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.

  1. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019HIV Surveillance Report 2021;32.
  2. CDC. Estimated HIV incidence and prevalence in the United States, 2015–2019 [PDF – 3 MB]. HIV Surveillance Supplemental Report 2021;26(1).
  3. CDC.  Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2019. HIV Surveillance Supplemental Report 2021;26(2).
  4. CDC. Sexually transmitted disease surveillance, 2019. Accessed September 1, 2021.
  5. CDC. Behavioral and clinical characteristics of persons with diagnosed HIV infection—Medical Monitoring Project, United States, 2020 cycle (June 2020–May 2021)HIV Surveillance Special Report 2022;29.
  6. CDC. HIV infection risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance, 23 U.S. cities, 2017. HIV Surveillance Special Report 2019;22.
  7. CDC. HIV care outcomes among men who have sex with men with diagnosed HIV infection—United States, 2015MMWR 2017;66(37):969-74.
  8. CDC. HIV testing experience before HIV diagnosis among men who have sex with men—21 jurisdictions, United States, 2007–2013MMWR 2016;65(37):999-1003.
  9. Clark HA, Oraka E, DiNenno EA, et al. Men who have sex with men (MSM) who have not previously tested for HIV: Results from the MSM testing initiative, United States (2012-2015). AIDS Behav 2019;23(2):359-65. PubMed abstract.
  10. Kwan CK, Rose CE, Brooks JT, Marks G, Sionean C. HIV testing among men at risk for acquiring HIV infection before and after the 2006 CDC recommendations. Public Health Rep 2016;131:311-9. PubMed abstract.