UPDATE COMING We’re currently working to update this article. Studies have shown that a person living with HIV who is on regular antiretroviral therapy that reduces the virus to undetectable levels in the blood is NOT able to transmit HIV to a partner during sex. This page will be updated soon to reflect the medical consensus that “Undetectable = Untransmittable.”
Knowing the risks associated with having sex and choosing the best prevention options is always important. The risk of contracting a serious condition like human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs) is greater for men who have sex with men than for the rest of the population.
You can decrease your risk of contracting HIV or STIs by educating yourself, getting tested frequently, and using protection.
It’s crucial to understand the risks of engaging in sexual activity with other men to protect yourself from getting HIV or an STI.
Gay and bisexual men’s sexual health has been hit the toughest, with more individuals infected with HIV and STIs than other groups, according to research published in Clinical Infectious Diseases. So it’s more likely you will encounter a partner with one of these conditions than people in other sexually active populations. Still, transmission of HIV or an STI can occur regardless of sexuality.
According to the Centers for Disease Control and Prevention (CDC), 15 percent of the gay and bisexual population in the United States is living with HIV. However, not all men realize they are infected with HIV. The CDC adds that nearly one in seven gay and bisexual men living with HIV are unaware that they have it.
HIV is a chronic health condition that can be transmitted through sexual activity or using an intravenous needle or syringe of someone infected. Men in sexual relationships with other men can be exposed to HIV through:
- pre-seminal fluid
- rectal fluids
Exposure to HIV occurs from contact with fluids near mucous membranes. These are found inside the rectum, penis, and mouth.
Individuals living with HIV can manage their condition with a daily medication called antiretroviral therapy (ART). ART needs to be taken for the rest of their lives.
Individuals with a partner who has an HIV diagnosis may choose to use medications like pre-exposure prophylaxis (PrEP) to decrease their chance of getting infected with the virus. This medication is also recommended for gay or bisexual men who have engaged in condomless sex or had an STI within the last six months. You must take this medication daily.
There is also an emergency medication you can take if you've been exposed to HIV. Examples of when to take this include if a condom malfunctions and there’s potential to be exposed to HIV, or you share an intravenous needle or syringe with someone infected. These medications are known as post-exposure prophylaxis, or PEP. You must see a doctor within 72 hours of exposure and begin treatment right away. This medication must be taken twice a day for 28 days.
In addition to HIV, other STIs can be transmitted between sexual partners through intercourse or the touching of skin around the genitals. Both semen and blood can also transmit STIs.
There are many STIs, all with different characteristics. Some can be cured, while others are chronic and may lead to more serious conditions like cancer if not treated early enough. Symptoms may not always be present, which makes it difficult to know if you or someone else is living with an STI.
- hepatitis B and C
- human papillomavirus
Your doctor will discuss with you the best course of action to treat an STI. Managing an STI varies from condition to condition.
If you’re sexually active with other men, it’s important to get screened frequently for HIV and other STIs. This will help you maintain your health and avoid transmitting any of these conditions to a sexual partner.
The CDC recommends getting tested for STIs regularly and at least once a year for HIV. They recommend getting tested more frequently if you engage in sexual activity with risk for exposure.
If you or your partner are screened and diagnosed with an STI or HIV, you need to receive treatment immediately to reduce your risk of transmitting it to others.
Knowledge about HIV and STIs can help guide your choices about sex, but it’s most important to practice safe sex. This means taking measures to protect yourself from contracting HIV and STIs.
Safer sex options include:
- wearing condoms and using lubricants
- understanding safer sexual positions
- protecting yourself from certain STIs through preventative measures like vaccines
- avoiding situations that may lead to poor sexual choices
- considering your sexual activity and who you partner with
Use condoms and lubricants
Condoms and lubricants are essential to maintain safer sex practices. Condoms made with synthetic materials like latex are the most reliable. You can use other synthetic condoms if you’re allergic to latex.
Lubricants prevent condoms from breaking or malfunctioning. You should only use lubricants that are made from water or silicone. Lubricants like Vaseline or lotion are made from oil and can lead to the condom breaking. Avoid lubricants with nonoxynol-9. This ingredient can irritate the anus and increase the chance of getting HIV.
Condoms help prevent the transmission of HIV and some STIs by blocking the exchange of bodily fluids or skin-to-skin contact.
Engage in safer sexual positions
This is particularly important if you are concerned about contracting HIV. Keep in mind that you can get other STIs through many sexual acts, including anal and oral sex and others that don’t involve bodily fluids.
For HIV-negative people, being on the top during anal sex can decrease your chances of getting HIV. Oral sex is less risky for transmitting HIV but not necessarily for other STIs. While you can't get HIV from sexual acts that don’t involve bodily fluids, you can get some STIs from these behaviors.
Receiving vaccinations against STIs like hepatitis A and B and human papillomavirus is also an option for practicing safer sex. Talk to your doctor about these vaccinations. The vaccination for human papillomavirus is available for men under the age of 26.
Avoid certain social situations
It’s important to choose your social situations wisely. Drinking alcohol or misusing drugs can potentially lead you to make poor sexual choices. Intoxication may lead you to engage in unsafe sex or sex with a person you don’t know well.
Choose sexual partners wisely
You should be mindful of your sexual partners. Having sex with fewer people may reduce your chances of contracting HIV or other STIs. Make sure you and your partner get tested before engaging in sexual activity to avoid contracting HIV or an STI.
Having unsafe sex can lead to serious outcomes regardless of your sexuality. Men who have sex with men have the highest risk of contracting HIV and other STIs than any other group or population. So, understanding the risks of sexual activity is important. Getting tested regularly for STIs and practicing safer sex techniques can also assist you in maintaining your sexual health.