Gay and Bisexual Men's Health
Consistent and Correct Use of Condoms
To achieve maximum protection by using condoms, they must be used consistently and correctly.
The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use, rather than product failure.
Serosorting is a practice some gay, bisexual and other men who have sex with men (MSM) use in an effort to reduce their HIV risk. CDC does not recommend as a safer sex practice.
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.
How is HIV spread?
In the United States, HIV is spread mainly by
- Having sex with someone who has HIV. In general:
- Anal sex is the highest-risk sexual behavior. Receptive anal sex (bottoming) is riskier than insertive anal sex (topping).
- Vaginal sex is the second highest-risk sexual behavior.
- Having multiple sex partners or having other sexually transmitted infections can increase the risk of infection through sex.
- Sharing needles, syringes, rinse water, or other equipment (works) used to prepare injection drugs with someone who has HIV.
Less commonly, HIV may be spread by
- Oral sex—using the mouth to stimulate the penis, vagina, or anus (fellatio, cunnilingus, and rimming). Giving fellatio (mouth to penis oral sex) and having the person ejaculate (cum) in your mouth is riskier than other types of oral sex.
What are the signs and symptoms of HIV?
Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last for a week or two, but others have no symptoms at all. After initial infection, people may have no symptoms for years.
How can I prevent HIV?
Be smart about HIV. Here's what you can do:
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.
- Choose less risky sexual behaviors. Oral sex is much less risky than anal or vaginal sex. Anal sex is the highest-risk sexual activity for HIV transmission. If you are HIV-negative, insertive anal sex (topping) is less risky for getting HIV than receptive anal sex (bottoming). Sexual activities that do not involve the potential exchange of body fluids carry no risk for getting HIV (e.g., touching).
- Use condoms consistently and correctly.
- Reduce the number of people you have sex with. The number of sex partners you have affects your HIV risk. The more partners you have, the more likely you are to have a partner with HIV whose viral load is not suppressed or to have a sex partner with a sexually transmitted disease. Both of these factors can increase the risk of HIV transmission.
- Talk to your doctor about pre-exposure prophylaxis (PrEP), taking HIV medicine daily to prevent HIV infection. PrEP should be considered if you are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner. PrEP also should be considered if you are HIV-negative and 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.
- Talk to your doctor right away (within 3 days) about post-exposure prophylaxis (PEP) if you have a possible exposure to HIV. An example of a possible exposure is if you have anal or vaginal sex without a condom with someone who is or may be HIV-positive, and you are HIV-negative and not taking PrEP. Your chance of exposure to HIV is lower if your HIV-positive partner is taking antiretroviral therapy (ART) consistently and correctly, especially if his/her viral load is undetectable. Starting PEP immediately and taking it daily for 4 weeks reduces your chance of getting HIV.
- Get tested and treated for other STDs and encourage your partners to do the same. If you are sexually active, get tested at least once a year. STDs can have long-term health consequences. They can also increase your chance of getting HIV or transmitting it to others.
Find an STD testing site.
- 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.
Visit Act Against AIDS for more information about HIV and what you can do to stop HIV.