal laws.

 

 

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