---
title: "HIV in Gay Men: Symptoms, Testing, Treatment and Cure Research"
description: "Find out how HIV is passed on during anal and oral sex, which symptoms can occur, which tests are available and how treatment works today."
url: https://gay-blog.tomrockets.com/en/hiv-symptom/
date_published: 2023-04-09
date_modified: 2026-10-14
---
# HIV in Gay Men: Symptoms, Testing, Treatment and Cure Research

## Inhaltsverzeichnis

- [HIV in gay and bisexual men: figures and how HIV is passed on during sex](#h-hiv-in-gay-and-bisexual-men-figures-and-how-hiv-is-passed-on-during-sex)
- [Symptoms of HIV and how it progresses without treatment](#h-symptoms-of-hiv-and-how-it-progresses-without-treatment)
- [HIV testing: test types, window periods and where to get tested](#h-hiv-testing-test-types-window-periods-and-where-to-get-tested)
- [HIV treatment: pills, injections and living with HIV](#h-hiv-treatment-pills-injections-and-living-with-hiv)
- [Is HIV curable? What cure research shows](#h-is-hiv-curable-what-cure-research-shows)
- [How to protect yourself from HIV](#h-how-to-protect-yourself-from-hiv)

HIV is a virus that damages the immune system. Without treatment, the infection can progress to AIDS, its late stage. People with HIV who get on and stay on effective treatment can live long, healthy lives. They can also protect their partners, says the US Centers for Disease Control and Prevention (CDC). In England, gay and bisexual men accounted for 29 per cent (810 of 2,773) of all new HIV diagnoses in 2024. The figures come from the UK Health Security Agency (UKHSA).

## HIV in gay and bisexual men: figures and how HIV is passed on during sex

Worldwide, the risk of acquiring HIV is 18 times higher among gay men and other men who have sex with men (MSM). The Joint United Nations Programme on HIV/AIDS (UNAIDS) gives this comparison with all adults aged 15 to 49 in its Fact Sheet 2026. UNAIDS names marginalisation, discrimination and in some cases criminalisation as factors that compound this risk.

In the US in 2022, gay, bisexual and other men who reported male-to-male sexual contact accounted for 21,400 of the 31,800 estimated new HIV infections. That is 67 per cent, according to the CDC.

Only certain body fluids can transmit HIV: blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids and vaginal fluids, the CDC explains. These fluids must reach a mucous membrane, damaged tissue or the bloodstream for transmission to occur.

The CDC states that [anal sex](https://gay-blog.tomrockets.com/en/fucking-anal/ "anal sex") is the riskiest type of sex for HIV transmission. For someone without HIV, being the receptive partner (bottom) for anal sex is the riskiest sexual activity for getting HIV. For someone with HIV, being the insertive partner (top) is the riskiest sexual activity for transmitting it.

The CDC also gives per-act estimates for anal sex with a partner who has HIV. On average, an HIV-negative receptive partner has about a 1 in 70 chance of getting HIV each time. An HIV-negative insertive partner has about a 1 in 900 chance each time. Being the receptive partner for anal sex is about 13 times more risky for getting HIV than being the insertive partner. A partner with HIV who takes HIV medicine as prescribed and keeps an undetectable viral load will not transmit HIV through sex, the CDC says.

HIV can be in pre-cum, so pulling out before ejaculating does not remove the risk (CDC). The chance of getting HIV from oral sex with an HIV-positive partner is extremely low, the CDC says. However, the exact risk is hard to know because many people who have oral sex also have anal sex. A separate guide covers [protecting yourself during oral sex](https://gay-blog.tomrockets.com/en/safer-oral-sex-risks-protection-2/).

The appeal of condomless sex is the subject of another article, [why unprotected sex appeals and how to stay safe](https://gay-blog.tomrockets.com/en/unprotected-sex/).

## Symptoms of HIV and how it progresses without treatment

HIV causes a short flu-like illness in some people around 2 to 6 weeks after infection, the National Health Service (NHS) says. It can include:

- a sore throat
- a high temperature
- swollen glands
- muscle aches and tiredness
- a skin rash

These symptoms can have many other causes, the NHS says. Some people have no symptoms at all (CDC).

Without treatment, HIV damages the immune system and can later cause serious illnesses such as tuberculosis, pneumonia or cancer, according to the NHS. The CDC describes three stages of untreated HIV. Stage 1 is acute HIV infection. Stage 2 is chronic HIV infection.

