To reduce the risk of getting or transmitting HIV

• Get tested for HIV at least once a year. You may want to get tested more often if you are engaging in high-risk behaviours such as unprotected anal sex with casual partners. For information on where to get tested.
• Talk about STIs and HIV with each partner before having sex.
• Learn as much as you can about your sexual partners' past behaviours (including sex and drug use).
• Ask sexual partners if they have recently been tested for HIV; encourage those who have not been tested to do so.
• Use a latex condom and lubricant every time you have sex
• If you think you might have been exposed to another STI such as gonorrhea, syphilis, or chlamydia, get treatment. These infections can increase your risk of getting HIV.  
• If you inject illicit drugs (drugs not prescribed by a doctor) use a new needle/syringe every time you inject.  Never share needles, syringes or other works with others. Dispose of used needles/syringes properly in a plastic sharps container (you can make one out of an empty plastic 2L drink bottle).
• Using drugs or alcohol can cloud your mind and may result in riskier sex. Plan ahead. Choose not to have sex when you are drinking or using.  If you do have sex, make sure you always have condoms and lubricant on you and make sure you use them.

Risk factors and barriers to prevention

Since HIV/AIDS was first diagnosed in 1981, gay and bisexual men have been leaders in dealing with the challenges of the epidemic. Gay organizations and activists in Canada, the United States and around the globe have contributed greatly to many of the current prevention programs and guidelines for treatment and care of people living with HIV/AIDS.

For the past 25 years, HIV activists have worked hard to challenge homophobic attitudes, to reduce the stigma associated with HIV/AIDS and to educate men about the importance of HIV prevention. Due to their hard efforts rates of HIV among MSM declined from the early 1990's up to 2000. However, despite current knowledge that HIV affects all members of society, negative attitudes about HIV as a "gay man's disease" and resulting discriminatory beliefs persist.

Since 2000 rates of HIV diagnoses among MSM in Canada have been increasing yearly.  Over the past few years, there has also been an increase in the number of MSM diagnosed with a sexually transmitted infection such as syphilis indicating that some MSM continue to engage in risky sexual behaviours.  The reasons for this are varied and complex.  Some of the barriers to HIV prevention among MSM may include:

• A mistaken belief among some that HIV is no longer a problem due to the availability of treatment.  In one study, MSM reported that because of HIV treatment (HAART) they were less concerned about becoming HIV-infected or infecting someone and were, therefore, more likely to have unprotected sex.
• Drug and alcohol use can increase risk for HIV transmission by increasing the chances that a person will engage in risky sexual behaviours including unprotected sex and needle sharing.  Meth and other "party" drugs like ecstasy, ketamine and GHB may be used to decrease social inhibitions and enhance sexual experiences.  These drugs, along with alcohol have been strongly associated with risky sexual practices among MSM.
• A lack of direct experience related to HIV/AIDS among younger gay men and the perception among younger men that HIV is a problem for older men.
• Gay men who are just coming out may not be as knowledgeable about HIV or not know where and how to access information.
• Stigma, discrimination and negative attitudes towards homosexuality may make men unwilling or unable to access information.  For example men may not be able to talk openly with health care providers thus leaving them without access to information, appropriate testing or resources.