Report: Black Gay Men In U.S. At Greater Risk Of HIV Infection Than Entire World


The Black AIDS Institute’s latest report, “Back of the Line: The State of AIDS Among Black Gay Men In America” offers distressing news: black men living in the United States have a 1 in 4 chance of contracting HIV, even though they represent only 1 in 500 Americans.

HIV represents a lifelong threat for Black gay men. A young Black gay man has a roughly 1-in-4 chance of being infected by age 25. By the time he is 40 years old, the odds a Black gay men will be living with HIV is roughly 60%. One can scour the entire world and struggle to find a population more heavily affected by HIV/AIDS than Black gay in the U.S.

Black gay men’s higher risk of HIV does not stem from higher levels of risk behavior. Rather, their disproportionate risk of HIV can be traced to their poor access to health services, a high prevalence of sexually transmitted diseases, and early patterns of sexual behavior among young gay men.

No one has responded to this health crisis with the urgency it warrants.

Even with new antiretroviral treatments and medical breakthroughs, the group says, “the combined effects of poverty, unemployment, lack of health coverage, racism and homophobia, Black gay men face profound obstacles in obtaining basic health services.”

Here’s a PDF of the Institute’s report.


  1. jason says

    I’m sorry but this report by the Black AIDS Institute is nonsense. It’s identity politics at its worst. Let me repeat for the hard of hearing: you are NOT at higher risk of HIV infection because of who you are (ie gay or black). You are at higher risk because of your behavior, not because of who you are.

    If it’s true that gay black men are at highest risk of HIV infection, you’d have to say that HIV is a racist, homophobic virus. It’s a silly notion, don’t you think?

  2. ratbastard says

    I’m confused about the access to healthcare part. Where do most black gay and bi men live? In urban areas? Suburban? Rural? What part of the country? The Southeast? Southwest? Northeast? Midwest? Are a large number of them classified as ‘poor’? All these things matter more than race. If you live in a decent sized metro area [and most Americans do] you should have little to no problem getting easy, even free access to HIV prevention heathcare and AIDS treatment, even though the cocktail of drugs is expensive. But assuming you have heath insurance, it should generally be adequately covered, and of course there’s Medicaid. If you’re ‘poor’ you of course can get Medicaid for free, not to mention the MANY inexpensive and free heathcare options and clinics for ‘poor’ people.

    I’m sorry, but I don’t think eternal discrimination is the cause of the very high rates of HIV infection among black males. I think internal discrimination within the black commu nity, and a widespread DL lifestyle and risky behavior is the primary cause[s].

  3. mike128 says

    Yes, how can you say that the higher risk does not stem for higher levels of risk behavior (in one sentence). (Then in the next sentence) say that it’s related to higher levels of STDs and early patterns of sexual behavior? The conclusions seem to contradict themselves.

    Also – the fact that gay black men are statistically 1 out of 500 americans is not at all related to their 1 in 4 chance of contracting HIV. I could have a 50% chance of getting a cavity next year… doesn’t matter if there are 10 other people out there with teeth or 1 million. Nor is it any more or less shocking based on how large the society is that I live in.

    I AM very interested in this data but skeptical because of the poor way it has been written up…

  4. say what says

    also per a recent Dan rather reports the southern US states have seen a huge upswing in HIV cases

    The southern states reason is easy to figure out = lack of sex ed and, the demonziation of condoms amongst the bible belt southerners, + poverty hindering prevention and treatment availability = southern states are the poorest in the nation

    the uprise amongst AA males is less easy to pin point but with the south having a large AA population and all of the above reasons for south upswing contributes to AA upswing in infections

  5. Fenrox says

    Jason is clearly illiterate, so you know, I would read the report instead of listening to him.

    This is a pretty clear wake up call. The gay community needs to stay together in this. We have a long history of dealing with HIV and AIDS and we need to double down as APPARENTLY (Honestly Jason, How do you learn if you don’t want to?) our young black men are getting HIV at alarming rates.

    Get involved in your community and online! This is an information problem!

  6. ratbastard says

    I would agree that probably most or a disproportionate number of black males, including gay and bi, live in southern [southeast] states, and it’s the southeast deep south states that have the highest poverty levels and worse access to healthcare in the country. They also have the lowest level of those with health insurance and highest rates of those on Medicaid. This has a lot more to do with their plight than racism.

  7. endo says

    Jason is a common name, but presumably it’s the same Jason who has for years commented on this site that AIDS is not caused by HIV, but rather by the use of poppers.

    So that’s who you’re dealing with there.

  8. AggieCowboy says

    @Jason: It’s not meaningless, you’re not taking cultural/community influences into account as the cause of risky behavior. It’s not as black and white as you’d like to believe. What it means is that certain population communities (in this case, the African-American community) need to be targeted for education and open dialogue to help overcome the stigmas surrounding HIV infections.

