Men Who Have Sex With Men (MSM)- Not everyone has the same set of risks…

Sexually transmitted infections (STIs)

The incidence of STIs in sexually active MSM is high – that is to say that STIs are frequent. Here we include the "easy to treat" or "curable" infections such as chlamydia, gonorrhea, scabies, pubic lice, syphilis and others. We may also talk about the "difficult to treat" or "no cure" infections such as HIV/AIDS, Genital Herpes, Genital warts(HPV), Hepatitis A, B, and C, etc. Prevention through safe sex is key!

HIV/AIDS

MSM are at an increased risk of HIV infection. The history of HIV/AIDS in the community since its description in the early 1980s is one of success through education and prevention. The last several years have evidenced a new wave of HIV infections in the young gay MSM population – tandem with the return, in many urban centers, of unsafe sexual practices (fucking without a condom or "barebacking"). Prevention is key: safer sex reduces the risk of HIV transmission and infection! Newer and potent medications available to treat HIV/AIDS are not the answer. (For detailed information on safer sexual practices please consult the chapter on HIV/AIDS.)

Hepatitis

MSM are at an increased risk of contracting hepatitis – particularly hepatitis A and B (STD section on hepatitis), and possibly hepatitis C. Hepatitis B may be transmitted through sexual relations including unprotected penetration(fucking) and oral sex (blow-job or fellatio)…only rarely is hepatitis B transmitted through saliva contact (kissing). MSM with multiple sexual partners have a 10-15 time greater risk of contracting hepatitis B than the general population. Hepatitis A is transmitted through the fecal-oral route (anus to mouth, or "rimming"and/or fingering the anal region) and typically requires direct or indirect contact with feces. Hepatitis A and B are preventable diseases – Universal vaccination of all men who have sex with men is recommended. Speak with your physician today! There is no cost to you, so don’t hesitate! Safe sex is an effective means of decreasing the risk of hepatitis. When discussing hepatitis C, there is no vaccination currently available, so safe sex is the only means to avoid infection with this difficult viral liver infection.

Hepatitis B

100 times easier to catch than HIV! Get vaccinated against this disease!

Hepatitis A

Get vaccinated against this disease!

Anal-genital warts or Human Papilloma Virus

Anal warts are a very common sexually transmitted infection – they are easily spread between sexual partners. While these infections are often felt to be purely a cosmetic or aesthetic problem, they may actually have important long-term consequences. It is felt that the presence of anal HPV warts (certain types) may be implicated in the risk of anal cancers (more frequent in MSM). Studies are currently underway to evaluate the potential benefit of routine screening tests in an attempt to detect and treat early uncomplicated cancers (similar to cervical PAP tests routinely performed on sexually active women). Treatments exist, erradication is at times difficult and recurrences are not uncommon. Don’t ignore this part of your body! Examine yourself, or have your physician evaluate for the presence of HPV/warts both anal and genital at your next STI visit.

Substance abuse

Substance abuse occurs in all populations. It is felt that MSM consume illicit substances at a higher rate. Regardless, the use of substances including Ecstasy, Ketamine, amphetamines (speed), pot or marijuana and amyl nitrate (poppers) is common. The potential long-term consequences of many of these recreational drugs is unknown. It is hoped that ongoing research may help to determine the potentially serious outcomes that may be associated with regular use over time. What is known is that several of these substances (including alcohol) are associated with disinhibition and increased sexual risk taking. If you think you have a substance problem, consult your physician!