Gay and Bisexual Men's Health Issues
Research has shown that the following are some of the most common health concerns faced by gay and bisexual men. While they may not all apply to each individual, they are important concerns for men and their health care providers to be aware of.
Intimate Partner Violence
Intimate partner violence takes many forms but involves physical or emotional harm by a significant other — usually a boyfriend, girlfriend, ex-boyfriend, ex-girlfriend or date. Typically, intimate partner violence begins with verbal threats and escalates to physical abuse, which is why it’s important to recognize it early and get help as soon as possible. Intimate partner violence often involves manipulation and control. For men who have sex with men, intimate partner violence includes threatening to “out” the victim to his family, friends and co-workers.
Research suggests that men who have sex with men are just as likely to face intimate partner violence as heterosexual women, but men who have sex with men may be hesitant to seek help because they fear that revealing their sexual orientation to others will put them in greater danger.
While it’s true that most intimate partner violence resources are for women, specific assistance is available for gay and bisexual men.
Because of stress and discrimination, gay and bisexual men are more likely to abuse tobacco and alcohol than the general population. Among other dangerous health effects, tobacco use puts men at much higher risk for several cancers, and excessive alcohol use contributes to permanent liver damage and risky sexual behaviors. Several tobacco and alcohol companies specifically target gay and bisexual men in their ad campaigns.
Among gay men, certain drugs — especially crystal meth, also known as “Tina” — have become widely used. In addition to being highly addictive, crystal meth greatly increases the risk of unsafe sex and HIV transmission.
Gay and bisexual men have higher rates of body dysmorphia and eating disorders. Many factors influence the prevalence among these men, including low self-esteem, discrimination, depression and unrealistic body standards.
Reproduction and Fertility
There are a few options for gay men and bisexual men in same-sex relationships who aspire to have children, including surrogacy, where sperm is used to fertilize a donated egg, which is then carried to term by a surrogate mother.
It’s important for them to find a provider or center that understands their specific needs and offers services in a caring and compassionate environment for their family.
Sexually Transmitted Infections
Men who have sex with men are at greater risk for certain sexually transmitted infections (STIs). Besides abstinence, the best method to prevent STIs is to use a condom every time you have sex. These diseases include:
HIV is a virus that can lead to AIDS if left untreated. HIV impairs the immune system’s ability to fight infections and certain cancers. HIV is spread through direct contact with body fluids that contain the virus — often through needle sharing and anal, vaginal and (very rarely) oral sex. Knowing your HIV status is an important part of protecting yourself and others.
The World Health Organization recommends that all men who have sex with men consider taking pre-exposure prophylaxis (PrEP) to prevent HIV. PrEP is a drug that, when combined with consistent condom use, can minimize HIV transmission. Ask your doctor if PrEP is right for you.
Syphilis is a bacterial infection that can harm the heart and nervous system if not treated promptly. Syphilis is transmitted through oral, anal and vaginal sex.
Gonorrhea is a bacterial infection that can lead to fertility complications if left untreated. Gonorrhea is passed between partners through oral, anal and vaginal sex. Rates of gonorrhea are on the rise among men who have sex with men, and new, more drug resistant strains are becoming more common. It is important to be tested to ensure adequate treatment.
Hepatitis A and B
Hepatitis A and B are both viral infections that cause damage to the liver. Hepatitis A is mostly spread through contaminated food but can also be spread through anal and oral sex. Hepatitis B is transmitted through needle sharing and anal, oral and vaginal sex. Hepatitis A infections usually clear on their own, but hepatitis B can cause permanent or chronic damage to the liver, resulting in liver cancer.
Vaccines are available to prevent both hepatitis A and B. They should be discussed with your health care provider if you haven’t already received them — or if you need a booster.
HPV is a group of viruses that can cause genital warts and certain cancers. HPV is spread through oral, anal and vaginal sex. Men who have sex with men can receive a vaccine to protect themselves against the forms of HPV that lead to genital warts and the development of certain cancers.
Meningitis is most often spread through germs in coughs and sneezes but can also be passed to others through close contact. Men with compromised immune systems — for example, those with HIV or AIDS — are especially at risk. Speak with your health care provider to see if you should receive an immunization against meningitis.
Oral HPV | Johns Hopkins Q&A
Johns Hopkins head and neck surgeon Carole Fakhry answers questions about oral HPV, the HPV vaccine and recommendations for the vaccine’s use.