Words by Ian Howley @ianhowley

Most HIV-positive gay men will tell you living with HIV can be frustrating at times, not because of the condition but because of other people’s attitudes. In our ‘Big Gay Sex Survey’, out of the 3,141 men who took part 9% said they were living with HIV. So we looked at the sex lives of the men who know they have HIV to see the differences, if any, between HIV-positive men and HIV-negative men when it comes to sex and relationships. 

Who is HIV-positive?

In terms of ages, men aged 45-54 were most likely to say they were HIV-positive. 97% were gay with 2% saying they were bisexual. 1% identified themselves as ‘straight - but have/had sex with men’. 

The age breakdown of the men who took our survey and said they were HIV-positive versus the men who said they were HIV-negative is as follows:

18 and under: 0% 100%
18-24: 1.7% 98.3%
25-34: 7.3% 92.7% 
35-44: 14.6% 85.4%
45-54: 20.2% 79.8% 
55-64: 15.4% 84.6%
65 and older: 8.7% 91.3% 

We asked men living with HIV: Do you know what your viral load is?

  • 83.5% said that they were undetectable.
  • 10.4% said that they were not undetectable.
  • 6.1% said that they didn’t know.

When asked when they last had sex: 

  • 15% said they’d had sex the day they took the survey compared with 13% of HIV-negative men.
  • 46% said in the previous week. Exactly the same as HIV-negative men.
  • 15% said a couple of weeks ago. Again, same as HIV-negative men. 

So for recency of sex, there was virtually no difference between HIV-positive men and HIV-negative men. 

When asked how many sexual partners they had in the last year:

None:  2% 4%
1: 15% 28%
2-4:  17% 24%
5-12: 18% 21%
13-29: 18% 11%
30-99: 23% 6%
100+:  5% 2%

This suggests HIV-positive men have a greater number of sexual partners compared with HIV-negative men

The question this raises is, are men who have more sexual partners more likely to become HIV-positive? Or once they become positive do they become more sexually active? Or a bit of both?

So what’s sex like for an HIV-positive man?

Colm, 44 from Cork told us: “I consider myself a very sexual and sensual person. I do need physical interaction. I’m single and live alone, so by default I opt for a hookup as the easiest way of getting that without having to expose too much of who I am. Yet when there’s a good connection in the hookup, I become more interested in conversation and learning more about the person and the sex becomes secondary. I do also consider sex a very natural and social activity, which can be great when shared, and which is at its best when undertaken with a generous and considerate spirit.”

John, 37 from London told us: “I do feel like sex has taken over and I spend far too much of my time and energy looking for sex and always chasing the next catch. I guess you hear friends chatting about their sex life and sometimes think you should be keeping up, but that is dumb as you never know for sure what other people are actually up to. I also feel that since becoming HIV-positive last year I have slipped into a bareback chemsex circle far more than I would have wanted. This is going to sound like a very stereotypical statement but... I would love a relationship so I could step off the crazy roundabout and just chill with someone more personally and not have to keep looking for sex.”

Andrew, 30 from London said: “Since getting HIV, I’ve been rejected by a lot by guys when I disclose. I also have experienced fatigue since I seroconverted, so I haven’t been able to keep my body as fit as it was, so I’ve struggled with not feeling attractive.”

David, 38 from Coventry described what’s it’s like to live with both HIV and hep C. “I have HIV and hep C. I’m open about my status to people I meet but once they find out I have hep C they run a mile, so now I seem to never have sex apart from with people who just don’t care or if I take drugs and just go somewhere like CumUnion. It’s all rather depressing and I don’t really know how to sort it. I see someone at Heartlands in Birmingham and it works a bit but taking the drugs just seems a way out. I take them at home on my own and I catch myself hoping they will kill me.”

Jon, 52 from London said: “I would prefer to have less casual sex and more sex with a regular partner (but an open relationship). I didn’t use chems last time but all too often sex and chems are linked and it seems that most people I meet cannot do one without the other. I wish chems were the exception rather than the rule.”

Martin, 28 from Southport told us: “Since finding out my HIV status my confidence levels have dropped dramatically when meeting up with men. I’m not sure if it’s through stigma or me being worried about the outcome. But I’m finding it hard to meet someone.”

A lot of HIV-positive men told us similar stories. Either they are having loads of sex that is meanlingless, drug centred and would like to be settled with someone or they find it difficult to find someone because of their low self-esteem and the stigma surrounding HIV. 


Next we looked at whether there were differences between HIV-positive and HIV-negative men in terms of who they last had sex with. 

We asked: Who did you last have sex with?

Casual:  41% 31%
Dating: 8% 11%
Sex buddy:  13% 10%
Boyfriend/LTP: 20% 36%
Husband/CP 5% 8%
Threesome 5% 2%
Group sex 8% 2%

HIV-positive men were more likely to have a casual partner, less likely to have sex with a boyfriend or long term partner and more likely to be invloved in group sex. 

What about relationship status? Are HIV-positive men more likely to be single?

Single: 41% 31%
Dating: 8% 11%
Mon Rel: 13% 10%
Open Rel: 20% 36%
Married/CP 5% 8%
Other 5% 2%

The HIV-positive men who took our survey are more likely to be single or more likely to be in an open relationship. However other surveys have found that HIV-positive men were more likely to be in a relationship than HIV-negative men.  

