Most Are Unaware of New Prevention Options, Such as PrEP, or Current Treatment Recommendations
MENLO PARK, CA – More than thirty years into the HIV/AIDS epidemic, and at a time when infections among gay and bisexual men are on the rise in the U.S., a new national survey of gay and bisexual men by the Kaiser Family Foundation (KFF) finds that though HIV/AIDS is named as the number one health issue facing their population, a majority (56%) are not personally concerned about becoming infected, and relatively few report having been tested recently.
Only three in 10 (30%) gay and bisexual men say they were tested for HIV within the last year, including 19 percent who report being tested within the last six months (these figures exclude the 10% who self-identify as HIV-positive). Gay and bisexual men under the age of 35 are twice as likely as those who are older to report never having been tested for HIV (44% vs. 21%). The CDC recommends at least annual HIV testing for this population with more frequent testing advised by many health departments.
Only about a quarter (26%) know about PrEP (pre-exposure prophylaxis), a daily pill that people who are HIV-negative can take to lower their risk of becoming infected. Eight in 10 (80%) say they have heard “only a little” or “nothing at all” about the new prevention option.
Fewer than half (46%) of gay and bisexual men are aware that the current guidelines for people with HIV are to start antiretroviral (ARV) treatment as soon as they are diagnosed, and only a quarter (25%) know about treatment as prevention. (Research shows that taking consistent ARV treatment can reduce the risk of passing HIV on to others by as much as 96 percent.)
More than half (56%) say that a doctor has never recommended they get tested for HIV, and six in 10 (61%) say they rarely or never discuss HIV when they visit their doctor.
“These survey results underscore the importance of getting the word out among gay and bisexual men about risk and new treatment and prevention options,” said Kaiser Family Foundation President and CEO Drew Altman, Ph.D.
Just a third (32%) realize that new infections are on the rise among gay and bisexual men. One in four (22%) think the number is decreasing and the rest either think the situation is staying the same or acknowledge that they don’t know.
Reflecting the disproportionate impact of HIV in communities of color, gay and bisexual men who are members of racial and ethnic minority groups are more likely to say that HIV/AIDS is a significant issue for them personally than white gay men (64% versus 42%) and to say that they are personally concerned about becoming infected (53% versus 28%).
Overall, three quarters (75%) say that gay and bisexual men not knowing their HIV status is a major reason it has been hard to control the spread of HIV among this group. Complacency about HIV in the gay community (62%) and HIV-related stigma (56 percent) are also named by majorities as major factors.
Many say HIV is not a topic that comes up often, if all, even with those closest to them. Three quarters (68%) say they “rarely” or “never” discuss HIV with friends, and large shares report not talking much about the disease with casual sexual partners (50%) or with long-term partners (60%).
While most gay and bisexual men (76%) say they are comfortable having non-sexual relationships with HIV-positive persons, large majorities say they would be uncomfortable with more intimate relationships, including being in a long-term sexual relationship (66%) and having casual sex (77%) with someone who is HIV-positive. Gay and bisexual men under the age of 35 are more likely to say they would be uncomfortable having relationships, sexual or otherwise, with someone who is HIV-positive. Nearly two in five (37%) gay and bisexual men who did not identify as HIV-positive themselves say they have decided not to pursue a sexual relationship specifically because the person was HIV-positive.
Just over half (53%) report being in a committed relationship, including one in five (20%) who say they are married. Twelve percent live in a household with at least one child under the age of 18.
Gay and bisexual men under the age of 35 are less likely to report personal connections to HIV than those who are older. Nearly half (47%) of gay and bisexual men 35 and older say they have lost someone close to them to the disease, compared to only 8 percent of those who are younger. Overall, half (49%) of gay and bisexual men say they personally know someone living with HIV and one in three (32 percent) have had someone close to them who has died.
THE CURRENT STATE OF THE EPIDEMIC AMONG GAY MEN IN THE U.S. According to U.S. Centers for Disease Control and Prevention (CDC), one in five gay men in 20 major cities is estimated to be HIV positive with about one third not knowing they are positive. KFF estimates, based on CDC data, are that 12-13 percent of gay men are HIV positive. There is evidence that the situation is worsening. Between 2008-2010, CDC reports new infections rose 12 percent overall among gay men, and 22 percent among younger gay men, driven by increases among men of color.
The survey was designed and analyzed by researchers at the Kaiser Family Foundation and funded by M·A·C AIDS Fund. It was conducted from July 17-August 3 among a sample of 431 men ages 18 and older who self-identified as gay or bisexual. Interviews were conducted in English and Spanish using GfK’s KnowledgePanel, a nationally representative, probability-based online research panel. The margin of sampling error is plus or minus 7 percentage points for the full sample. For results based on subgroups, the margin of sampling error is higher.