HIV and Gay and Bisexual Men

Gay and bisexual men^a are the population most affected by HIV in the United States. In 2016, gay and bisexual men accounted for 67% of the 40,324 new HIV diagnoses^b in the United States and 6 dependent areas.^c Approximately 492,000 sexually active gay and bisexual men are at high risk for HIV; however, we have more tools to prevent HIV than ever before.

The Numbers

HIV Diagnoses^d

In 2016, gay and bisexual men accounted for 67% (26,844) of all HIV diagnoses and 82% of diagnoses among males aged 13 and older.

In 2016:

• Among all gay and bisexual men who received an HIV diagnosis in the United States and 6 dependent areas, blacks/African Americans^e accounted for the highest number (10,226; 38%), followed by Hispanics/Latinos^f (7,689; 29%) and whites (7,392; 28%). Other races/ethnicities accounted for 1,537 (6%) diagnoses among gay and bisexual men.

• Gay and bisexual men aged 13 to 34 account for two-thirds (64%) of HIV diagnoses among all gay and bisexual men. But the age distribution varies by race/ethnicity.
  • African American: 36% (3,720) were aged 13 to 24; 39% (3,994) were aged 25 to 34; 13% (1,291) were aged 35 to 44; 8% (808) were aged 45 to 54; and 4% (413) were aged 55 and older.
  • Hispanic/Latino: 23% (1,751) were aged 13 to 24; 41% (3,181) were aged 25 to 34; 21% (1,578) were aged 35 to 44; 12% (885) were aged 45 to 54; and 4% (293) were aged 55 and older.
  • White: 15% (1,095) were aged 13 to 24; 32% (2,340) were aged 25 to 34; 19% (1,414) were aged 35 to 44; 22% (1,598) were aged 45 to 54; and 13% (946) were aged 55 and older.
  • Other races/ethnicities: 23% (351) were aged 13 to 24; 41% (626) were aged 25 to 34; 19% (299) were aged 35 to 44; 11% (172) were aged 45 to 54; and 6% (94) were aged 55 and older.

From 2011 to 2015:

HIV diagnoses remained stable at about 26,000 per year among all gay and bisexual men. Trends for HIV diagnoses among gay and bisexual men varied by race/ethnicity.

• African American: Remained stable.
• Hispanic/Latino: Increased 13%.
• Asian: Increased 35%.
• White: Decreased 10%.
• Other races/ethnicities: Decreased 23%.

Trends for HIV diagnoses among gay and bisexual men also varied by age.

• Ages 13 to 24: Remained stable.
• Ages 25 to 34: Increased 21%.
• Ages 35 to 44: Decreased 15%.
• Ages 45 to 54: Decreased 14%.
• Ages 55 and older: Remained stable.

HIV Diagnoses Among Gay and Bisexual Men
By Age and Race/Ethnicity in the United States and 6 Dependent Areas, 2016

Subpopulations representing 2% or less of HIV diagnoses among gay and bisexual men are not reflected in this chart.
Source: Diagnoses of HIV infection in the United States and dependent areas, 2016. HIV Surveillance Report 2017;28.

Living With HIV

In the 50 states and the District of Columbia:

• An estimated 632,300 gay and bisexual men had HIV at the end of 2015, representing 56% of everyone with HIV.^g By race/ethnicity, 240,900 were white, 201,800 were African American, 151,200 were Hispanic/Latino, and 38,400 were other races/ethnicities.
• An estimated 83% (526,456) of gay and bisexual men were aware of their infection at the end of 2015.
• Among all gay and bisexual men with HIV in 2015, 62% received some HIV medical care, 48% were retained in HIV care, and 52% had a suppressed viral load.^h A person with HIV who takes HIV medicine as prescribed and gets and stays virally suppressed or undetectable can stay healthy and has effectively no risk of sexually transmitting HIV to HIV-negative partners.

Deaths

In 2015, there were 6,531 deaths among gay and bisexual men with diagnosed HIV in the United States and 6 dependent areas. These deaths may be due to any cause.

Prevention Challenges

A much higher proportion of gay and bisexual men have HIV compared to any other group in the United States. Therefore, gay and bisexual men have an increased chance of having an HIV-positive partner.

1 in 6 gay and bisexual men with HIV are unaware they have it. People who don’t know they have HIV cannot get the medicines they need to stay healthy and prevent transmitting HIV to their partners. Therefore, they may transmit the infection to others without knowing it. Among African American gay and bisexual men who have HIV, a lower percentage know their HIV status compared to HIV-positive gay and bisexual men of some other races/ethnicities.ⁱ

Most gay and bisexual men get HIV from having anal sex without using condoms or taking 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.

According to the Medical Monitoring Project, which collects data about the experiences and needs of people with HIV, 13% of sexually active gay and bisexual men with HIV engaged in high-risk sex in the past 12 months.

Gay and bisexual men are also at increased risk for other sexually transmitted diseases (STDs), like syphilis, gonorrhea, and chlamydia. Condoms can protect from some STDs, including HIV.

Homophobia, stigma, and discrimination may place gay and bisexual men at risk for multiple physical and mental health problems and may affect whether they seek and are able to obtain high-quality health services.

Socioeconomic factors, such as having limited access to quality health care, lower income and educational levels, and higher rates of unemployment and incarceration, may place some gay and bisexual men at higher risk for HIV.

What CDC Is Doing

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

• Under the current funding opportunity, CDC will award around $400 million per year to health departments for surveillance and prevention efforts. This funding opportunity 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 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 funding opportunities to help health departments reduce HIV infections and improve HIV medical care among gay and bisexual men.
  • 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.
  • 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, Data2Care, and Evaluation) supports 12 health departments in implementing pre-exposure prophylaxis (PrEP) and Data to Care demonstration projects for gay and bisexual men.
• The Capacity Building Assistance for High-Impact HIV Prevention is a national program that provides training and technical assistance for health departments, CBOs, and healthcare organizations to help them better address gaps in the HIV continuum of care and provide high-impact prevention for people at high risk for HIV.
• Through its Act Against AIDS campaigns and partnerships, CDC provides gay and bisexual men with effective and culturally appropriate messages about HIV prevention and treatment. For example,
  • Start Talking. Stop HIV. helps gay and bisexual men communicate about safer sex, testing, and other HIV prevention issues.
  • Doing It, a national HIV testing and prevention campaign, encourages all adults to know their HIV status and make HIV testing a part of their regular health routine.
  • HIV Treatment Works shows how people 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 Lesbian & Gay Journalists Association and National Black Justice Coalition, is raising awareness about testing, prevention, and retention in care among populations disproportionately affected by HIV, including gay and bisexual men.

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

^a 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.
^b The numbers reported in this fact sheet include infections attributed to male-to-male sexual contact only, not those attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors).
^c American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
^d HIV diagnoses refers to the number of people who received a diagnosis of HIV during a given period of time, not when the people were infected.
^e Referred to as African American in this fact sheet.
^f Hispanics/Latinos can be of any race.
^g Includes diagnosed and undiagnosed HIV infections.
^h People are considered retained in care if they get two viral load or CD4 tests at least 3 months apart in a year. (CD4 cells are the cells in the body’s immune system that are destroyed by HIV.) Viral suppression is based on the most recent viral load test.
ⁱ 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.