Although women in sub-Saharan Africa are more at risk of HIV than men, men are more likely to die from an AIDS-related illness (AIDS is what HIV turns into if it is not treated). This is one reason why men must not be forgotten in the HIV response. 

If someone with HIV is on treatment and that treatment is working, it can reduce the amount of HIV in their body to such a low level that HIV cannot be passed on. 

Because men are less likely than women to be on effective HIV treatment, they have a greater risk of passing HIV on. This means getting men with HIV diagnosed and on treatment will benefit both men and women.

If a condom is not being used then both types of sex carry some risk for the man. During vaginal sex, if a woman has HIV it can be passed from her vaginal fluids and blood through the opening at the tip of the penis, the foreskin (if the penis isn’t circumcised), or cuts, scratches or open sores on the penis. During anal sex, HIV can be transmitted from the woman’s blood and rectal fluids through the penis.

Because of the differences between men and women’s bodies it is actually the woman who is more at risk of HIV during either type of sex. Having receptive anal sex carries the biggest risk because the rectum’s lining is thin and can easily tear, which gives HIV the opportunity to enter the body. But having vaginal sex also carries a big risk for women. 

If a man is having anal sex with another man and he is the one being penetrated, he also has an increased risk of HIV.