“I consider being gay a very high risk factor”: How Perceptions of a Partner’s Sexual Identity Influence Perceptions of HIV Risk Among Gay and Bisexual Men

Gay and bisexual men (GBM) in the USA experience a disproportionate burden of new HIV infections. Previous studies demonstrate that gay self-identification and outness are associated with GBM’s sexual risk-taking behaviors. However, little is known about the extent to which GBM make sexual decisions based on the level of HIV risk they associate with a male partner’s sexual identity. Using qualitative interviews with 13 GBM, we examine how a partner’s gay identification, outness, and sex with women influence perceptions of HIV risk and decisions about condoms. Participants discussed a reduced HIV risk perception for partners who were not gay-identified, not out, or having sex with women, based on the belief that they were not having sex with other men. Some participants stated that this could lead to condomless sex. Participants perceived lower risk despite stating that these partners had reduced exposure to HIV prevention interventions and increased substance use during intercourse. These findings indicate a potential discrepancy between how GBM perceive HIV risk and the behavioral factors associated with risk. HIV prevention messages and policies should focus on tackling the myth that a non-gay identity is protective of HIV and decentralize messages and policies from being only about gay men.