Preventive Care for Men Who Have Sex With Men
Stephen McMullan1, Therese Anderson1, Nadine Elhage1
1Mayo Clinic Florida, Jacksonville, Florida.
Abstract:
Men who have sex with men (MSM) is an inclusive term used to refer to phenotypic males who have insertive or receptive sex (penile-anal or penile-oral) with other phenotypic males, including people who are transgender or have other gender identities. MSM may report their sexual orientation as homosexual, bisexual, heterosexual, or something else, but this stated sexual orientation may not align with their sexual attraction or behaviors. Several health conditions disproportionately affect MSM compared with age-matched heterosexual men, including HIV infection, anal cancer, syphilis, and depression. Clinicians should use culturally sensitive questions to obtain a comprehensive sexual history and assess sexual risk. MSM should receive regular screening for HIV, hepatitis B and C, gonorrhea, chlamydia, and syphilis. Vaccinations for hepatitis A and B and human papillomavirus should be offered. MSM may benefit from preexposure prophylaxis to prevent HIV infection, postexposure prophylaxis to reduce the risk of HIV transmission, and counseling on safer sexual practices. Screening for anal cancer associated with human papillomavirus may be performed by digital anal rectal examination, although the optimal screening strategy has yet to be determined. Clinicians should also consider more frequent screenings for mental health issues in the MSM population because the rates of depression, suicide, substance use, and other psychosocial issues are higher than those of the general population.
Insights
Men who have sex with men (MSM) face higher risks for HIV, anal cancer, and depression. Regular screenings and vaccinations are crucial for their health. Tailored preventive strategies are recommended.
Area of Science:
- Public Health
- Sexual Health
- Epidemiology
Background:
- Men who have sex with men (MSM) experience disproportionately higher rates of certain health conditions compared to heterosexual men.
- These conditions include HIV infection, anal cancer, syphilis, and depression.
- Understanding the unique health needs of the MSM population is vital for effective public health interventions.
Purpose of the Study:
- To outline key health considerations and recommended screenings for men who have sex with men (MSM).
- To emphasize the importance of culturally sensitive approaches in healthcare for MSM.
- To highlight preventive strategies and vaccinations beneficial for the MSM population.
Main Methods:
- Review of existing literature and clinical guidelines concerning the health of men who have sex with men (MSM).
- Identification of prevalent health conditions and risk factors within the MSM community.
- Synthesis of recommendations for screening, vaccination, and preventive interventions.
Main Results:
- MSM are at increased risk for HIV, hepatitis B and C, gonorrhea, chlamydia, syphilis, and anal cancer.
- Higher rates of depression, suicide, and substance use are observed in the MSM population.
- Preexposure prophylaxis (PrEP) and vaccinations (Hepatitis A/B, HPV) are recommended for HIV prevention and other infections.
Conclusions:
- Comprehensive sexual health screening and risk assessment are essential for MSM.
- Regular screenings for HIV, STIs, and mental health issues should be prioritized.
- Proactive vaccination and preventive measures, including PrEP, can significantly improve health outcomes for MSM.
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