Key Health Concerns for MSM (Men Who have Sex with Men)

Men who have sex with men and gay men are at increased risk for certain types of chronic diseases, cancers, and mental health problems. Below is a list of the key health concerns gay men and men who have sex with men should consider discussing with their doctor.

#1: HIV/AIDS

Men who have sex with men continue to be at increased risk for HIV infection. Safe sex using condoms and non-petroleum-based lubricants has been proven to reduce the risk of both getting and transmitting HIV. Although HIV is now a disease that can be managed, there is still no cure, and preventing infection remains the key to ending the epidemic.

Men who have sex with men should get regular HIV tests and appropriate risk-based counseling about safe sex practices and ways to reduce risk.

#2: Anal Papilloma

Gay men are at high risk for getting the human papilloma virus (HPV), which can cause anal papilloma and certain types of anal cancers. Some men may benefit from a vaccine to prevent HPV from being transmitted. Also, some health professionals recommend routine anal pap smears to screen for cancer. HPV can be treated, but it often comes back, and infections spread easily between sexual partners.

Men who have sex with men should be screened for anal papilloma. Gay men under age 27 should get the HPV vaccine.

#3: Hepatitis Immunization

Gay men are at increased risk for getting hepatitis, a disease of the liver. Hepatitis can cause serious health problems, including liver cancer, cirrhosis, liver failure, and even death. You can be immunized against two of the three most serious hepatitis viruses: A and B, and this is recommended for all gay men. Safe sex, which reduces the risk of transmission of all types of viral hepatitis, is the only way to prevent transmitting hepatitis C.

Men who have sex with men should be immunized against Hepatitis A & B.

#4: Substance Use

Gay men abuse substances at higher rates compared to others. Substances used include amyl nitrates (poppers), amphetamines (including crystal meth), marijuana, ecstasy, and cocaine. Use of these drugs has been linked to higher rates of HIV transmission through impaired decision making during sex. Although the long-term effects are unknown, evidence suggests that prolonged use of these substances is likely to have serious negative health consequences.

Men who have sex with men should be screened for substance use and get appropriate education and risk-based counseling.

#5: Depression and Anxiety

Men who have sex with men have higher rates of depression and anxiety compared to others. These problems are often worse for men who are closeted or don’t have adequate social support. As a result, gay teenagers and young adults have an increased risk of suicide. However, culturally sensitive mental health services can help prevent and treat these problems.

Men who have sex with men should be screened for signs and symptoms of depression and anxiety, and should seek appropriate mental health services as needed.

#6: Sexually Transmitted Diseases (STDs)

Men who have sex with men are at risk for sexually transmitted diseases. These include infections for which there are effective cures (gonorrhea, chlamydia, syphilis, pubic lice or crabs), as well as those for which treatments are more limited (HIV, hepatitis A, B, or C, human papilloma virus). Safe sex, including the use of condoms, is key to preventing STDs.

Men who have sex with men who are sexually active should be routinely screened for sexually transmitted diseases.

#7: Prostate, Testicular, and Colon Cancer

All men, including gay men, are at risk for prostate, testicular, and colon cancer. However, because many gay men do not have access to cancer screening services, they may be at increased risk for death and other complications from these treatable diseases. All gay men should have regular prostate, testicular, and colon cancer screenings.

Men who have sex with men should be screened for prostate, testicular, and colon cancer as generally recommended, based on their personal and family medical history.

#8: Alcohol

Studies show that men who have sex with men have higher rates of alcohol abuse and dependence. Although limited alcohol use, such as one drink a day, may not be unhealthy, any use can be a problem for men with an alcohol-related disorder. Alcohol abuse is a common problem among gay men and can increase the risk for being injured or becoming the victim of a crime.

All men who have sex with men should be screened for alcohol dependence and abuse, and alcohol use should be limited.

#9: Tobacco

Gay men smoke and use tobacco products at much higher rates than others. This can lead to a number of serious health problems, including heart disease, high blood pressure, lung disease, and lung cancer.

Men who have sex with men should be screened for tobacco use and offered tobacco cessation programs.

#10: Body image problems and obesity

Men who have sex with men are more likely to have body image problems than others. This includes higher rates of eating disorders, such as anorexia nervosa and bulimia. Also, using anabolic steroids and nutritional supplements can be unhealthy. Obesity is also a problem among some gay men, and this can lead to heart disease and diabetes.

Men who have sex with men should be screened for body image disorders, use of anabolic steroids, and obesity. Tailored exercise and nutritional guidance should be provided.

For information only. Not to replace the advice of your health care provider. Copyright © 2012 Vanderbilt University Medical Center. All rights reserved.