Health issues for gay men and men who have sex with men
Understand important health issues for gay men and men who have sex with men — from sexually transmitted infections to depression — and get tips for taking charge of your health.By Mayo Clinic Staff
All men face certain health risks. However, gay men and men who have sex with men have some specific health concerns.
Although your individual risks are shaped by many factors beyond your sexual orientation and practices — including family history and age — it's important to understand common health issues for gay men and steps you can take to stay healthy.
Protect yourself from sexually transmitted infections
Men who have sex with men are at increased risk of contracting HIV, the virus that causes AIDS, as well as other sexually transmitted infections.
To protect yourself from sexually transmitted infections:
- Use a condom or other protection. Use a new condom every time you have sex, especially during anal sex but ideally during oral sex as well. Use only water-based lubricants, not petroleum jelly, body lotion or oils. Oil-based lubricants can weaken latex condoms and cause them to break.
- Be monogamous. Another reliable way to avoid sexually transmitted infections is to stay in a long-term mutually monogamous relationship with a partner who isn't infected.
- Limit the amount of alcohol you drink, and don't use drugs. If you're under the influence, you're more likely to take sexual risks. If you choose to use injectable drugs, don't share needles.
- Get vaccinated. Vaccinations can protect you from hepatitis A and hepatitis B, serious liver infections that can spread through sexual contact. Not all sexually transmitted infections are prevented by vaccines, however. Hepatitis C is not covered by any vaccine and can lead to liver failure, liver cancer and death. The human papillomavirus (HPV) vaccine is available to men up to age 26. HPV is associated with anal cancer in men who have sex with men.
- Get tested and have your partner tested. Don't have unprotected sex unless you're certain you and your partner aren't infected with HIV or other sexually transmitted infections. Testing is important because many people don't know they're infected, and others might not be honest about their health.
Pre-exposure prophylaxis (PrEP). PrEP is a way for people who don't have HIV to prevent HIV infection by taking a pill every day. Use of the combination drug emtricitabine-tenofovir (Truvada) can reduce the risk of sexually transmitted HIV infection in those who are at high risk. Truvada is also used as an HIV treatment along with other medications.
When used to help prevent HIV infection, Truvada is only appropriate if your doctor is certain you don't already have HIV. Your doctor should also test for hepatitis B infection. If you have hepatitis B, your doctor should test your kidney function before prescribing Truvada. The drug must also be taken daily exactly as prescribed. And it should only be used along with other prevention strategies such as condom use every time you have sex.
Gay men and men who have sex with men might be at higher risk of depression and anxiety.
If you're reluctant to seek treatment, confide in a trusted friend or loved one. Sharing your feelings might be the first step toward getting treatment.
Address body image concerns
Gay men are more likely to experience body image problems and eating disorders, such as anorexia and bulimia nervosa, than are their straight counterparts.
One potential explanation is that, as a result of growing up with images of slender and effeminate gay men or men with muscular bodies, some gay and bisexual men worry excessively about their weight.
If you're struggling with body image concerns or an eating disorder, get help. Talk to your doctor or a mental health provider about treatment options.
Seek help for substance abuse
In the U.S., gay men are more likely to smoke than are heterosexual men and gay men are more likely to deal with alcoholism than is the general population.
If you have a substance abuse concern, remember that help is available. Local lesbian, gay, bisexual and transgender health, mental health, or community centers often provide substance abuse treatment. Organizations such as the GLMA also might provide referrals.
Recognize domestic violence
Domestic violence can affect anyone in an intimate relationship. Gay men might be more likely to stay silent about this kind of violence due to fear of discrimination and a lack of facilities designed to accommodate them.
Staying in an abusive relationship might leave you depressed, anxious or hopeless. If you don't want to disclose your sexual orientation, you might be less likely to seek help after an assault. Still, the only way to break the cycle of domestic violence is to take action — the sooner the better.
If you're a target of domestic violence, tell someone about the abuse, whether it's a friend, loved one, health care provider or other close contact. Consider calling a domestic violence hotline and creating a plan to leave your abuser.
Make routine health care a priority
Don't let fear of homophobia or the stigma associated with homosexuality prevent you from seeking routine health care. Instead, take charge of your health.
Look for a doctor who puts you at ease. Identify yourself as gay or bisexual, and ask about routine screenings recommended for men in your age group — such as blood pressure and cholesterol measurements and screenings for prostate, testicular and colon cancers.
If you're not in a long-term, mutually monogamous relationship, schedule regular screenings for sexually transmitted infections. Share any other health concerns you might have with your doctor as well. Early diagnosis and treatment help promote long-term health.
Oct. 05, 2017
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- Makadon HJ. Primary care of gay men and men who have sex with men. https://www.uptodate.com/contents/search. Accessed Sept. 11, 2017.
- Makadon HJ, et al. The Fenway Guide to Lesbian, Gay, Bisexual and Transgender Healthcare. Philadelphia, Pa.: American College of Physicians; 2015.
- CDC fact sheet: What gay, bisexual and other men who have sex with men need to know about sexually transmitted diseases. Centers for Disease Control and Prevention. https://www.cdc.gov/std/life-stages-populations/STDFact-MSM.htm. Accessed Sept. 11, 2017.
- Sexually transmitted diseases treatment guidelines, 2015. Centers for Disease Control and Prevention. https://www.cdc.gov/std/tg2015/default.htm. Accessed Sept. 11, 2017.
- Pre-exposure prophylaxis (PrEP) for HIV prevention. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/risk/prep/index.html. Accessed Sept. 11, 2017.
- Stigma and discrimination. Centers for Disease Control and Prevention. https://www.cdc.gov/msmhealth/stigma-and-discrimination.htm. Accessed Sept. 11, 2017.
- Intimate partner abuse and relationship violence. American Psychological Association. http://www.apa.org/about/division/activities/abuse.aspx. Accessed Sept. 11, 2017.