In this section you will find information on sex with men that is mostly relevant to casual sex partners. We cover issues relating to more permanent relationships in the section on relationships. This section doesn’t cover advice on safer sex. For information on safer sex, go to our sex and sexual health website.

Most gay men that have HIV were infected through sex. And while a significant number of gay men become infected with HIV when practising safer sex (condoms break or slip off) and a few through oral sex (the UK’s Public Health Laboratory Service estimates that between 1% and 3% of HIV cases may be due to oral sex [1]) the majority of us become infected through unprotected anal intercourse that was consensual. Most of that unprotected anal intercourse happened with no discussion about HIV status. So while very few men set out to deliberately infect others with HIV and very few men set out to become infected, this is how the majority of gay HIV infections occur.

So why are we stating the obvious to people who know this more than anyone else? Well now that you have HIV, it’s important to remember that the way most of us became infected is how most of us will pass on HIV to others if our behaviour remains the same. Moreover whatever our reasons were for taking risks when we were negative, those reasons don’t disappear just because we received an HIV diagnosis. So while the vast majority of us don’t set out to infect people, around 40% of us in any year fuck without condoms with people whose HIV status we don’t know or who are HIV negative. This undoubtedly puts our sexual partners at risk and accounts for a substantial number of the new infections that occur every year.

To get more information on issues related to HIV and your sexual partners, expand the articles below by clicking on the "Read More" button. 

Responsibility for safer sex
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Neither positive men nor men without HIV are solely responsible for the sex they have together. This doesn’t imply that either person can push all of the responsibility for keeping sex safe onto the other person, it means that you have responsibility for the sex you take part in whatever your partner chooses to do. As people with HIV, we have responsibility because we have the potential to harm and the means to avoid inflicting harm. Negative men have responsibility because they have the motivation and the means to avoid personal harm.

Taking responsibility for our actions isn’t difficult. As adults we do it all the time, and just because we have a particular virus, we are no less capable of taking responsibility for our actions than other people, nor are we less willing to be responsible. However people confuse responsibility and blame. Taking responsibility for your actions when you have sex is not the same as taking on blame. Only you can decide whether or not you are going to accept responsibility for your actions.

HIV disclosure by partners
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From the Gay Men’s Sex Survey 2002 (Sigma Research) it was found that 70.7% of men who had not been diagnosed with HIV expect a man with HIV to disclose his status before sex. This is particularly true of men who live in areas with a low prevalence of HIV or do not know many people with HIV [2]. These men will often assume that men with HIV will avoid fucking without a condom. This naivety places these men at particular risk of HIV exposure if you do not disclose your HIV status as they will often assume you are HIV negative and that there is no risk in fucking without condoms. Men who are naïve about the HIV status of their sexual partners will rarely think to disclose their own HIV status nor ask you to disclose your HIV status. If you disclose your HIV status, these same men will often believe that all sex with you carries a HIV risk which they are not prepared to take and will choose not to have sex with you. This creates real difficulties for men with HIV, because when it comes to disclosing our own HIV status it feels like we’re damned if we do and damned if we don’t.

Men who live in areas with a high prevalence of HIV, men who have HIV and men who have lots of acquaintances with HIV, are less likely to expect you to disclose your HIV status [3]. However many still do expect disclosure. The less naïve a person is about the potential HIV status of their sexual partners, the more likely they are to be comfortable about having sex with people with HIV. However, these men are also unlikely to disclose their own HIV status or ask about yours.

So in summary, whatever the HIV status of your sexual partners, wherever they live, it is unlikely that they will disclose their HIV status to you. It is therefore important not to draw any conclusions about the HIV status of your partner when no disclosure occurs – just as you wouldn’t want anyone drawing conclusions about your HIV status if you choose not to disclose. We discuss issues of disclosure and how to disclose, in depth in the section Disclosing your HIV Status.

Changing behaviour
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Very few of us intended to get infected with HIV, but for most of us, our sexual behaviour put us at risk and we became infected. Likewise, even though most of us are clear that we have no desire to pass on our HIV infection to others, around 40% of us still fuck without condoms with people we know to be HIV negative or whose HIV status we don’t know. So, more than most people, we know that what we do when we have sex doesn’t always match what we intend to do, and it isn’t always obvious why this is.

If you find yourself having sex that puts either your partners or you at risk of infections when you didn’t intend to, it’s worth trying to discover why you don’t have the control you’d like to have over your sex life. For some of us it is as simple as examining some of our thought processes, for others it may require acquiring easily learnt skills and, for some, the solution may be to take some time out by talking through their situation with a professional who can help. Whatever the solution, most people find that the rewards of being in control of their sex life outweigh any effort it takes to get there.

In the heat of the moment we can often tell ourselves, and believe, things that we know not to be true, and this can lead to situations where we risk passing on HIV. Here are some common examples which may sound familiar to you:

“He’s probably positive” – depending on where you are in the country, between 2% and 13% reported that they have HIV [4]. Therefore, unless you serosort (which we explain later on this page), the majority of men you have sex with will not be HIV positive.

“He wouldn’t put himself at risk if he was negative” – if this was true, hardly anyone would become infected through sex. Moreover, as people with HIV, we know that we were negative once and most of us put our self at risk.

