HIV and African American Gay and Bisexual Men

Black/African Americana gay, bisexual, and other men who reported male-to-male sexual contact b,c are more affected by HIV than any other group in the United States and dependent areas. d In 2018, Black/African American gay and bisexual men accounted for 26% (9,712) of the 37,968 new HIV diagnoses and 37% of new diagnoses among all gay and bisexual men. e

The Numbers

HIV Diagnosesf

Of the 37,968 new HIV diagnoses in the US and dependent areas in 2018, 26 percent were among Black/African American gay and bisexual men.
New HIV Diagnoses Among Gay and Bisexual Men in the US and Dependent Areas by Age and Race/Ethnicity, 2018
About 3 out of 4 Black/African American gay and bisexual men who received an HIV diagnosis were aged 13 to 34.

New HIV Diagnoses Among Gay and Bisexual Men in the US and Dependent Areas by Age and Race/Ethnicity, 2018. Race/Ethnicity, 2018. 13-24: Asian:  134, Black/African American: 3,334, Hispanic/Latino :  1,788, White: 1,087, Multiple Races: 185. 25-34: Asian:  303, Black/African American: 3,988, Hispanic/Latino:  3,309, White: 2,427, Multiple Races: 277. 35-44: Asian:  141, Black/African American: 1,255, Hispanic/Latino:  1,595, White: 1,367, Multiple Races: 114. 45-54: Asian:  80, Black/African American: 727, Hispanic/Latino:  918, White: 1,216,  Multiple Races: 59. 55+: Asian:  38, Black/African American: 408, Hispanic/Latino:  385, White: 944, Multiple Races: 29.

Subpopulations representing 2% or less of HIV diagnoses among gay and bisexual men are not reflected in this chart.
* Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America.
Hispanics/Latinos can be of any race.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

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From 2014 to 2018, HIV diagnoses remained stable overall among Black/African American gay and bisexual men. But trends for HIV diagnoses among Black/African American gay and bisexual men varied by age.e While good progress has been made with reducing HIV diagnoses among some age groups, efforts will continue to focus on lowering diagnoses among all age groups.

HIV Diagnoses Among Black/African American* Gay and Bisexual Men in the US and Dependent Areas, 2014-2018
HIV diagnoses among Black/African American gay and bisexual men in the US and dependent areas, 2014-2018 and shows trends by age. Image shows 13-24:  down 17 percent, 25-34: up 12 percent, 35-44: stable, 45-54: down 15 percent, and 55 and older: down 8 percent.

*Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

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Living With HIV

Adult and Adolescent Black/African American* Gay and Bisexual Men With HIV
At the end of 2018, an estimated 1.2 million Americans had HIV in 50 states and the District of Columbia. Of those, 235,100 were Black/African American gay and bisexual men.

4 in 5 Black/African American gay and bisexual men knew they had the virus.

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It is important for Black/African American gay and bisexual men to know their HIV status so they can take medicine to treat HIV if they have the virus. Taking HIV medicine every day can make the viral load undetectable. People who get and keep an undetectable viral load (or stay virally suppressed) can live a long and healthy life. They also have effectively no risk of transmitting HIV to HIV-negative sex partners.


 The chart represents the continuum of care for Black/African American gay and bisexual men in 41 states and the District of Columbia. Compared to all people with diagnosed HIV, Black/African American gay and bisexual men have lower viral suppression rates. More work is needed to increase these rates. For every 100 Black/African gay and bisexual men with diagnosed HIV in 2018: 75 received some HIV care, 56 were retained in care, and 61 were virally suppressed. For comparison, for every 100 people overall with diagnosed HIV, 76 received some HIV care, 58 were retained in care, and 65 were virally suppressed.
The chart represents the continuum of care for Black/African American gay and bisexual men in 41 states and the District of Columbia. Compared to all people with diagnosed HIV, Black/African American gay and bisexual men have lower viral suppression rates. More work is needed to increase these rates. For every 100 Black/African gay and bisexual men with diagnosed HIV in 2018: 75 received some HIV care, 56 were retained in care, and 61 were virally suppressed. For comparison, for every 100 people overall with diagnosed HIV, 76 received some HIV care, 58 were retained in care, and 65 were virally suppressed.

*Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America.
† Includes infections attributed male-to-male sexual contact only.  Among Black/African American men with HIV infection attributed to male-to-male sexual contact and injection drug use, 94% knew they had HIV.
ǂ Had 2 viral load or CD4 tests at least 3 months apart in a year.
** Based on most recent viral load test.
†† Learn more about CDC’s two different HIV care continuum approaches at  www.cdc.gov/hiv/pdf/library/factsheets/cdc-hiv-care-continuum.pdf pdf icon[PDF – 247 KB].
Source: CDC. Estimated HIV incidence and prevalence in the United States 2014–2018 pdf icon[PDF – 3 MB]HIV Surveillance Supplemental Report. 2020;25(1).
Source: CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. pdf icon[PDF – 4 MB] HIV Surveillance Supplemental Report 2020;25(2).

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Deaths

In 2018, there were 2,407 deaths among Black/African American gay and bisexual men with diagnosed HIV in the US and dependent areas. These deaths could be from any cause.

Prevention Challenges

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Racism, HIV stigma, and homophobia.  Racism, HIV stigma, and homophobia can negatively impact risk-taking behaviors, knowledge of HIV status, HIV care, and other needed services for many African American gay and bisexual men.

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Delay in linkage to HIV medical care. According to an MMWR, only 67% of 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.

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Low percentages of viral suppression. African American gay and bisexual men have lower percentages of viral suppression compared to gay and bisexual men of other races/ethnicities. Because of the low percentages 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.

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Socioeconomic factors. The poverty rate among African Americans is high. The socioeconomic factors associated with poverty—including limited access to high-quality health care, housing, and HIV prevention education—directly and indirectly increase the risk for HIV and affect the health of people with and at risk for HIV. These factors may explain why African Americans have worse outcomes on the HIV continuum of care, including lower rates of linkage to care and viral suppression.

What CDC Is Doing

CDC is pursuing a high-impact HIV prevention approach to maximize the effectiveness of HIV prevention interventions and strategies. Funding state, territorial, and local health departments and community-based organizations (CBOs) to develop and implement tailored programs is CDC’s largest investment in HIV prevention. This includes longstanding successful programs and new efforts funded through the Ending the HIV Epidemic in the U.S. initiative. In addition to funding health departments and CBOs, CDC is also strengthening the HIV prevention workforce and developing HIV communication resources for consumers and health care providers.

  • Under the integrated HIV surveillance and prevention cooperative agreement, CDC awards around $400 million per year to health departments for HIV data collection and prevention efforts. This award directs resources to the populations and geographic areas of greatest need, while supporting core HIV surveillance and prevention efforts across the US.
  • In 2019, CDC awarded $12 million to support the development of state and local Ending the HIV Epidemic in the U.S. plans in 57 of the nation’s priority areas. To further enhance capacity building efforts, CDC uses HIV prevention resources to fund the National Alliance of State and Territorial AIDS Directors (NASTAD) $1.5 million per year to support strategic partnerships, community engagement, peer-to-peer technical assistance, and planning efforts.
  • In 2020, CDC awarded $109 million to 32 state and local health departments that represent the 57 jurisdictions across the United States prioritized in the Ending the HIV Epidemic in the U.S. This award supports the implementation of state and local Ending the HIV Epidemic in the U.S. plans.
  • Under the flagship community-based organization cooperative agreement, CDC awards about $42 million per year to community organizations. This award directs resources to support the delivery of effective HIV prevention strategies to key populations.
  • In 2017, CDC awarded nearly $11 million per year for five years to 30 CBOs to provide HIV testing to young gay and bisexual men of color and transgender youth of color, with the goal of identifying undiagnosed HIV infections and linking those who have HIV to care and prevention services.
  • In 2019, CDC awarded a 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.
  • Through its Let’s Stop HIV Together campaign, CDC offers resources about HIV stigma, testing, prevention, and treatment and care. This campaign is part of the Ending the HIV Epidemic in the U.S. initiative.

a Black refers to people having origins in any of the black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America. This web content 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 web content uses the term gay and bisexual men to represent gay, bisexual, and other men who reported male-to-male sexual contact aged 13 and older.
c Based on sex at birth and includes transgender people.
d 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.
e Includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors).
f 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.