People living with HIV are at risk for meningococcal disease, which can be prevented with a vaccine. Neisseria meningitidis bacteria can cause life-threatening meningitis and septicemia. Of the 527 cases reported in the United States between 2012 and 2015, 14% were among men who have sex with men, and among those with a known status, 59% had HIV. A new report from the Centers for Disease Control and Prevention (CDC) describes 29 cases among HIV-positive people reported in 2022. Fifteen were part of an ongoing outbreak among gay and bi men in Florida. People with HIV accounted for 10% of all reported cases that year. Meningococcal bacteria are present in saliva and respiratory secretions. The most common symptoms of meningococcal meningitis are fever, headache and a stiff neck. Two vaccines, MenACWY and MenB, protect against different strains of the bacteria. The CDC recommends MenACWY for people with HIV, and both vaccines are recommended for people in communities experiencing an outbreak.