Men Who Have Sex With Men

by Michael_Koger

Men who have sex with men (MSM) are at especial risk for the acquisition of sexually transmitted diseases.

The transmission of disease through sexual contact occurs at much higher rates in gay/bisexual individuals than in heterosexual clients. Every year in the United States, there are approximately 31,000 new cases of human immunodeficiency virus (HIV) infection in MSM [1]. Though the percentage of these clients in the population as a whole in that country is quite small, their acquisition of HIV is a large portion of all new yearly cases.

This disproportionate occurrence in MSM mandates a patient care protocol which will prevent spread of these medical conditions. First, they need screening for the presence of sexually transmitted diseases once or twice a year [1]. Second, they need education about the ways these infections transmit and what measures are available to dramatically lower the number of cases.

Risk Factors for Transmission

Since there are many situations which increase the risk for disease spread, these individuals, and everyone else, have to know which behaviors worsen or ameliorate the problem.  For example, unprotected sex with anyone will increase the risk of transmission.  Moreover, anal intercourse, particularly when it is without a condom, will heighten the occurrence of these infections [1].

It is well-known that the presence of multiple sexual partners places all of the participants at risk for acquisition of HIV and other sexually transmitted infections.  This is true regardless of whether the partners are of the same or opposite gender [1].

When one partner has HIV and the other does not, the HIV-negative person is more likely to acquire the infection when he is the receptive anal intercourse individual than the insertive partner.  The susceptibility of the receptive person may be 10 times higher than it is for the one who performs insertive anal intercourse [1].

Men who have sex with men, however, are less likely to transmit or acquire HIV infection when they practice oral sex than when they have anal intercourse [1].

A similar situation exists in heterosexual couples who have sex without a condom.  The woman is more likely to acquire many of these medical conditions than the man.  This may have to do with the larger surface area of a woman’s vaginal mucous membranes than the man’s penile surface area.

Without question, for anyone who has sex, the use of condoms will significantly reduce the risk of transmission for all of these diseases [1].  Condoms also dramatically lower the occurrence of pregnancy.


The situation with sexually transmitted diseases today is essentially a major public health crisis which has found its way to every continent of the globe.  Regular preventive medical care as well as health education to facilitate behavior change are essential steps to eventually bring it under control.


  1. Wilkin, T.  (2015). Primary care for men who have sex with men.  New England Journal of Medicine, 373, 854-862.
  2. The photo shows a library at the Centers for Disease Control and is reprinted with permission from that organization.


The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 12/29/2015, Michael_Koger
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