    The graphic shown here, however, is rather meaningless as it only shows the number of cases diagnosed without population statistics. Of course, you also have to pose the question: How many undiagnosed cases are there within the various study populations? Unfortunately, this question inherently can’t be answered, although a (very) rough estimate might be obtainable.

  9. ratbastard says

    Actually, when it started, HIV saw an opportunity to infect those with greatly weakened immune systems, mostly those whose immune systems were weakened probably by substance abuse, including poppers. To a degree this still holds true today. So ‘Jason’ isn’t entirely off the mark.

  10. say what says


    “Over 50 percent of new infections are in the southern United States and the South accounts for 53 percent of the HIV-related deaths in the entire country – meaning someone in Mississippi is 50 percent more likely to die of AIDS than someone in New York.”

    take a look at the map …the south eastern states “old south” has the largest AA population in the US

    thus logic would say the biggest factor is the state of HIV prevention in south eastern states is the biggest contributor to upswing amongst AA males…not the only reason BUT an undeniable HUGE factor

  11. jason says

    There is no such thing as a racist, homophobic virus. Therefore, it is NOT possible for a group defined on the basis of race or homosexuality (black or gay or both) to be at higher risk of catching it. Yet, this is exactly what the Black AIDS Institute seems to be saying.

    Perhaps inadvertently, the Black AIDS Institute’s terminology supports the homophobic, racist viewpoint.

  12. say what says

    PS like mentioned above by myself and ratbastard ….yes sometimes we can agree :-)

    the financial situation of the old south + state of sex ed in old south, + health care access in old south, etc

  13. Rick says

    Typical. This report demonstrates the common pattern of blacks in general and black gays in particular (as we see on this site all the time) trying to blame their problems on everybody but themselves.

    Just scream racism at the top of your lungs and avoid dealing with the real causes of your problems,,,,,

    Let’s get real here. You don’t become infected with HIV because of “not having access to health services”. You get it by engaging in unsafe sex practices. Plainly and simply.

    And unsafe sex practices are a direct consequence of being deeply closeted and on the “down low” as most black gay and bi men are.

    And why are they deeply closeted? Because they live in a community where homophobia is more widespread and more intense than in any other community in the country…..AND because, rather than confronting that homophobia in their own community, as gays of other races have done, black gays stay closeted and when white gays come in to confront homophobia among blacks (only doing so because black gays themselves are not doing so)…they yell “racism” and attack the white gays that are trying to help them rather than the black homophobes who are the cause of their problems.

    And anybody who has read the comments on this site for any amount of time has seen this phenomenon demonstrated time after time after time. In fact, the only time most black gays seem to surface here is to accuse white gays of “racism” whenever they criticize someone who is black for their homophobic actions.

    It is time for black gays to take responsibility for themselves and if they are not willing to do so, then they will just have to live with the consequences. Other gays have lost their patience with them, I am afraid……

  14. Dan says

    @ Mike128, it has to do with the higher presence of HIV and STIs in the community. (“community prevalence” or “community viral load”) Essentially, risk behavior is the same across racial/ethic groups, but that stakes are higher for men of color because of this higher prevalence of disease in the community.

    Here’s the scenario: People tend to (but not always, of course) have sex with partners of the same race, and a black man having unprotected sex with a black man is at higher risk of infection just by nature of probability that his partner is infected. These are totally arbitrary numbers, but let’s say among white guys, there is a 1 in 10 chance of your partner having HIV/STI, and among black guys, it’s 1 in 5. This is, obviously, overly simplified and does not account for other behavioral factors, but I hope it explains the concept.

    The higher rates of STIs and HIV also have a lot to do with healthcare access and quality, in that infections go undiagnosed and untreated and thus remain “contagious” within the community. Hope that makes sense!

  15. qj201 says

    it’s simple math or epidemiology for those that can be bothered with big words.

    If there are more people around you with HIV, even though you have no more unprotected sex than someone else, you still have increased the chances that you will be exposed to HIV.

    And NO it is NOT racist to point out that the “leaders” in the black community have been criminally silent on the issue.

  16. jason says

    What puzzles me about the gay community is its contradictory positions on AIDS. On the one hand, gay community members keep telling us that AIDS is not a gay illness, that AIDS does not attack you because you’re gay.

    On the other hand, there is this huge AIDS industry which keeps promoting the idea that being gay or being black makes you more prone to getting AIDS. This view is often promoted by Gay Inc.

    If you can’t see the massive contradiction here, there’s no point in arguing with you. Something within the gay community is going wrong. We are losing our integrity as we seek to play the politics of the victim on the one hand and the politics of the non-victim on the other.

  17. Gregoire says

    AIDS affects gay men more strongly in situations and communities where being gay is not as accepted, but places where sex is readily available. Hello, ‘the down low’?

