HIV Among Gay and Bisexual Men

Gay, bisexual, and other men who have sex with men^a made up an estimated 2% of the population but 55% of people living with HIV in the United States in 2013. If current diagnosis rates continue, 1 in 6 gay and bisexual men will be diagnosed with HIV in their lifetime, including 1 in 2 black/African American^b gay and bisexual men, 1 in 4 Hispanic/Latino^c gay and bisexual men, and 1 in 11 white gay and bisexual men. But these rates are not inevitable. We have more tools to prevent HIV than ever before.

The Numbers

HIV and AIDS Diagnoses^d

In 2014:

• Gay and bisexual men accounted for 83% (29,418) of the estimated new HIV diagnoses among all males aged 13 and older and 67% of the total estimated new diagnoses in the United States.
• Gay and bisexual men aged 13 to 24 accounted for an estimated 92% of new HIV diagnoses among all men in their age group and 27% of new diagnoses among all gay and bisexual men. 
• Gay and bisexual men accounted for an estimated 54% (11,277) of people diagnosed with AIDS. Of those men, 39% were African American, 32% were white, and 24% were Hispanic/Latino.

Although HIV diagnoses increased among gay and bisexual men overall from 2005 to 2014—and increased sharply among African American and Hispanic/Latino gay and bisexual men—diagnoses overall have stabilized in more recent years:

• From 2010 to 2014, diagnoses increased less than 1% among all gay and bisexual men overall and among African American gay and bisexual men. Diagnoses:
  • Declined 6% among white gay and bisexual men.
  • Increased 13% among Hispanic/Latino gay and bisexual men.
• From 2010 to 2014, among young (aged 13 to 24) gay and bisexual men, diagnoses: 
  • Declined 2% among young African American gay and bisexual men.
  • Declined less than 1% among young white gay and bisexual men.
  • Increased 16% among young Hispanic/Latino gay and bisexual men.

Living With HIV

• At the end of 2013, 687,800 gay and bisexual men were living with HIV. Of those, 15% were unaware of their infection.
• Among gay and bisexual men diagnosed with HIV infection in 2014, 84% were linked to medical care within three months of diagnosis.^e
• During 2013, 57% of gay and bisexual men who had been living with diagnosed HIV for at least a year were retained in care (receiving continuous HIV medical care) and 58% had a suppressed viral load (a very low level of the virus). ^e

Prevention Challenges

• Gay and bisexual men continue to experience the greatest burden of HIV compared to any other group in the United States. Therefore gay and bisexual men have an increased chance of being exposed to HIV. A 2016 analysis estimated that there are nearly 4.5 million gay and bisexual men in the United States and that 15% are living with HIV infection (11% diagnosed).
• Nearly 1 in 7 gay and bisexual men living 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 reduce the likelihood of transmitting HIV to their partners. Therefore, they may transmit the infection to others without knowing it.
• Most gay and bisexual men acquire HIV through having anal sex with an HIV-positive person without using a condom or without taking daily medicine to prevent HIV called pre-exposure prophylaxis (PrEP) or without their partner taking medicine to treat HIV called antiretroviral therapy (ART). Anal sex is the riskiest type of sex for getting or transmitting HIV. Receptive anal sex is 13 times as risky for acquiring HIV as insertive anal sex. Using condoms the right way every time and taking medicines to prevent or treat HIV each can reduce the risk of getting or transmitting HIV. Combining 2 or more options provides more protection from HIV and condoms also protect from some sexually transmitted diseases (STDs).
• Gay and bisexual men are also at increased risk for other STDs, like syphilis, gonorrhea, and chlamydia.
• Homophobia, stigma, and discrimination may place gay and bisexual men at risk for multiple physical and mental health problems and affect whether they seek and are able to obtain high-quality health services.

What CDC Is Doing

CDC funds health departments and other community-based organizations (CBOs) to support HIV prevention services for gay and bisexual men. For example,

• Starting in 2012, CDC has awarded at least $330 million each year ($343.7 million in 2015) to health departments to direct resources to the populations and geographic areas of greatest need, including gay and bisexual men, and prioritize the HIV prevention strategies that will have the greatest impact.
• Beginning in 2011, CDC awarded $11 million per year for 5 years to 34 community-based organizations to provide HIV testing to more than 90,000 young gay and bisexual men of color and transgender youth 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 that will begin in 2017 and continue for 5 years, depending on the availability of funds.
• In 2015, CDC added three new funding opportunities (FOAs) to help health departments reduce HIV infections and improve HIV medical care among gay and bisexual men. These FOAs will support effective models of prevention and care, increase health departments’ capacity to use their surveillance data for program purposes, and increase gay and bisexual men’s access to PrEP.

CDC supports 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 health departments, CBOs, and health care organizations. The estimated annual funding is $22 million.

CDC supports biomedical approaches to HIV prevention. People at very high risk for HIV can take PrEP to greatly reduce the chances that they will get HIV. Post-exposure prophylaxis (PEP), which involves beginning a regimen of HIV medicines soon after possible exposure to HIV, also plays a role in HIV prevention, but should be not be considered a primary means of prevention.

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,

• Doing It is a new national HIV testing and prevention campaign that encourages all adults to know their HIV status and make 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 provides resources on how to live well with HIV.
• Partnering and Communicating Together (PACT) to Act Against AIDS is a new 5-year partnership to raise HIV awareness 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.

^aThe 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.

^b Referred to as African American in this fact sheet.

^c Hispanics/Latinos can be of any race.

^d HIV and AIDS diagnoses refers to the number of people diagnosed with HIV infection and AIDS during a given time period, not when the people were infected.

^e From 32 states and the District of Columbia (the areas with complete lab reporting by December 2014).