“If he doesn’t care, why should I?” – think back to when you found out that you had HIV. You cared, it’s no different for negative men now.

“He’ll know I have HIV if I use a condom” – most gay men who fuck use condoms most of the time whether or not they have HIV. Using a condom doesn’t indicate that you have HIV and is just as likely to be perceived by your partner as you protecting yourself from HIV infection as protecting him.

“It’s too late to stop now” – you may not want to stop, but sex can be stopped at any time. Moreover, if you fuck someone and cum, the risk of passing on HIV increases.

“My viral load is undetectable, so I can’t pass on HIV” – your viral load is the measure of the amount of HIV in your blood, not your cum or the mucus in your arse. Even if your viral load is ‘undetectable’ the amount of HIV in your cum or up your arse could be much higher. Therefore you can still pass on HIV even with an undetectable viral load.

“I can’t pass on HIV if I’m a bottom” - the foreskin and skin around the end of the cock is very susceptible to HIV infection and anal mucus up your arse can have a high concentration of HIV so, even if you’re always the bottom in sex there is a very real risk that you could infect your partner.

If you find that you are having unprotected sex that you didn’t intend and you can’t remember why you did it or what you said to yourself, it can be very tempting to pass it off as “it just happened”. However, even if there is no verbal communication, you know when you are going to have sex, you know when you are about to fuck or get fucked without a condom, and so you have an opportunity to take responsibility and communicate whether or not you are agreeing to the sex you are about to have.

If you are having trouble taking control of the sex you have, it may help to speak to a counsellor. A course of counselling will give you the opportunity to explore you feelings around sex and examine your behaviour in a non-judgemental environment. It could be that you want to talk through problems that you’re having since being diagnosed HIV positive, or you may find solutions to problems that you have been carrying around since before you were diagnosed. Either way, it’s important to remember that accessing counselling is done for your benefit not anyone else’s. It gives you the opportunity to focus on you and any aspect of your sex life or behaviour that you want to change. Details of some free counselling available to gay men in London can be found on our London Prevention and Support Services webpages, and if you need help finding counselling more suited to your needs you can call THT Direct on 0808 802 1221.

If you find it difficult to negotiate the kind of sex you want with your partners, an assertiveness course can help you to analyse what stops you from asking for what you want, and increase your communication skills so you are able to ask for what you want. For help finding something suitable for you, call THT Direct on 0808 802 1221.

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Serosorting is a perfectly legitimate sexual strategy. It is a strategy that means that HIV positive gay men are making an informed choice about the sex they have, weighing up the possible risks to themselves through unprotected sex against the intimacy of sex without condoms and the knowledge that they won’t be putting anyone at risk of getting HIV.

As we said above however, serosorting is not without its risks to you and the men you have sex with. You can still get or pass on other sexually transmitted infections, the most serious of which being Hepatitis B or C. There’s also a chance that even though you are already HIV positive you could become infected with another strain of HIV which, if resistant to some of the available anti-HIV drugs, could reduce your HIV treatment options. You can read more about this in the section on Protecting Yourself.

Saunas, sex clubs and anonymous sex
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If you use sex venues such as saunas or sex clubs, or go cruising then there’s a good chance that a lot of the sex you have in these places is anonymous and does not involve any conversation or discussion whatsoever. In these situations the decision about condoms may well be up to you. Think about why you would want to use a condom – maybe because you really don’t want to pass HIV on to anyone else, or maybe because you don’t want to put yourself at risk of infections such as hepatitis. Don’t assume everyone in a backroom or sauna is HIV positive. It simply isn’t true.

Responsible sex venues that cater for all gay men, HIV positive and negative, should have a good supply of condoms and lube. Not all places do, however, so it’s always a good idea to take plenty of condoms and lube with you so you don’t find yourself in a situation where you may feel pressured into doing something you don’t want to do. There’s also the possibility that some gorgeous guy you want to fuck won’t be up for it unless you use condoms, and you wouldn’t want to miss out on that!

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Well, accidents do happen. Condoms can slip or break, and not everyone manages to be safe 100% of the time. If you think you have exposed someone you have just had sex with to HIV then you might consider discussing PEP with him. PEP stands for Post Exposure Prophylaxis, and consists of a 28 day course of anti-HIV drugs which should stop someone from becoming infected with HIV if they have been recently exposed. Never be tempted to just give your sexual partner some of your anti-HIV drugs instead of getting them to access PEP properly. It’s possible that they could be allergic to the drugs you are taking, or that they are not suitable for PEP.

There’s more information about PEP on our Sex and Sexual Health pages including a link to a list of clinics where you can access it.


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1 Sexual Health for People Living with HIV. Reproductive Health Matters, 2007; 15(29 Supplement):67–92.
2 Out and About: findings of the United Kingdom Gay Men's Sex Survey 2002. Sigma Research, 2003.
3 Out and About: findings of the United Kingdom Gay Men's Sex Survey 2002. Sigma Research, 2003.
4 Multiple Chances: findings of the United Kingdom Gay Men's Sex Survey 2006. Sigma Research, 2008.