Gay and Bisexual Men's Health
HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome, or AIDS. Unlike some other viruses, the human body cannot get rid of HIV. That means that once you have HIV, you have it for life.
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 many sex partners or having other STDs can increase the chances of getting HIV through sex.
- Anal sex is the highest-risk sexual behavior.
- Sharing needles, syringes, rinse water, or other equipment (works) used to make injectable drugs with someone who has HIV.
Less commonly, HIV may be spread by
- Oral sex. The chances of getting HIV through oral sex are much less than from anal or vaginal sex. Learn more about oral sex and HIV risk.
What are the Signs and Symptoms Of HIV?
Within a few weeks of getting HIV, some people get flu-like symptoms that last for a week or two, but others have no symptoms at all. After initial infection, people may not have any symptoms for years. HIV can be controlled with the right medical treatment and care. However, if it’s left untreated, it may develop into AIDS (acquired immunodeficiency syndrome).
You can take steps to prevent HIV. Here's what you can do:
- Understand what are riskier and safer sexual behaviors. Your chances of getting HIV from oral sex are much less than from anal or vaginal sex. You have the most chance of getting or giving someone HIV from anal sex. If you are HIV-negative, insertive anal sex (topping) is less risky for getting HIV than receptive anal sex (bottoming). You won’t get HIV or give it to someone else from sexual activities that do not involve exchanging body fluids.
- Use condoms each time you have sex and make sure to use them correctly each time.
- Reduce the number of people you have sex with. The number of sex partners you have affects your chances of getting HIV. The more partners you have, the more likely you are to have a partner with HIV or who has an STD. Both of these raise your chances of getting HIV.
- If you have HIV, take HIV antiretroviral treatment (ART) regularly to greatly lower the chances of giving HIV to others and improve your own health.
- 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 giving HIV to sex partners if taken regularly and correctly.
- Talk to your doctor about pre-exposure prophylaxis (PrEP), taking HIV medicine daily to prevent getting HIV. You should consider PrEP if you are
- HIV-negative and are in an ongoing sexual relationship with an HIV-positive partner;
- HIV-negative and are in an ongoing sexual relationship with a sex partner who injects drugs;
- HIV-negative and have had an STD or anal sex 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) regularly 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 giving it to others. Find an STD testing site.
Visit Act Against AIDS for more information about HIV and what you can do to stop HIV.
Serosorting among Gay, Bisexual and Other Men Who Have Sex With Men
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. This means they try to limit unprotected anal sex to partners with the same HIV status as their own. However, gay, bisexual, and other men who have sex with men who practice serosorting are at greater risk for HIV and other sexually transmitted infections (STIs) compared to those who always use condoms.
CDC does not recommend serosorting as a safer sex practice. Serosorting is not recommended because: (1) too many gay, bisexual, and other men who have sex with men who have HIV do not know they are infected because they have not been tested for HIV recently, (2) gay, bisexual, and other men who have sex with men’s assumptions about the HIV status of their partners may be wrong, and (3) some HIV-positive gay, bisexual, and other men who have sex with men may not tell or may misrepresent their HIV status. All of these factors increase the risk that serosorting could lead to HIV infection.
For sexually active gay, bisexual, and other men who have sex with men, the most effective ways to prevent HIV and other STIs are to avoid anal sex, or for gay, bisexual, and other men who have sex with men who do have anal sex, to always use condoms, and to (as appropriate) use PrEP. Serosorting does not protect against other STIs, like hepatitis B virus (HBV), hepatitis C virus, syphilis, and herpes.
CDC recommends that gay, bisexual, and other men who have sex with men be tested for HIV and STDs at least annually. CDC data show that sexually active gay, bisexual, and other men who have sex with men might benefit from more frequent testing (e.g., every 3 to 6 months). Regular testing allows people who have HIV to know their status, get life-saving treatment and care, and prevent HIV transmission to others.