HIV and gay men at risk

Most gay men agree that HIV is no longer a death sentence but a large majority of men still believe that HIV is a big deal and remain very concerned about HIV being transmitted. A small proportion of gay men (around 18%) occasionally have sex without condoms with casual partners.

What do we know about the men who are being diagnosed with HIV? Virtually all HIV infections in gay men are the result of anal sex without condoms. There seems to be three major circumstances where unprotected anal sex is leading to HIV infections:

New infections
  • 25% of men recently diagnosed with HIV were probably in SERODISCORDANT RELATIONSHIPS (where one partner has HIV and the other doesn't) and usually avoid unprotected sex but may occasionally take a risk or experience a condom breakage. In other cases a partner may have been unaware he had HIV and inadvertently passed it on.
  • 35% of men recently diagnosed with HIV were probably SEXUALLY ADVENTUROUS and play in networks where unprotected sex is more likely to occur including when men have many different sexual partners, have group sex and take drugs during sex.
  • 35% of men recently diagnosed with HIV usually used condoms but were likely to have SLIPPED UP on this occasion for a variety of reasons.

Note: There is overlap between groups as the boundaries are blurred. Men can also belong to two groups and often change from one group to another over time.

Many HIV negative men in relationships agree to not use condoms with each other but to keep using condoms outside of the relationship. This is a long standing practice but there's evidence that the number of men in relationships who have made an explicit agreement with each other has declined in recent years. Both partners should get tested at the same time before stopping using condoms.

Some men, both positive and negative, try to make sure that if they don't use condoms with casual partners, that these partners have the same HIV status as them. Around a third of HIV negative men and just over a third of HIV positive men who have unprotected sex with casual partners say they consistently disclose and discuss HIV status. However, many other men just assume their partners have the same HIV status rather than discussing or confirming it. Some HIV infections are caused by men just guessing each other's HIV status. A third of HIV infections occur when men think they're still HIV negative but have become HIV positive and then have unprotected sex with others.

HIV is still a concern for gay men. Unprotected sex early in a relationship, assuming another man's HIV status and not getting tested for HIV regularly all contribute to HIV infections.

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I can't live in fear and never have sex. But I can try to minimise the chances of getting HIV

James, HIV negative

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