People in stage 2 may have no symptoms but can transmit HIV. Without treatment, this stage may last a decade or longer, or may progress faster.

Stage 3 is AIDS. People who take HIV treatment as prescribed may never reach stage 3, the CDC says. In the UK, most people being treated for HIV do not develop AIDS, the NHS says.

## HIV testing: test types, window periods and where to get tested

HIV can only be ruled out by a test after the window period has passed, which depends on the type of test, the CDC says. The window period is the time between exposure to HIV and when a test can detect the virus. These are the CDC window periods for the US:

| Test | Can usually detect HIV |
| --- | --- |
| Antibody test | 23 to 90 days after exposure |
| Rapid antigen/antibody test | 18 to 90 days after exposure |
| Antigen/antibody lab test | 18 to 45 days after exposure |
| NAT | 10 to 33 days after exposure |

UK guidance sets the window period for fourth-generation lab tests at 45 days. This comes from the British HIV Association (BHIVA), the British Association for Sexual Health and HIV (BASHH) and the British Infection Association (BIA).

The CDC distinguishes three types of HIV test: antibody tests, antigen/antibody tests and nucleic acid tests (NAT). A NAT, which looks for the actual virus in the blood, can detect HIV sooner than the other types.

According to the NHS, HIV tests in the UK use saliva from the mouth or blood from a finger. A clinic usually sends the sample to a laboratory, and the result comes within a few days. With a home testing kit, the result is often available within a few minutes. After a negative result, another test a few weeks later may be advised, especially after a recent exposure. The NHS adds that a positive home test means you’ll need to have a blood test at a clinic.

In the UK, HIV tests are offered by GPs and sexual health clinics, according to the NHS. The NHS also lists charity clinics such as the Terrence Higgins Trust, family planning clinics and pharmacies that provide home testing kits. Private clinics also offer tests, but you pay for them. The NHS points to a free HIV testing website where you can check whether you are eligible for a free test.

In England in 2024, under a third of gay and bisexual men newly diagnosed with HIV (190 of 642) were diagnosed late. The UKHSA, which defines a late diagnosis, reports these figures. A further guide deals with [protecting yourself from other STIs such as syphilis](https://gay-blog.tomrockets.com/en/sti-in-gays/).

### How often to get tested

BHIVA, BASHH and BIA recommend an annual test as a minimum for sexually active MSM, except those with one long-term mutually exclusive partner. They advise testing every 3 months for MSM reporting condomless anal sex with a partner whose HIV status is unknown or different from yours. This applies to sex over the last 12 months and to partners whose HIV is not known to be suppressed by treatment. Testing every 3 months is also advised for MSM with multiple or anonymous partners since the last HIV test. In the US, the CDC says men who have had sex with another man should get tested at least once a year. Sexually active gay and bisexual men may benefit from testing every 3 to 6 months, the CDC adds.

## HIV treatment: pills, injections and living with HIV

HIV treatment, antiretroviral therapy (ART), should start as soon as possible after diagnosis, the CDC says. ART is medicine that a health care provider prescribes. There are two types of HIV treatment: pills and shots.

The viral load is the amount of virus in the blood. An undetectable viral load is one so low that a test cannot detect it.

In the US, pills are recommended for people just starting HIV treatment, the CDC says. Most people can get HIV under control within six months, the CDC says. Shots are long-acting injections, given once a month or once every other month. The US Food and Drug Administration (FDA) approved the first complete injectable regimen in 2021.

Shots may be right for an adult with HIV who has had an undetectable viral load for at least three months, the CDC says. The agency also lists two more conditions: no history of treatment failure and no known allergy to the medicines in the shot.

BHIVA names the primary aim of ART as viral suppression, meaning a viral load below 50 copies per millilitre.

The NHS describes HIV as a lifelong condition. A UK analysis cited by BHIVA shows what treatment can mean for life expectancy. It looked at people who started ART between 2000 and 2010. The analysis measured life expectancy in people with an undetectable viral load and a CD4 cell count above 350 cells per cubic millimetre. Their life expectancy was the same as, or slightly better than, that of the general population.

### Undetectable means untransmittable

With effective treatment and an undetectable viral load, you cannot pass HIV on to someone else, the NHS says. UK testing guidelines from BHIVA, BASHH and BIA refer to this absence of sexual transmission with an undetectable viral load as treatment as prevention. The guidelines use the public health message U=U: undetectable equals untransmittable.