    If people don’t identify their sexual practices as gay — even if they are sleeping with men — then it’s likely people are not using precautions associated with risky sex.

    Information about safe sex is readily accessible to people who are in a coming-out process. But those in denial are hardly seeking out this information.

    This can happen in a rural white, urban black or suburban Latino community. It’s about education and access, not race.

    This is why we have to underscore the importance of a man like Frank Ocean coming out of the closet. He reaches into communities that Neil Patrick Harris and Anderson Cooper clearly do not. And some parts of that community have not normalized the gay experience in any meaningful way.

  18. Michael says

    Okay, sorry to be a stickler here, but the original quote is “Representing a mere 1 in 500 people living in the U.S., Black gay men account for nearly 1 in 4 new HIV infections.” The quote on Towleroad reproduced here is an awful and misleading misstatement. First: Black GAY men, NOT black men represent 1 in 500 Americans (obviously more than 0.2% of our population are black men!). Second: “even though” implies that there is some connection between these two statistics, but there is not. Just because you represent 1 in 500 Americans doesn’t mean you should have a 1 in 500 chance of contracting HIV. That is nonsense. Of course black gay men having a 1 in 4 chance of contracting HIV is shocking and important information. But what does that have to do with how few Americans are black gay men? Towelroad needs to get their sh*t together.

  19. Mark says

    Over the last decade, infection rates have risen among gay men but they’ve fallen among intravenous drug users and heterosexuals. Most disturbingly, it’s risen the fastest among young gay men (and young gay black men in particular). How much longer can we blame stigma and discrimination and a lack of education? We know how to prevent HIV and discrimination and stigma are no worse (and are probably less of an issue) today than they were 10 years ago. We’re becoming complacent and that’s a huge problem.

  20. says

    “If you live in a decent sized metro area [and most Americans do] you should have little to no problem getting easy, even free access to HIV prevention heathcare and AIDS treatment.”

    Uh… yes and no. I live across the street from a free HIV testing facility and though it’s technically free. It isn’t exactly easy. Even on a slow day, you’re looking at an hour wait before someone so much as takes your name and an even longer wait before you see a doctor. On the days that most people have off its even worse. To somehow imply that this is as easy as getting a blood test with you next physical is more than wrong, it’s a lie.

    Also, I really don’t know how to process what you’re talking about when you mention external vs internal discrimination. The only way I can interpret this is that you’re saying that this is a black people problem and thus not of your concern. If my interpretation is correct then I can just point to your comment to explain the racism component of the Black AIDS institute’s report.

  21. anon says

    I wonder how the fact 25% of all black men in the US end up in prison affects this number.

    The statistics cited show how the rates of infection in black MSM men are much higher than for other populations, which correlates with risk of infection because of selection bias in sex partners.

    It is very easy for a disease to affect different populations differently, so yes, viruses can discriminate. White men have a 2% chance of being immune to HIV, while other populations do not, and it’s probable that white men have a harder time getting infected (based on total viral load exposure) than other populations even if they are not completely immune.

    Lack of medical treatment will mean that infected men go around not knowing they are infected but still having unsafe sex.

  22. daftpunkydavid says

    quick note:

    “distressing news: black men living in the United States have a 1 in 4 chance of contracting HIV, even though they represent only 1 in 500 Americans.”

    So icelanders should have a 100% chance of contracting HIV since they are 100% of Icelanders? Or, since black people overall account for 12% of the US population, so should they also have a 12% chance of contracting HIV?

    Your statement is misleading.

    What I think you wanted to say, is that of the new cases of seroconversion, black men who sleep with men are overrepresented: even though they represent 0.2% of the Americans, they account for 25% of new cases of seroconversion.

    Otherwise, your sentence does not make a lot of sense.

  23. Tom in long beach says

    This is so tragic. Access to information and condoms is important. But more important is the having self esteem to be safe until you find someone you can really trust. Also any stigma attached to birth control or safe sex is just wrong. I just wish we all treated each other better. In the long run this also shows why marriage equality is important. Gay people deserve stable long term relationships. Also the importance of coming out.

  24. Derrick from Philly says

    ‘It is time for black gays to take responsibility for themselves and if they are not willing to do so, then they will just have to live with the consequences. Other gays have lost their patience with them, I am afraid…”

    Oh, my, we’re so afraid of loosing the patience of people who have nothing to do with us anyway. Whatever shall we do?

  25. Chitown Kev says


    What are you blathering about?

    The black gays on this site are pretty well informed AND (in my experience) will scream even louder at a black homophobes that white gay racist asshats (such as yourself).

  26. Francis says

    Looks like the trolls have certainly made their impression on this page.

