HIV and Gay and Bisexual Men
Gay, bisexual, and other men who reported male-to-male sexual contacta are the population most affected by HIV in the United States. In 2018, gay and bisexual menb made up 69% of the 37,968 new HIV diagnosesc 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 Diagnosesb
![Of the 37,968 new HIV diagnoses in the US and dependent areas in 2018, 69 percent were among gay and bisexual men.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-new-diagnoses-1000x177.png)
New HIV Diagnoses Among Gay and Bisexual Men in the US and Dependent Areas by Race/Ethnicity, 2018
![Among gay and bisexual men who received an HIV diagnosis in 2018, racial and ethnic disparities continue to exist.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-diagnoses-2018-people-700x369.png)
![This bar chart shows HIV diagnoses among gay and bisexual men in the United States and dependent areas in 2018 by race. Black/African American gay and bisexual men made up 37 percent of new HIV diagnoses, Hispanic/Latino gay and bisexual men made up 30 percent, White gay and bisexual men made up 27 percent, Asian gay and bisexual men made up 3 percent, gay and bisexual men of multiple races made up 3 percent, American Indian/Alaska Native gay and bisexual men made up 1 percent and Native Hawaiian and Other Pacific Islander gay and bisexual men made up less than 1 percent of new HIV diagnoses.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-diagnoses-graph-700x346.png)
* 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
![Gay and bisexual men aged 13 to 34 made up most new HIV diagnoses among all gay and bisexual men.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-diagnoses-by-age-people-700x359.png)
![cdc-hiv-msm-diagnoses-by-age-graph-700x358 This bar chart shows new HIV diagnoses among gay and bisexual men in the United States and dependent areas in 2018 by age. Gay and bisexual men aged 13 to 24 made up 25 percent of new HIV diagnoses, gay and bisexual men aged 25 to 34 made up 39 percent, gay and bisexual men aged 35 to 44 made up 17 percent, gay and bisexual men aged 45 to 54 made up 11 percent, and gay and bisexual men aged 55 and older made up 7 percent of new HIV diagnoses.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-diagnoses-by-age-graph-700x358.png)
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
![This trend chart shows HIV diagnoses among gay and bisexual men in the US and dependent areas from 2014 to 2018. By race/ethnicity, Black/African American gay and bisexual men remained stable; Hispanic/Latino gay and bisexual men remained stable; White gay and bisexual men decreased 15 percent; Asian gay and bisexual men remained stable; gay and bisexual men of multiple races decreased 44 percent; American Indian/Alaska Native gay and bisexual men increased 15 percent; and Native Hawaiian and Other Pacific Islander gay and bisexual men increased 78 percent.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-trends-age-534x418.png)
![cdc-hiv-msm-trends-race-700x418 This trend chart shows HIV diagnoses among gay and bisexual men in the US and dependent areas from 2014 to 2018. By race/ethnicity, Black/African American gay and bisexual men remained stable; Hispanic/Latino gay and bisexual men remained stable; White gay and bisexual men decreased 15 percent; Asian gay and bisexual men remained stable; gay and bisexual men of multiple races decreased 44 percent; American Indian/Alaska Native gay and bisexual men increased 15 percent; and Native Hawaiian and Other Pacific Islander gay and bisexual men increased 78 percent.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-trends-race-700x418.png)
* 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
![At the end of 2018, an estimated 1.2 million Americans had HIV. Of those, 740,000 were gay and bisexual men.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-2018-700x150.png)
![5 in 6 gay and bisexual men knew they had the virus.](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/msm/2020/cdc-hiv-msm-5-in-6-knew-700x150.png)
![graphic of a bottle of pills](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/group/pill-bottle-86x100.png)
It is important for gay and bisexual men to know their HIV status so they can take medicine to treat HIV if they have the virus. Taking HIV medicine every day can make the viral load undetectable. People who get and keep an undetectable viral load (or stay virally suppressed) can live a long and healthy life. They also have effectively no risk of transmitting HIV to HIV-negative sex partners.
* 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).
Deathsb
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
![two-men-couple-125x110 icon of two men](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/two-men-couple-125x110.png)
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.
![icon of stop sign with stigma text](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/stop-stigma-125x125.png)
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.
![icon of a man with question marks](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/questions-125x108.png)
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.
![icon of two men in bed](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/men-in-bed-125x131.png)
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-pill-125x88 icon of prep pill](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/prep-pill-125x88.png)
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.
![doctor-bag-125x113 icon of doctor bag](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/doctor-bag-125x113.png)
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.
![icon of a wall between a doctor and two men](https://webarchive.library.unt.edu/web/20201219044137im_/https://www.cdc.gov/hiv/images/icons/wall-doc-patients-men-125x126.png)
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.
- CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018. HIV Surveillance Report 2020;31.
- CDC. Estimated HIV incidence and prevalence in the United States, 2014-2018 pdf icon[PDF – 3 MB]. HIV Surveillance Supplemental Report 2020;25(1).
- CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018 pdf icon[PDF – 4 MB]. HIV Surveillance Supplemental Report 2020;25(2).
- CDC. Selected national HIV prevention and care outcomes pdf icon[PDF – 2 MB] (slides).
- CDC. Sexually transmitted disease surveillance, 2018. Accessed September 8, 2020.
- CDC. Behavioral and clinical characteristics of persons with diagnosed HIV infection—Medical monitoring project, United States, 2018 cycle (June 2018–May 2019) pdf icon[PDF – 905 KB]. HIV Surveillance Special Report 2020;25.
- CDC. HIV infection risk, prevention, and testing behaviors among men who have sex with men—National HIV Behavioral Surveillance, 23 U.S. cities, 2017 pdf icon[PDF – 898 KB]. HIV Surveillance Special Report 2019;22.
- CDC. HIV care outcomes among men who have sex with men with diagnosed HIV infection—United States, 2015. MMWR 2017;66(37):969-74.
- CDC. HIV testing experience before HIV diagnosis among men who have sex with men—21 jurisdictions, United States, 2007–2013. MMWR 2016;65(37):999-1003.
- Habarta N, Boudewyns V, Badal H, et al. CDC’S testing makes us stronger (TMUS) campaign: was campaign exposure associated with HIV testing behavior among black gay and bisexual men? AIDS Educ Prev 2017;29(3):228-40. Pubmed abstractexternal icon.
- 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 abstractexternal icon.