LGBTQIA+ Sexual Health and HIV Screening and Prevention

Approximately 1.2 million people in the U.S. currently live with HIV. Though that is a small number relative to the country’s total population, statistics show that the LGBTQIA+ community is disproportionately impacted by the virus and the social stigma and discrimination attached to it.

Knowing your HIV status is an important part of your sexual health. Here’s what you should know to protect yourself and others.

What Is HIV?

Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS), which in the further absence of treatment can prove fatal.

There is still no cure for HIV or AIDS. However, thanks to advances in health care, HIV is much easier to control. People who receive effective treatment can live long, healthy lives and protect their partner(s) from becoming infected.

HIV screening is the only way to know if you have HIV. Understanding your HIV status helps you make healthy decisions to prevent getting or transmitting the virus. Most HIV tests are free, easy, and you can administer them with a self-test or in-person test at a pharmacy.

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Symptoms of HIV

Many people with HIV report having flu-like symptoms around two to four weeks after infection. Symptoms like fever, rash, fatigue, night sweats, sore throat, and muscle aches are all associated with HIV but are common with other illnesses as well.

Some people with HIV never show any symptoms. About 13% of people in the U.S. right now are HIV positive but do not know they have the virus. That is why it’s best to get tested to confirm your HIV status.

If HIV is not treated, it often progresses to AIDS. People with AIDS can become ill with certain types of pneumonia, thrush, brain infections, and other usual infections.

HIV in the LGBTQIA+ Community

Though HIV is a general health crisis in the U.S., the epidemic continues to disproportionately impact certain members of the LGBTQIA+ community.

In 2020, men who had sex with other men (MSM), were the population most affected by HIV in the U.S.:

  • MSM accounted for 71% of new HIV diagnoses in the U.S.
  • Black/African American MSM made up 39% of those new diagnoses.
  • Hispanic/Latino MSM made up 31% of those new diagnoses.

Transgender people accounted for about 2% of the new HIV diagnoses in 2020, yet it disproportionately affected younger people:

  • The largest percentage of diagnoses of HIV infections among transgender persons was for transgender women ages 25 to 29 years old (28%), followed by transgender women ages 20 to 24 years old (21%).

In most states, it is legal to discriminate against someone based on their gender identity or sexual orientation. This can lead to job loss, housing loss, and a lack of health care insurance, which can significantly impact someone’s HIV treatment.

Discrimination against the LGBTQIA+ community can also directly facilitate the spread of HIV because some people may have few options left besides sex work to meet their most basic needs.

Anti-LGBTQIA+ bias in the U.S. has further enabled the spread of HIV because many people fear screening or treatment due to harassment and discrimination. A Kaiser Family Foundation survey of gay and bisexual men in the U.S. found that 30% did not feel comfortable discussing their sexual behavior with their health care provider, and 15% had received poor treatment because of their sexual orientation or gender identity.

For gay and bisexual youth, homophobia and harassment help explain why so many young people in the LGBTQIA+ community are unaware of their HIV status, furthering the possibility they will spread the infection.

HIV Treatment Options

People with HIV should seek medical attention as soon as possible. Medical providers will prescribe a medicine called antiretroviral therapy, or ART. This medicine reduces the viral load of HIV in the body to the point that tests can no longer detect the virus in the blood (called undetectable viral load).

Maintaining an undetectable viral load is the best thing people with HIV can do to stay healthy and keep their immune systems working well. With an undetectable viral load, the body will also prevent transmission from person to person through sex and from mother to child during pregnancy, childbirth, and breastfeeding.

If you suspect you or your partner(s) may have HIV, it’s very important to get tested and seek medical treatment. By taking care of yourself, you can avoid transmitting the infection to others.

HIV Prevention

Today, there are more effective options for preventing HIV than ever. Use this knowledge to keep yourself and your partner(s) safe.

Sexual health

Steps you can take to stay on top of your sexual health include:

  • Know the risks of sexually transmitted infections (STIs) — There is little to no risk of getting HIV through oral sex, compared to vaginal or anal sex. You can, however, get gonorrhea, chlamydia, and syphilis through oral sex.
  • HIV is only transmitted through bodily fluids (semen, vaginal fluid, blood).
  • Talk to your sexual partner(s) to understand their HIV status and encourage testing if they aren’t sure.
  • Use an external or internal condom the right way every time and for every type of sex, including oral sex. Condoms will help to prevent other STIs as well.
  • Use water-based or silicone-based lubricants to help prevent condoms from slipping or breaking.
  • Schedule regular HIV and STI screenings to keep your HIV status known.
  • Not having sex (abstinence) is a 100% effective way to make sure you won’t get HIV through sex.
  • Have honest conversations with your partners about the best way to have safer sex.
  • Take daily pre-exposure prophylaxis (PrEP) or use post-exposure prophylaxis (PEP) to prevent HIV.


Another way to prevent HIV is by taking a once-daily pill called PrEP (pre-exposure prophylaxis). This Food and Drug Administration-approved pill can reduce the risk of getting HIV from sexual intercourse by 99%.

PrEP blocks the virus from making copies of itself and spreading throughout the body. It’s important to know that PrEP only protects against HIV infection, not other STIs. PrEP also appears to work for those taking gender-affirming hormones, although more research is still necessary.

When taken daily, oral PrEP is a very effective way to prevent HIV. PrEP is effective for all individuals who may find they are at risk of exposure to HIV, including heterosexual and cisgender persons.


Another HIV-prevention strategy is PEP (post-exposure prophylaxis), a medication you can take immediately after a single high-risk event, such as condomless sex with a partner whose HIV status is unknown.

You must take PEP no more than 72 hours after your potential HIV exposure, with a three-drug regimen taken over 28 consecutive days. Though PEP has proved it works, taking it does not guarantee that someone exposed to HIV will not acquire the virus.

Talk to your health care provider to discuss PrEP, PEP, and other HIV-prevention methods.

Preventing HIV Transmission

Though HIV is still an incurable virus that infects thousands of people every year, health care modernization and public health education have helped many people with HIV find effective treatment and protect their partner(s) from transmission.

Still, because the infection impacts the LGBTQIA+ community more than it does other demographics, knowing how to screen for and prevent HIV is of paramount importance.

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 800 doctors’ offices and outpatient centers, with locations throughout Pennsylvania, Maryland, New York, West Virginia, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. We are dedicated to providing Life Changing Medicine to our communities.