HIV Among African American Gay and Bisexual Men

In the United States, gay, bisexual, and other men who have sex with men^a are disproportionately affected by HIV. Among gay and bisexual men, black/African American^b men, especially those who are younger, are the group most disproportionately affected by HIV. If current diagnosis rates continue, about 1 in 2 African American gay and bisexual men will be diagnosed with HIV in their lifetime—in comparison to 1 in 4 Hispanic/Latino^c gay and bisexual men, 1 in 11 white gay and bisexual men, and 1 in 6 gay and bisexual men overall. But these rates are not inevitable. We have more tools to prevent HIV than ever before.

The Numbers

HIV and AIDS Diagnoses^d

• Among all gay and bisexual men diagnosed with HIV in the United States in 2014, African Americans accounted for the highest number (estimated 11,201; 38%), followed by whites (estimated 9,008; 31%) and Hispanics/Latinos (estimated 7,552; 26%).
• In 2014, an estimated 39% (4,321) of African American gay and bisexual men diagnosed with HIV were aged 13-24. An estimated 36% (3,995) were aged 25-34; 13% (1,413) were aged 35-44; 9% (989) were aged 45-54; and 4% (486) were aged 55 or older.
• While the number of HIV diagnoses declined for African Americans as a whole from 2005 to 2014, diagnoses among African American gay and bisexual men increased 22% in that period. But diagnoses stabilized in recent years, increasing less than 1% between 2010 and 2014.
• From 2005 to 2014, HIV diagnoses among African American gay and bisexual men aged 13 to 24 increased 87%. But that trend has leveled off, with diagnoses declining 2% between 2010 and 2014.
• Among all gay and bisexual men diagnosed with AIDS in the United States in 2014, African Americans accounted for the highest number (estimated 4,343; 39%), followed by whites (estimated 3,564; 32%) and Hispanics/Latinos (estimated 2,665; 24%).

Living With HIV

• By the end of 2013, an estimated 493,543 gay and bisexual men were living with diagnosed HIV infection. Of those, 152,303 (31%) were African American, 210,299 (43%) were white, and 104,529 (21%) were Hispanic/Latino.

Estimated HIV Diagnoses Among Men Who Have Sex With Men, by Race/Ethnicity and Age at Diagnosis, 2014—United States

* Hispanics/Latinos can be of any race
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2014. HIV Surveillance Report 2015;26.

Prevention Challenges

In addition to risk factors affecting all gay and bisexual men (a larger percentage of men with HIV in sexual networks; a significant proportion of the population engaging in receptive anal sex, or “bottoming,” which is the riskiest sexual behavior for getting HIV; more sex partners compared to other men; stigma and homophobia), several factors are specific to African American gay and bisexual men. These include:

• Socioeconomic factors. For example, having limited access to quality health care, lower income and educational levels, and higher rates of unemployment and incarceration may place some African American gay and bisexual men at higher risk for HIV than men of some other races/ethnicities.
• Smaller and more exclusive sexual networks. African American gay and bisexual men are a small subset of all gay and bisexual men, and their partners tend to be of the same race. Because of the small population size and the higher prevalence of HIV in that population relative to other races/ethnicities, African American gay and bisexual men are at greater risk of being exposed to HIV within their sexual networks.
• Lack of awareness of HIV status. 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.^e People who do not know they have HIV cannot take advantage of HIV care and treatment and may unknowingly pass HIV to others.

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.

What CDC Is Doing

CDC is addressing HIV among African American gay and bisexual men with three areas of commitment:

• Engaging African American gay and bisexual communities and strategic partners.
• Expanding and focusing on the prevention strategies and programs with the greatest impact.
• Evaluating and disseminating information on prevention strategies and programs.

CDC funds state and local health departments and community-based organizations (CBOs) to support HIV prevention services for gay and bisexual men. In 2015, CDC added two new funding opportunities (FOAs) to help health departments reduce HIV infections and improve HIV medical care among gay and bisexual men of color. These FOAs will increase gay and bisexual men’s access to pre-exposure prophylaxis (PrEP), increase health departments’ surveillance capacity, and support effective models of prevention and care for gay and bisexual men of color.

CDC is also supporting Capacity Building Assistance for High-Impact HIV Prevention, a national program that addresses gaps in each step of the HIV care continuum by providing training and technical assistance for staff of health departments, CBOs, and health care organizations. The estimated annual funding is $22 million.

Beginning in 2011, CDC awarded $11 million per year for 5 years to 34 CBOs to provide HIV testing to more than 90,000 young gay and bisexual men of color, with the goals of identifying more than 3,500 previously unrecognized HIV infections and linking those who have HIV to care and prevention services. CDC recently announced a new funding opportunity focused on these populations that will begin in 2017 and continue for 5 years, depending on the availability of funds.

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,

• Doing It, a new national HIV testing and prevention campaign, 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 safer sex, testing, and other HIV prevention issues.
• 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 new 5-year partnership with organizations such as the National Black Justice Coalition and the Black Men’s Xchange, is raising awareness about testing, prevention, and retention in care among populations disproportionately affected by HIV, including African Americans.

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 men who have sex with men is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality.
^bReferred to as African American in this fact sheet.
^c Hispanics/Latinos can be of any race.
^d HIV and AIDS diagnoses indicate when a person is diagnosed with HIV infection or AIDS, not when the person was infected.
^e 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.