In the PARTNER2 study, published in The Lancet in 2019, gay couples reported condomless anal sex 76,088 times. In each of these couples, the HIV-positive partner was on suppressive treatment. Fifteen new HIV infections occurred, but none came from the HIV-positive partner.

## Is HIV curable? What cure research shows

HIV currently has no cure, the NHS says. What cure research does show are individual cases. Every successful cure so far has followed a stem cell transplant, a transplant of stem cells from another person, a paper in Nature reports.

The first case became known as the Berlin patient. Timothy Ray Brown, an American living in Berlin, was diagnosed with HIV in 1995, the Charité university hospital in Berlin says. In 2006 he received a diagnosis of acute myeloid leukaemia (AML). His doctors transplanted stem cells from a donor with a homozygous CCR5 delta 32 mutation, a mutation inherited from both parents. CCR5 is a co-receptor that plays a key role in enabling HIV to enter immune cells, Düsseldorf University Hospital explains.

The transplant treated the leukaemia and eradicated HIV from his body, the first such case worldwide, the Charité reports. The team made the case public in 2008 and published it in the New England Journal of Medicine in 2009. Brown died in the United States in 2020 at the age of 54, after his leukaemia returned.

The London patient was first described in Nature in 2019, in remission after a stem cell transplant for Hodgkin lymphoma. In a 2020 follow-up in a journal from The Lancet, its authors proposed that the findings represent a cure. The Düsseldorf patient was, according to Düsseldorf University Hospital’s release of 2023, just the third person worldwide completely cured of HIV via stem cell transplantation.

A woman in New York was described in the journal Cell in 2023 as the first remission and possible cure in a woman. The Geneva patient received cells from a donor without the CCR5 mutation. His viral load stayed undetectable for 32 months after stopping treatment, Nature Medicine reported in 2024.

### The second Berlin patient

In July 2024 the Charité reported a second Berlin patient who had tested positive for HIV in 2009 and was diagnosed with AML in 2015. His stem cell donor carried one normal and one mutated version of the CCR5 receptor, the mutation inherited from only one parent. He stopped the recommended antiviral treatment on his own in 2018. At the time of the report, doctors had found no detectable virus for more than five years without medication. The data had not yet been examined by independent experts.

Nature published the case of the second Berlin patient in December 2025. The paper counts six cures documented among an estimated 88 million people who have acquired HIV since the start of the epidemic.

### Why stem cell transplants are not a treatment for everyone

According to the Charité press release, stem cell transplantation is only an option in one situation. People living with HIV must also develop certain forms of leukaemia or lymphoma that do not respond to radiation or chemotherapy alone. The procedure is extremely complex, with a mortality rate of about ten per cent, and is used only in severe cases. Because of the significant risks, the method cannot be used as a standard treatment of HIV.

Reservoirs, places where HIV survives despite successful ART, are one obstacle to a cure, a paper in Nature Microbiology from 2026 explains. When ART stops, the virus rebounds from these reservoirs, even after many years of treatment. The same paper reports that stem cell transplants in people with HIV and blood cancers have substantially reduced the reservoirs. In several patients, they removed all viruses able to multiply, leading to a cure.

## How to protect yourself from HIV

PrEP (pre-exposure prophylaxis) is medicine taken as prescribed to prevent HIV, the CDC says. A separate guide on this blog explains [how PrEP protects you from HIV](https://gay-blog.tomrockets.com/en/hiv-prep/). After a possible exposure, PEP (post-exposure prophylaxis) should start as soon as possible, the UK PEP guideline led by BASHH says. Another article explains [how PEP works after a possible exposure](https://gay-blog.tomrockets.com/en/pep-hiv/). If you are unsure which advice to trust, there is also an overview of [common myths about safer sex](https://gay-blog.tomrockets.com/en/safer-sex-misconceptions/).

## FAQ

### Can I buy an HIV self-test in the US?

In the US, you can buy an HIV self-test at a pharmacy or online, the CDC says. You can use it at home or in another private place, and the result comes within 20 minutes. As of February 2025, the only HIV self-test approved by the FDA is an antibody test.

### How much does an HIV test cost in the US?

In the US, HIV tests are covered by health insurance without a co-pay, the CDC says. You can ask your health care provider for an HIV test, and many medical clinics, community health centres and hospitals offer them too. If you do not have insurance, some places offer free or low-cost tests.

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