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HIV and AIDS are relatively common among homosexual and bisexual men. Of all Dutch people who are diagnosed with HIV, about two-thirds are in this group. Every year, 700-800 men who have sex with men (MSM) are diagnosed with HIV. How come? Why are MSM vulnerable to HIV?

In this article we discuss the relationship between homosexuality and the increased risk of HIV. And how can HIV infection and its spread be prevented?

Homosexual and the risk of HIV


There are two main reasons why HIV affects so many homosexual men:

  1. HIV is transmitted more easily via (unsafe) anal sex than via unprotected vaginal sex;
  1. Many gay men have loose sexual partners.

More risk of HIV due to unprotected anal sex

The HIV virus is in the blood, semen, pre-cum and vaginal fluid of an infected person. If these bodily fluids come into contact with someone’s bloodstream or mucous membranes, the virus can enter the body.

The chance of getting infected with HIV is greater during anal sex than during vaginal sex, because the mucous membranes of the anus are more easily permeable than the mucous membranes of the vagina. The intestinal mucosa absorb the HIV virus easily because of their absorbent function. In addition, the mucous membranes of the anus are more vulnerable. This makes it easier to cause small wounds in this mucous membrane during anal sex. These wounds are a gateway for the HIV virus.

Optimal spread of HIV through changing sexual roles

The risk of HIV infection during anal sex is about 18 times greater than during vaginal intercourse. The ‘receiving’ partner during anal sex is more at risk of becoming infected with HIV than the partner who is penetrating. The spread of HIV among homosexual men is optimized because they often have a varying role in the ‘receiving’ and ‘giving’ of anal sex.

More chance of HIV due to loose partners

Many gay men have separate partners. If they have a permanent partner, there is often a so-called ‘open relationship’. They are therefore often sexually active outside of their relationship. A recent study showed that 41.3% of all gay couples have ‘open sexual arrangements’. Because both in the permanent relationship and in the outside world (also) are suffering insecure, there is an increased risk of being infected with HIV.

Risk of other STDs

An additional factor is that unsafe anal sex with changing partners also increases the risk of other STIs . In recent years, more and more STDs have been diagnosed among homosexual men. Because someone with an STD is more likely to contract HIV, this is one of the causes of a relatively large number of HIV infections in the gay scene.

Prevent HIV

HIV is a serious condition that you should try to prevent at all times. Although this virus infection can be treated well with HIV inhibitors , the symptoms of HIV symptoms often fail, but healing is not yet possible. Once you have contracted HIV, you will never get rid of it again. So safe sex. But how do you do that exactly?

Safe sex

  1. Always use a good condom in combination with a lubricant during anal sex . Condoms with a CE mark are suitable for anal sex. Never use a condom whose expiration date has expired. These cracks are easier. By using sufficient lubricant, you reduce the risk of the condom tearing. NB: Always wear a condom with you. Condom use must be self-evident;
  1. Piping is only safe if no sperm enters your mouth;
  1. Use a band or cut condom during rimming. If you do not, there is a risk of HIV transmission when there is hemorrhoids or blood due to anal contact;
  1. Do not share sex toys. If sperm, pre-fluid or blood is present here, the HIV virus can be transmitted;
  1. Choose less risky sex techniques, such as subtracting each other. Note that fingering is risky when there is sperm, pre-cum or blood on the fingers.

Testing for HIV

Relatively many HIV carriers only discover that they are infected with HIV if their immune system is so weakened that they get sick every time. They already have AIDS. In the meantime, they have been able to infect their sex partner (s) all the time. This contributes greatly to the spread of HIV virus among homosexual and bisexual men.

For men who have unsafe sex with changing, male partners, it is therefore very important to regularly (at least once every 6 months) to have HIV tested. This can be done at the GP, the GGD and through an HIV self-test. Those who turn out to be HIV positive can then be treated immediately. This way it can be prevented that they develop AIDS and that they spread the HIV virus further. Partner warning is also very important to prevent further spread of HIV.


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