Why gay men are more likely to get HIV
First off let’s take a look at how HIV is transmitted. HIV can only be transmitted from one infected person to another. This transference has to take place in the form of direct contact with bodily fluids. So exactly what type of fluids are we talking about? It could be through blood (including menstrual blood), semen (cum and pre-cum), ejaculate, rectal fluids, vaginal secretions and breast milk. For transmission to occur these fluids must come in contact with a mucous membrane or other damaged tissue or be directly injected into the bloodstream via a needle or syringe. Mucous membranes are found inside of the rectum, vagina, penis and mouth.
According to the Centers for Disease Control and Prevention the most common way for HIV to spread in the U.S. is by having unprotected (without the use of condoms) anal or vaginal intercourse with an infected person or someone who is taking medicines to prevent or treat HIV. The second most common way is in syringes or needles where the virus can live for up to 42 days depending on such factors as the temperature in which the needle has been stored.
While we do not know exactly how long HIV survives outside the body on surfaces, we do know that once it exits the body it begins to die very rapidly on exposed surfaces making the possibility of any environmental infection very remote. Also HIV cannot be contracted by insects, saliva or tears that are not mixed with blood of the infected HIV person. There is no need to worry about things like shaking hands, sharing same toilet seats, eating from the same dishes, or even other sexual activities which don’t include the sharing of bodily fluids (for example caressing, massage or playful touching).
Contracting HIV through oral sex is also relatively low. However, it is possible when ejaculation occurs in a mouth which has oral ulcers, bleeding gums or when genital sores are present.
So why is it then that gay men are more likely to get HIV? The answer lies in the risky behaviours that their lifestyle incorporates. Anal sex is by far the highest risk factor of all the “risky sexual behaviours” for HIV transmission. Men who practice receiving a penis during anal intercourse are at a higher risk of contracting HIV while men who practice insertive (or giving) anal intercourse are more likely to transmit it. Hence this is why the combination of both receptive and insertive anal sex produces the highest risk combination of contracting and spreading HIV.
Another factor that puts gay men in a higher risk category is the fact that sex tends to be more between casual partners rather than long-term relationships. The results across three major surveys conducted in 2010; the Asia Internet MSM Sex Survey (AIMSS), Online Buddies Men’s National Sex Study (MNSS), and EMIS, the European MSM Internet Survey, revealed that in Asia only 33% of men had been in a relationship for more than six months while in the U.S. a mere 42% of the men said they had been in a relation of more than three months. According to another study, they estimated cases of infection would fall significantly if gay (and bisexual) men had more long-term relations.
Finally, although many men are aware of the ways in which they can stop the spread of HIV if they are positive (or think they may be), the social discrimination against them often makes it difficult for them to ask or obtain access to health care. If gay men actually felt safe at disclosing this information they might get tested more often and obtain the required treatment sooner; making it safer for them and any of their current or future partners.