HIV and African American Gay and Bisexual Men

New HIV Diagnoses Among Gay and Bisexual Men by Age and Race/Ethnicity in the US and Dependent Areas, 2017^d

Hispanics/Latinos can be of any race. Subpopulations representing 2% or less of HIV diagnoses among gay and bisexual men are not reflected in this chart.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2017. HIV Surveillance Report 2018;29.

From 2010 to 2016, HIV diagnoses remained stable overall among black/African American gay and bisexual men in the 50 states and the District of Columbia. But trends for HIV diagnoses among black/African American gay and bisexual men varied by age.^d

HIV Diagnoses Among Black/African American Gay and Bisexual Men
in the 50 States and District of Columbia, 2010-2016^d

CDC. NCHHSTP AtlasPlus. Accessed January 24, 2019.

Living With HIV

In the 50 states and the District of Columbia:

• An estimated 1,122,900 people had HIV at the end of 2015.^f Black/African American gay and bisexual men accounted for 19% (218,600) of all people with HIV and 32% of all gay and bisexual men with HIV.^d
• Among black/African American gay and bisexual men with HIV in 2015, an estimated 80% of those whose infection was attributed to male-to-male sexual contact (but not injection drug use) had received a diagnosis. An estimated 95% of those whose infection was attributed to male-to-male sexual contact and injection drug use had received a diagnosis.

Deaths

In 2016, there were 2,406 deaths among black/African American gay and bisexual men with diagnosed HIV in the US. These deaths may be due to any cause.^d

Prevention Challenges

Stigma, homophobia, and discrimination put gay and bisexual men of all races/ethnicities at risk for multiple physical and mental health problems and may affect whether they seek and are able to receive high-quality health services, including HIV testing, treatment, and other prevention services. In addition to stigma and other risk factors affecting all gay and bisexual men, several factors are specific to African American gay and bisexual men. These include:

• Lack of awareness of HIV status. Among people who have HIV, a lower percentage of African American gay and bisexual men know their HIV status compared to gay and bisexual men of some other races/ethnicities.^g People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others.
• Timely linkage to HIV medical care. According to a recent MMWR, only 67% of HIV-positive African American gay and bisexual men with newly diagnosed HIV, and 58% with previously diagnosed HIV, were linked to HIV medical care within 90 days of the diagnosis. Early linkage to HIV medical care is essential to achieving viral suppression.
• Low rates of viral suppression. African American gay and bisexual men have lower rates of viral suppression compared to gay and bisexual men of other races/ethnicities. Because of the low rates of viral suppression, the higher prevalence of HIV in that population, and the greater likelihood of having sexual partners of the same race, compared with other races/ethnicities, African American gay and bisexual men are at greater risk of being exposed to HIV.
• Socioeconomic factors. The poverty rate is higher among African Americans than other racial/ethnic groups. The socioeconomic issues associated with poverty—including limited access to high-quality health care, housing, and HIV prevention education—directly and indirectly increase the risk of HIV infection for some African American gay and bisexual men and may also affect the health of people who have HIV.

What CDC Is Doing

CDC funds state and local health departments and community-based organizations (CBOs) to deliver effective HIV prevention services for African American gay and  bisexual men. For example:

• Under the new integrated HIV surveillance and prevention cooperative agreement, CDC is awarding around $400 million per year to health departments for surveillance and prevention efforts. This award will direct resources to the populations and geographic areas of greatest need, while supporting core HIV surveillance and prevention efforts across the United States.
• In 2019, CDC will award a new cooperative agreement to strengthen the capacity and improve the performance of the nation’s HIV prevention workforce. New elements include dedicated providers for web-based and classroom-based national training and technical assistance tailored within four geographic regions.
• In 2017, CDC awarded nearly $11 million per year for 5 years to 30 CBOs to provide HIV testing to young gay and bisexual men of color and transgender youth of color, with the goals of identifying undiagnosed HIV infections and linking those who have HIV to care and prevention services.
• In 2015, CDC added three awards to help health departments reduce HIV infections and improve engagement and retention in HIV medical care among gay and bisexual men of color.
  • Targeted Highly-Effective Interventions to Reverse the HIV Epidemic (THRIVE) supports state and local health department demonstration projects to develop community collaborations that provide comprehensive HIV prevention and care services for gay and bisexual men of color at risk for and living with HIV infection.
  • Training and Technical Assistance for THRIVE strengthens the capacity of funded health departments and their collaborative partners to plan, implement, and sustain (through ongoing engagement, assessment, linkage, and retention) comprehensive prevention, care, behavioral health, and social services models for gay and bisexual men of color at risk for and living with HIV infection.
  • Project PrIDE (PrEP, Implementation, Data to Care, and Evaluation) supports 12 health departments in implementing PrEP and Data to Care demonstration projects for gay and bisexual men and transgender persons, with a particular emphasis on persons of color.

• Through its Act Against AIDS campaigns and partnerships, CDC provides African American gay and  bisexual men with effective and culturally appropriate messages about HIV prevention and treatment. For example,

• • Let’s Stop HIV Together fights stigma among all Americans and provides many stories about people living with HIV.
  • Doing It encourages all adults to know their HIV status and protect themselves and their community by making HIV testing a part of their regular health routine.
  • Start Talking. Stop HIV. helps gay and bisexual men communicate about testing and a range of HIV prevention strategies.
  • HIV Treatment Works shows how people living with HIV have overcome barriers to stay in care and provides resources on how to live well with HIV.
  • Partnering and Communicating Together (PACT) to Act Against AIDS, a 5-year partnership with organizations such as the National Black Justice Coalition, the National Urban League, and the Black Men’s Xchange, is raising awareness about testing, prevention, and retention in care among populations disproportionately affected by HIV, including African American gay and  bisexual men.

To learn more about health issues affecting gay and bisexual men, visit the CDC Gay and Bisexual Men’s Health site.

^a Black refers to people having origins in any of the black racial groups of Africa, including immigrants from the Caribbean, and South and Latin America. African American is a term often used for Americans of African descent with ancestry in North America. Individuals may self-identify as either, both, or choose another identity altogether. This fact sheet uses African American, unless referencing surveillance data.
^b The term male-to-male sexual contact is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This fact sheet uses the term gay and bisexual men.
^c Unless otherwise noted, the term United States includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
^d Includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors).
^e HIV diagnoses refers to the number of people who received an HIV diagnosis during a given time period, not when the people got HIV infection.
^f Includes diagnosed and undiagnosed HIV infections.
^g Though African American gay and bisexual men report higher HIV testing in the past year than Hispanic/Latino or white gay and bisexual men, they also have a higher prevalence of HIV. That means a greater proportion of those who have not been tested recently are HIV-positive.