HIV and Gay and Bisexual Men: Prevention Challenges

Racism, discrimination, HIV stigma, and homophobia affect the overall health and well-being of some gay and bisexual men. Additionally, lower income and educational levels, and higher rates of unemployment and incarceration may place some gay and bisexual men at higher risk for HIV and make it harder to seek and receive high-quality health care, including HIV testing, treatment, and other prevention services. Addressing these social and structural barriers and encouraging safe and supportive communities can help improve health outcomes for gay and bisexual men.

Other factors that can increase the chances of getting or transmitting HIV include:

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HIV prevalence. A higher proportion of gay and bisexual men have HIV compared to any other group in the US. Therefore, gay and bisexual men have an increased chance of having a partner who has HIV.

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Knowledge of HIV status. It is important for everyone to know their HIV status. People who don’t know they have HIV can’t take advantage of HIV care and treatment and may pass HIV to others without knowing it.

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Sexual behaviors. Some factors put gay and bisexual men at higher risk for HIV, including having anal sex with someone who has HIV without using protection (like condoms or medicines to prevent or treat HIV). Anal sex is the riskiest type of sex for getting or transmitting HIV. Receptive anal sex is 13 times as risky for getting HIV as insertive anal sex.

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Low PrEP (pre-exposure prophylaxis) use. PrEP use among gay and bisexual men, especially Black/African American and Hispanic/Latino gay and bisexual men, remains low. If taken as prescribed, PrEP is highly effective for preventing HIV.

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Other sexually transmitted diseases (STDs). Gay and bisexual men are at increased risk for other STDs, like syphilis, gonorrhea, and chlamydia. Having another STD can increase a person’s chance of getting or transmitting HIV. Condoms can protect from some STDs, including HIV.

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