HIV and Gay and Bisexual Men

Gay, bisexual, and other men who reported male-to-male sexual contact^a are the population most affected by HIV in the United States. In 2018, gay and bisexual men^b made up 69% of the 37,968 new HIV diagnoses^c in the United States (US) and dependent areas.^d 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^b

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* Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America.
† Hispanics/Latinos can be of any race.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

New HIV Diagnoses Among Gay and Bisexual Men in the US and Dependent Areas by Age, 2018

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Total may not equal 100% due to rounding.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

From 2014 to 2018, HIV diagnoses decreased 7% among gay and bisexual men overall. But trends varied for different groups of gay and bisexual men.

HIV Diagnoses Among Gay and Bisexual Men in the US and Dependent Areas, 2014-2018

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* Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for Americans of African descent with ancestry in North America.
† Hispanics/Latinos can be of any race.
‡ Changes in subpopulations with fewer HIV diagnoses can lead to a large percentage increase or decrease.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

Living With HIV

Gay and Bisexual Men With HIV in 50 States and the District of Columbia

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^* Includes infections attributed to male-to-male sexual contact only. Among men with HIV attributed to male-to-male sexual contact and injection drug use, 12 in 13 knew they had HIV.
† Had 2 viral load or CD4 tests at least 3 months apart in a year.
^‡ Based on most recent viral load test.
Source: CDC. Estimated HIV incidence and prevalence in the United States 2014–2018 pdf icon[PDF – 3 MB]. HIV Surveillance Supplemental Report 2020;25(1).
Source: CDC. Selected national HIV prevention and care outcomes pdf icon[PDF – 2 MB]. (slides).

Deaths^b

In 2018, there were 8,049 deaths among gay and bisexual men with diagnosed HIV in the US and dependent areas. These deaths could be from any cause.

Prevention Challenges

A much 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.

Stigma, homophobia, and discrimination affect the health and well-being of gay and bisexual men and may prevent them from seeking and receiving high-quality health services, including HIV testing, treatment, and other prevention services. These issues place gay and bisexual men at higher risk for HIV.

1 in 6 gay and bisexual men with HIV are unaware they have it. People who do not know they have HIV can’t take advantage of HIV care and treatment and may unknowingly pass HIV to others.

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 medicine 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.

PrEP (pre-exposure prophylaxis) use among gay and bisexual men, especially Black/African American and Hispanic/Latino gay and bisexual men, remains low. According to a report pdf icon[PDF – 1 MB], only 19% of Black/African American gay and bisexual men and 21% of Hispanic/Latino gay and bisexual men took PrEP compared to 31% of White gay and bisexual men. If taken as prescribed, PrEP is highly effective for preventing HIV.

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

Socioeconomic factors such as 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 is pursuing a high-impact HIV prevention approach to maximize the effectiveness of HIV prevention interventions and strategies. Funding state, territorial, and local health departments and community-based organizations (CBOs) to develop and implement tailored programs is CDC’s largest investment in HIV prevention. This includes longstanding successful programs and new efforts funded through the Ending the HIV Epidemic initiative. In addition to funding health departments and CBOs, CDC is also strengthening the HIV prevention workforce and developing HIV communication resources for consumers and health care providers.

• Under the integrated HIV surveillance and prevention cooperative agreement, CDC awards around $400 million per year to health departments for HIV data collection and prevention efforts. This award directs resources to the populations and geographic areas of greatest need, while supporting core HIV surveillance and prevention efforts across the US.
• In 2019, CDC awarded $12 million to support the development of state and local Ending the HIV Epidemic plans in 57 of the nation’s priority areas. To further enhance capacity building efforts, CDC uses HIV prevention resources to fund the National Alliance of State and Territorial AIDS Directors (NASTAD) with $1.5 million per year to support strategic partnerships, community engagement, peer-to-peer technical assistance, and planning efforts.
• In 2020, CDC awarded $109 million to 32 state and local health departments that represent the 57 jurisdictions across the United States prioritized in the Ending the HIV Epidemic initiative. This award supports the implementation of state and local Ending the HIV Epidemic plans.
• Under the flagship community-based organization cooperative agreement, CDC awards about $42 million per year to community organizations. This award directs resources to support the delivery of effective HIV prevention strategies to key populations.
• 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 goal of identifying undiagnosed HIV infections and linking those who have HIV to care and prevention services.
• In 2019, CDC awarded a cooperative agreement to strengthen the capacity and improve the performance of the nation’s HIV prevention workforce. New elements include dedicated providers for web-based and classroom-based national training, and technical assistance tailored within four geographic regions.
• CDC is funding a demonstration project in 4 jurisdictions to identify active HIV transmission networks and implement HIV interventions for Hispanic/Latino gay and bisexual men. Activities include assessing transmission and risk networks, HIV testing, and linking people with HIV to care and treatment.
• Through its Let’s Stop HIV Together campaign, CDC offers resources about HIV stigma, testing, prevention, and treatment and care. This campaign is part of the Ending the HIV Epidemic initiative.

^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 web content uses the term gay and bisexual men to represent gay, bisexual, and other men who reported male-to-male sexual contact aged 13 and older.
^b Includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors).
^c HIV diagnoses refers to the number of people who received an HIV diagnosis during a given time period, not when the people got HIV infection.
^d Unless otherwise noted, the term United States (US) includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.