What type of sex are HIV-positive men into? Are they more or less likely to have anal sex? 

We asked: What did you do the last time you had sex? (tick all that apply)

Got blow job: 72% 72%
Gave blow job: 77% 75%
Fucked (top): 44% 37%
Fucked (bottom):  56% 40%

When it comes to oral sex there was basically no difference. However HIV-positive men were more likely to have anal sex. 

Are HIV-positive men more or less likely to use a condom when having anal sex? 

We asked: Did you use a condom the last time you had anal sex with a casual partner?

Yes 90% 34%
No 10% 66%

90% of HIV-positive men used a condom the last time they had sex with a casual partner. Only 10% of HIV-positive men said they didn’t compared to 66% of HIV-negative men. 

But did they cum? 

Yes: 70% 86%
No: 30% 14%

HIV-negative men are more likely to cum when they have anal sex with a casual partner. 

Where did they cum?

On myself: 38% 37%
On him:  18% 29%
Floor, bed, wall: 19% 9%
Up his arse: 17% 16%
In his mouth: 8% 9%

The only big difference here was that HIV-negative men are more likely to cum on their partner. HIV-positive men were more likely to cum on a bed, floor, wall, etc. 


Sex, drugs and rock and roll. Are HIV-positive men more or less likely to engage in drug-fuelled sex? 

We asked: Were you high the last time you had sex? 

Yes 28% 7%
No 72% 93%

It’s clear that HIV-positive men are more likely to use drugs while having sex. Many HIV-positive men told us that sometimes the two go hand in hand and it’s difficult to get away from it. 

 Miles, 40 from London told us: “I went from having loads of sex every week to none. But that’s because it was always with drugs. Now I’ve stopped using – I haven’t had sex for over five weeks.” 

Jose, 43 from London told us: “Drugs have taken centre stage and though I enjoy doing it while on them now and then, I feel it is not the way I want to carry on in life.”

Zed, 29 from London said: “I haven’t had sex in over two years. I came out of a five year relationship. Now the scene is so different. There are chems everywhere. I tried it once but the sex felt weird.”

What drugs did these men use?

Mephedrone: 52% 29%
G: 46% 23%
Crystal meth: 31% 8%
Cocaine:  7% 18%
MDMA: 19% 18%

There was more ‘chemsex’ drug use amoung HIV-positive men. They are more likely to do harder drugs such as meph, G and crystal meth. HIV-negative drug users were more likely to do cocaine. 


Who is having the best sex? We asked both HIV-positive and HIV-negative men if they were happy with their current sex life. 

Yes 42% 48%
No 40% 37%
Not sure 18% 15%

So what they think could help them to have a happier sex life?

“If I were HIV-negative and if had not got into drugs in the first place.” Said Michael, 33 from London.

John, 37 from London said: “A relationship possibly... being able to move away from the whole chemsex thing.”

Chaim, 21 from London said: “All I want is to find a stable, trusting and loving partner.”

Richard, 49 from Leeds said: “A better acceptance and understanding of undetectable.”

Finley, 27 from Brighton said: “I would like greater self-confidence.”

Miles from London told us: “I would like to get used to sober sex a bit more.” 

And finally, Jamie 34 from London said: “ I would like people to answer their texts quicker.” So do most guys, Jamie. 

HIV-positive men are...

Overall our survey found the following:

  • HIV-positive men have more sexual partners.
  • HIV-positive men are more likely to be single or in an open relationship.
  • HIV-positive men are more likely to use a condom with a casual sex partner than HIV-negative men.
  • HIV-positive men are more likely to have anal sex than HIV-negative men.
  • HIV-positive men are more likely to use drugs for sex, and those drugs are likely to be harder sex drugs such as crystal meth.

We asked Matthew Hodson of GMFA for his thoughts. “All too often I hear people living with HIV described as ‘irresponsible’, or people talk about us as if we’re on some warped mission to infect others. On the contrary, the FS survey illustrates that the vast majority of HIV-positive men are behaving responsibly to prevent their sexual partners from getting the virus. Condom use with casual partners is impressively high, at 90% among those who know they are living with HIV compared to just one in three for men who believe they are HIV-negative.

The differences in satisfaction with their sex-lives between HIV-positive and HIV-negative men are not significant. What difference there is may well be down to the fact that, in our survey, positive men were more likely to be single, and our survey found an association between being single and not being happy with your sex life. Major surveys, such as the Gay Men’s Sex Survey, usually found that HIV-positive men were more likely to be in relationships. Some of that data was taken a long time ago so it will be interesting to see whether this was just a blip from the sample in our survey or whether things have changed. Positive men are more likely to be involved in chemsex, and this has increased in recent years, so it’s possible that this has led to changes in positive men’s experience of sex and relationships.” 


For details about counselling services that may be available and suitable for your needs, call THT Direct on 0808 802 1221. 

GMFA has a section of its website dedicated to gay men living with HIV. Including:

- Positive sex | www.gmfa.org.uk/positive-sex.
- Disclosing your status | www.gmfa.org.uk/disclosing-your-status
- Looking after yourself |www.gmfa.org.uk/looking-after-yourself.

This article is from FS magazine #150