Health issues for gay men and other men who have sex with men

All men face certain health risks. However, there are some specific health concerns that gay men and other men who have sex with men need to be aware of.

Individual health risks are shaped by many factors beyond sexual orientation and sexual behavior, including family history and age. But it’s important for men who have sex with men to understand the following health issues that may affect them and take steps to stay healthy.

Men who have sex with men are at a higher risk of infection with HIV, the virus that causes AIDS, as well as other sexually transmitted infections. Take these steps to protect against sexually transmitted infections:

• Use a condom. 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.
• Have only one sexual partner. Another reliable way to avoid sexually transmitted infections is to stay in a long-term relationship with only one partner who isn’t infected.
• Limit alcohol, and don’t use drugs. If you’re drunk or high, 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. These are serious liver infections that can spread through sex. 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. Mpox vaccination also may be advised for some men who have sex with men. Not all sexually transmitted infections can be prevented by vaccines. For example, hepatitis C is not covered by a vaccine, and it can lead to liver failure and liver cancer.
• Get tested and have your partner tested. Don’t have sex without a condom 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. Others might not be honest about their health.
• Ask about medicine to lower your risk. A medicine called doxycycline may be an option to lower the risk for getting syphilis, chlamydia and gonorrhea. Taking doxycycline within three days of sexual activity makes an infection less likely. Talk to your healthcare professional about doxycycline, and ask about testing you may need while taking it.

• Consider pre-exposure prophylaxis (PrEP). PrEP is a way for people who don’t have HIV to prevent HIV infection by taking medicine. Several PrEP medicines are available that can reduce the risk of HIV infection in those who are at high risk.

  PrEP can be taken as a pill or as an injection. Talk to your health care provider about which type of PrEP is right for you.

  Before you can use PrEP, you need to be tested to make sure that you don’t already have HIV. Your health care provider also should test you for hepatitis B. If you have hepatitis B, you need to have your kidney function tested before you can take PrEP.

  For PrEP to be most effective, follow all the directions your health care provider gives you. While you are taking PrEP, you still need to use other HIV prevention strategies, such as using a condom every time you have sex.

Gay men and other men who have sex with men may be at an increased risk of depression, bipolar disorder and anxiety. If you’re concerned about your mental health, talk to your health care provider or to a mental health provider. If you’re hesitant to seek treatment, consider talking with a trusted friend or loved one. Sharing your feelings might be the first step toward getting help.

Gay men also are more likely to have body image problems and eating disorders, such as anorexia and bulimia, than are other men. If you have challenges with body image or an eating disorder, get help. Talk to your health care provider or a mental health provider. Treatment is available.

Gay men are more likely to deal with alcohol use disorder than are other people. If you have concerns about your alcohol use, help is available. Talk to your health care provider. Many health care and mental health organizations focused on the lesbian, gay, bisexual and transgender community also offer substance use treatment or may be able to provide information about local resources.

If you smoke cigarettes or use other tobacco products, quitting will greatly lower your risk of health problems. Talk to your health care provider about resources to help you quit.

Violence can affect anyone in an intimate relationship. And research has shown that gay men and other men who have sex with men experience intimate partner violence at a higher rate than do other men. But gay men might be more likely to stay silent about this kind of violence due to fear of discrimination. A lack of shelters and other facilities equipped to offer gay men a safe, supportive place to get help also may make it daunting to seek care.

In addition to the physical risks, staying in an abusive relationship might leave you depressed, anxious or hopeless. If you don’t want to tell others about your sexual orientation or same-sex relationship, it may be hard to ask for help. But the only way to break the cycle of violence is to take action.

If you’re the target of intimate partner violence, tell someone about the abuse, whether it’s a friend, a loved one, a health care provider or another close contact. Or consider contacting a domestic violence hotline for help.

Concern about homophobia and the stigma sometimes associated with homosexuality may prevent some gay men from getting routine health care. But it’s important that you get the care you need.

Look for a health care provider who understands your concerns and puts you at ease. For you to get high-quality health care, it’s important that your provider knows and understands your sexual orientation and sexual behavior. So it’s crucial that you feel comfortable talking honestly with your health care provider.

Also, ask your provider about routine screenings recommended for people in your age group. Those may include blood pressure and cholesterol measurements, as well as screenings for prostate, testicular and colon cancers. If you’re not in a long-term relationship with one sexual partner, schedule regular screenings for sexually transmitted infections.

Talk with your health care provider about any other health concerns you might have. Open communication can help promote good long-term health.