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 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.

LGBT Youth

Most lesbian, gay, bisexual, (LGB) youth are happy and thrive during their adolescent years. Having a school that creates a safe and supportive learning environment for all students and having caring and accepting parents are especially important. Positive environments can help all youth achieve good grades and maintain good mental and physical health. However, some LGB youth are more likely than their heterosexual peers to experience negative health and life outcomes.

For youth to thrive in schools and communities, they need to feel socially, emotionally, and physically safe and supported. A positive school climate has been associated with decreased depression, suicidal feelings, substance use, and unexcused school absences among LGB students. 1

How CDC Promotes Health Safety Among Youth: LGBTQ* Youth Programs-At-A-Glance

LGBT Youth

Lesbian, Gay, Bisexual, and Transgender Health

People who are lesbian, gay, bisexual, or transgender (LGBT) are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the country. The perspectives and needs of LGBT people should be routinely considered in public health efforts to improve the overall health of every person and eliminate health disparities.

Find health services by state and city on CDC’s updated LGBT Health Resources page

Learn about the risk of getting or transmitting HIV and lowering your risk

Lesbian, Gay, Bisexual, and Transgender Health

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.

Prevention Challenges

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.

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.

What CDC Is Doing

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

* 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 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

Total may not equal 100% due to 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

* 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 CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated)HIV Surveillance Report 2020;31.

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

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 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. Selected national HIV prevention and care outcomes pdf icon[PDF – 2 MB]. (slides).

Experiences with Violence

Compared with other students, negative attitudes toward LGB persons may put these youth at increased risk for experiences with violence. 2 ‘Violence’ can include behaviors such as bullying, teasing, harassment, and physical assault.

According to data from the 2015 national Youth Risk Behavior Survey (YRBS), of surveyed LGB students:

How CDC Promotes Health Safety Among Youth – Read LGBTQ* Youth Programs-At-A-Glance

Effects on Education and Mental Health

Exposure to violence can have negative effects on the education and health of any young person and may account for some of the health-related disparities between LGB and heterosexual youth. 4-6 According to the 2015 YRBS, LGB students were 140% (12% v. 5%) more likely to not go to school at least one day during the 30 days prior to the survey because of safety concerns, compared with heterosexual students.3  While not a direct measure of school performance, absenteeism has been linked to low graduation rates, which can have lifelong consequences.

A complex combination of factors can impact youth health outcomes. LGB youth are at greater risk for depression, suicide, substance use, and sexual behaviors that can place them at increased risk for HIV and other sexually transmitted diseases (STDs). 3 Nearly one-third (29%) of LGB youth had attempted suicide at least once in the prior year compared to 6% of heterosexual youth.3 In 2014, young gay and bisexual men accounted for 8 out of 10 HIV diagnoses among youth.7

What Schools Can Do

Schools can implement evidence-based policies, procedures, and activities designed to promote a healthy environment for all youth, including LGB students. For example, research has shown that in schools with LGB support groups (such as gay-straight alliances), LGB students were less likely to experience threats of violence, miss school because they felt unsafe, or attempt suicide than those students in schools without LGB support groups. 8 A recent study found that LGB students had fewer suicidal thoughts and attempts when schools had gay-straight alliances and policies prohibiting expression of homophobia in place for 3 or more years.9

To help promote health and safety among LGB youth, schools can implement the following policies and practices (with accompanying citations)

Be proactive.

Parents can access many organizations and online information resources to learn more about how they can support their LGB teen, other family members, and their teen’s friends.

Get more information from the CDC Fact Sheet: Cdc-pdf[PDF – 254 KB].

More resources for LGBTQ youth and their friends can be found on CDC’s web page

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