Men who have sex with men

Men who have sex with men (MSM) refers to all

In their assessment of the knowledge about the sexual networks and behaviors of MSM in Asia, Dowsett, Grierson and McNally concluded that the category of MSM does not correspond to a single social identity in any of the countries they studied.[6] There were no similar traits in all of the MSM population studied, other than them being males and engaging in sex with other men.

In some countries, homosexual relationships may be illegal or taboo, making MSM difficult to reach.^[7][8]

The term's precise use and definition has varied with regard to transgender and intersex people, who do not fall neatly into binary sex categories.^[9]

Prevalence

Determining the number of men who have ever had sex with another man is difficult. Worldwide, at least 3% of men have had sex at least once with a man.^[10]

In the U.S., among men aged 15 to 44, an estimated 6% have engaged in oral or anal sex with another man at some point in their lives, and about 2.9% have had at least one male sexual partner in the previous 12 months.^[11]

Sexual practices

Historically,

A 2007 study reported that two large population surveys found "the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women."[16]^[17] According to the 2013 NATSAL (a representative population study in the UK), MSM typically had 17 lifetime sexual partners (median), which included all forms of sexual contact including oral and anal sex.^[18] An epidemiological article in The BMJ reported that national probability surveys like the NATSAL have been found to better reflect the population of MSM but are limited by their smaller samples of MSM. Convenience sample surveys recruit larger samples of MSM but tend to over-represent MSM identifying as gay and reporting more sexual risk behaviors.^[19]

Health issues

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Sexually transmitted infections

Among men who have anal sex with other men, anal sex without use of a condom is considered to be high-risk for STI transmission. A person who inserts their penis into an infected partner is at risk because sexually transmitted infections (STIs) can enter through the urethra or through small cuts, abrasions, or open sores on the penis. Also, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky.^[20][21][22]

HIV/AIDS

In 2007, the largest estimated proportion of HIV/AIDS diagnoses among adults and adolescents in the U.S. were men who have sex with men (MSM). While this category is only 2% of the U.S. population[29] they accounted for 53% of the overall diagnoses and 71% among men. According to a 2010 federal study, one in five men who have sex with men are HIV positive and nearly half do not realize it.^[30]

According to a CDC study, HIV prevalence in the MSM population of the U.S. varies widely by ethnicity. "As many as 46% of black MSM have HIV" while "the HIV rate is estimated at 21% for white MSM and 17% for Hispanic MSM."

Pre-exposure prophylaxis (PrEP) is the use of medication to prevent HIV transmission in people who have not yet been exposed to the virus. When used as directed, PrEP has been shown to be highly effective, reducing the risk of contracting HIV up to 99%.^[39] As of 2018^[update], numerous countries have approved the use of PrEP for HIV/AIDS prevention, including the United States, South Korea,^[40] France, Norway,^[41] Australia,^[42] Israel,^[43] Canada,^[43] Kenya, South Africa, Peru, Thailand, the European Union^[44][45] and Taiwan.^[46] New Zealand was one of the first countries in the world to publicly fund PrEP for the prevention of HIV in March 2018.^[47]

Other sexually transmitted infections

Men who have sex with men are at a higher risk of acquiring hepatitis B and hepatitis A through unprotected sexual contact. The U.S. CDC and ACIP recommend hepatitis A and hepatitis B vaccination for men who have sex with men.^[48] About a third of the world's population, more than 2 billion people, have been infected with hepatitis B virus (HBV).^[49] Hepatitis B is a disease caused by HBV which infects the liver and causes an inflammation called hepatitis.

Syphilis (caused by infection with Treponema pallidum) is passed from person to person through direct contact with a syphilis sore; these occur mainly on the external genitals, or in the vagina, anus, or rectum.^[50] Sores also can occur on the lips and in the mouth.^[50] Transmission of the organism occurs during vaginal, anal, or oral sex.^[50] In 2006, 64% of the reported cases in the United States were among men who have sex with men.^[50] This is consistent with a rise in the incidence of syphilis among MSM in other developed nations, attributed by Australian and UK authors to increased rates of unprotected sex among MSM.^[51][52]

Though not commonly classified as an STI, giardiasis can be transmitted between gay men,^[57] and it can be responsible for severe weight loss and death for individuals who have compromised immune systems, especially HIV.^[58]

Mental health

According to the U.S. Centers for Disease Control, the majority of gay and bisexual men have and maintain good mental health, though research has shown that they are at greater risk for mental health problems. Stigma and homophobia can have negative consequences on health. Compared to other men, gay and bisexual men have a higher chance of having depression and anxiety disorders.^[59]

Mpox

Mpox has been shown to disproportionately affect men who have sex with men.^[60]

MSM blood and tissue donor controversy

Many countries impose restrictions on donating blood for men who have or have had sex with men, as well as their female sexual partners. Similar restrictions in many countries also prohibit donation of tissues such as

See also

References