    It’s revolting, really, even from a noted troll, that anyone would say gay people have “lost their patience” with black gays, as if they’re somehow not apart of our community. THAT is tragic right there. It’s why many out black gay people feel absolutely no support nor connection towards the larger gay community, which in itself is another factor in why HIV rates are so astronomical with MSM black people.

    While it is true that the fact black people have a higher percentage of HIV overall in general, regardless of sexuality, which is why HIV rates are so much higher in the community, that’s too simplistic a reason why we see tragic numbers as being reported today. What is known is that demonizing black people is NOT going to drive people to get tested and in fact is going to keep people scared from being open about their sexual practices, one of the major reasons why HIV continues being spread. Hopefully, people will put their agendas to the side because our people are DYING. And there are some legitimate cultural issues within the black community which need to be addressed going forward.

  27. Sargon Bighorn says

    Once again Gay Americas turn on each other like a pack of dogs, while individuals suffer for other reasons. So the study is flawed and every one every where all the time is at risk of getting HIV if they have unprotected sex with an HIV+ person. Shall we know get on with business if ya’ll are done fighting.

  28. ratbastard says


    I consider this a problem for the entire American community, not just a black problem. Black people don’t exist in a vacuum. My external vs internal comment regards biases including homophobia within the black community as opposed to external, i.e. racism directed by non-blacks at blacks. I think fear of being themselves [and not just gay black men] because of social pressure within the black community to conform to a certain male standard is one of the reason for the high rate of HIV and other STDs. I suspect the #1 reason is a disproportionate number of black males live in places like the southeast states where like I said in a previous post, access to decent heathcare and access to health insurance is a major issue for black and non-black alike, including heterosexuals. Add to this many live in rural areas where the situation is even worse. Honestly though, if you live in a city like Atlanta or D.C., heathcare including access to HIV prevention, etc. is not difficult. Yes, you may have a ‘wait’, but for Christ’s sake, this is true of every doctor’s office visit or visit to a hospital or clinic. It’s a fact of life people must deal with, I do, and I don’t like anymore than anyone else.

  29. BobN says

    We know the churches aren’t doing it. The govt isn’t doing it, not directly, at least. So who’s putting up all those billboards directed at black, gay men? And the ads on bus stops and in the papers?

    If it’s not the national gay and AIDS organizations, who is it?

  30. ? says

    Lots of young straight people in that same age group often have unprotected sex, yet you don’t see them becoming infected with HIV. There’s an unspoken ugly truth about HIV, and that is that it is still a disease that mainly afflicts gay men.

  31. AT says

    This is not new… We’ve known this for years. It’s the pinnacle of institutionalized racism and homophobia. And why the hell does that graphic have number of diagnoses? Population growth happens, people, so the number will rise even if the proportion stays the same (not that I’m saying it is). Misleading science! GAH.

  32. says

    My issue is that when you refer to homophobia as internal discrimination and racism as external discrimination, it’s clear that your frame of reference is Black people and not the gay community. These men are just as gay as they are black.

    These are gay men who are at increased risk of HIV. While it is true that this is a problem for the Black community it is just as big a problem for the gay community. You’re comments seem to want to downplay that.

    In terms of waiting, the more difficult it is to get tested, the less likely one is to do it. We often go to doctor’s offices and hospitals and wait because we know or suspect something is wrong. If you apply that same logic to HIV testing then prevention kind of goes out the window

  33. Donald says

    Hey guys, if we argue enough about the wording or the statistics or yell race baiting then we can just ignore what’s really going on with and happening to young black men.

  34. ratbastard says


    I’m well aware these black men are also gay. I’m not trying to disassociate myself or suggesting gays in general should because they’re black.

  35. Tatts says

    “Hey guys, if we argue enough about the wording or the statistics…we can just ignore what’s really going on with and happening to young black men.”

    The problem is, Donald, that the story is told with words and statistics, and they are of crucial importance here. And they are misrepresenting the reality. Gay black men in the US do NOT have a 1 in 4 chance of contracting HIV. The risk of contracting HIV is a 0% or 100% proposition for each individual, based on his actions.

    Look, it’s like Barack Obama. He didn’t get to be President because he just happened to luck into the group of black men who didn’t go to jail. And those who did go to jail didn’t get there through some bad-luck lottery. They are in jail because of their actions, not their skin color. Obama is President because of his actions, not his skin color.

    The same system that rewarded Barack Obama (and Colin Powell and Michael Jordan and Tina Turner and Shirley Chisolm, etc.), exists for everyone. And the safer-sex messages that are everywhere you turn for the past 20 years are there for everyone. Each person is responsible for his individual actions. The report, and the story, don’t imply that.

  36. andrew says

    “poor access to health services”? How about irresponsible individual behavior? I don’t know about the rest of the country but in the city of Phila pa there are scores of places where you can get FREE condoms. Condoms are a good way to prevent STD infections.

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