Can I see if he is HIV-positive?

In most cases, when gay men have sex with someone new they will not know their partner's HIV status.

As of 2019

• Research suggests that up to one in seven gay men on the London gay scene is living with HIV, it's roughly one in twelve for the overall London population. 
• Estimates suggest that there are a over 50,000 gay/bi men living with HIV in the UK 
• It's estimated that about 5% of gay men living with HIV are undiagnosed - this is that they don't know they have the virus yet.
• There are HIV-positive men of every age and every nationality living in every part of the UK.

Because of advances in treatment, it is virtually impossible to be able to tell that someone has HIV just by looking at them. It's easy to think that only a certain 'type' of gay man is likely to have HIV, however there are men on the extreme sex circuit who are HIV-negative, just as there are HIV-positive young guys dancing to Little Mix at G-A-Y Late. People living with HIV come in all shapes, sizes, ages and ethnic backgrounds. 

Will he always tell me if he is HIV-positive?

It is unrealistic to expect that everyone will tell you their HIV status.

• According to research, the majority of gay men expect HIV-positive men to disclose their status before sex.

• However, about a third of men living with HIV never disclose their status to casual partners. 

• Just under half of HIV-positive men sometimes tell their sexual partners that they are positive

• About one in five always disclose their HIV status.

Why don't some HIV-positive men share their status?

HIV is associated with stigma and fear; telling someone you’re positive often leads to rejection.

• Research shows that more than half of HIV-negative men wouldn’t have sex with a positive man which could explain why many positive men keep quiet about their status. 

• In saunas, sex clubs or when you are using apps like Grindr or Scruff, lengthy conversation isn't expected, which makes it difficult for both positive and negative men to discuss their status, even if they are about to have unprotected sex.

Is he HIV-negative if he doesn’t mention HIV?
Many HIV-negative men tend to think that if someone is willing to have unprotected sex with them, they will also be HIV-negative. Similarly, HIV-positive men may believe that their partner is also positive if they choose to have unprotected sex. This is how HIV is often transmitted.

• If someone you're going to have sex with doesn't mention HIV, it doesn't necessarily mean that he has the same HIV status as you. Many men don’t even know that they are HIV-positive which could be a reason why they may not reveal their status.

What if I only have sex with guys who have the same HIV-status as me?

If everyone only had sex with people who had the same HIV status (sero-sorting) then there would be no increase in the number of people living with HIV.

However there are still risks to unprotected sex between HIV-positive men.

• They can pick up other STIs, including hepatitis C. Some STIs will make it more likely that HIV will be passed on during sex. 

• It’s very difficult to sero-sort if you are HIV-negative because you can never be 100% certain that a person is indeed negative. Even if they are, there is still the risk of catching other STIs.

• Guys are more likely to have sex without condoms if they think someone has the same HIV status as them. However, research has shown that around 40% of HIV-negative men who say they 'know' their partner's HIV status are in fact guessing.

Some HIV-positive men use online dating sites, to find other positive men for condomless sex, because they feel more able to disclose online (although many positive men still won't choose to give out that information).

What if he says he is HIV-undetectable?

HIV-undetectable is a term used to describe someone who is living with HIV but on successful and effective treatment. Someone who is HIV-undetectable cannot pass on the virus through sex. 

Usually after someone is diagnosed with HIV they are put on treatment straight away, within a short period of time the medicine kicks in and that person's viral load (the amount of HIV in the body) begins to drop. Once it goes under a certain level they become 'undetectable', meaning that the amount of HIV in their body is so low that it will not show up on test. 

However, once they become HIV-undetectable then they cannot pass on the virus to anyone. 

The most recent study (PARTNER2) recruited and monitored gay couples between 2010-18, where one was HIV-undetectable and the other HIV-negative. There were 782 couples eligible for the study who had condomless anal sex 76,000 times and the study found no transmission of HIV between the couples.

The first PARTNER Study (2010-2014) monitored condomless sex between over 1,000 gay and straight couples where one was HIV-undetectable and the other HIV-negative. After these couples had condomless sex over 58,000 times the study found no transmission of HIV between the couples.

Can I be sure that he is HIV-negative?

The only way to be certain of your HIV status is to have an HIV test. It's not sensible to have unprotected sex with someone you've just met on the basis that they say they're HIV-negative. If they're willing to take that risk with you, they're probably willing to take that risk with other people too, and it's possible that they're HIV-positive but don't know it.

It's estimated that more than 80% of new HIV infections are from sex with someone who was unaware that they were HIV-positive.

Listen to these gay men talk about their life with HIV:

Listen to these gay men talk about 'coming out' about their status:

LAST UPDATED: 6 September 2019