Gay and Bisexual Men's Health
For Your Health: Recommendations for A Healthier You
Gay and bisexual men, like all men, need to be aware of the ways they can protect their health through all stages of life. For all men, the leading causes of death are heart disease and cancer. However, among men who have sex with men (MSM), there are higher rates of HIV and other sexually transmitted diseases (STDs), tobacco and drug use, and depression compared to other men.
Sexual health—the state of physical, emotional, mental, and social well being in relation to sexuality—is an important part of your overall health. The idea of sexual health emphasizes health and wellness as well as the avoidance of negative health outcomes that result from unhealthy sexual behaviors and attitudes. For gay and bisexual men, HIV, hepatitis, and other STDs are of particular concern. For example, gay and bisexual men account for over half of the 1.1 million people living with HIV in the U.S. and two thirds of all new HIV infections each year. In 2012, 75% of the reported syphilis cases were among men who have sex with men.
Many factors contribute to the higher rates of HIV and STDs among gay and bisexual men. Higher rates of HIV and STDs among MSM increase a person’s risk of coming into contact with an infected partner and becoming infected themselves.
Homophobia, stigma, and fear of discrimination may affect whether gay and bisexual men seek and are able to obtain high-quality prevention and health services. Lack of insurance, concerns about confidentiality, and fear of talking about risky behavior or sexual orientation may prevent some men from seeking testing, prevention and treatment services, and support from friends and family.
The large percentage of gay and bisexual men with HIV and STDs means that, as a group, they have an increased chance of being exposed to these diseases. And too many men are unaware of their status, which means they do not get medical care and are at increased risk of unknowingly transmitting these diseases to sexual partners.
Certain behaviors, such as not using condoms regularly and having anal sex, increase HIV and STD risk. Most gay and bisexual men acquire HIV through anal sex, which is the riskiest type of sex for getting or transmitting HIV. During anal sex, it’s possible for either partner—the insertive (top) or the receptive (bottom) to get HIV. However, if you are HIV-negative, receptive anal sex (bottoming) puts you at greater risk for getting HIV than insertive anal sex (topping). If you are positive, insertive anal sex (topping) is riskier for transmitting HIV to your partner.
What tests are recommended to help ensure the sexual health of gay and bisexual men?
All gay and bisexual men should be tested at least annually for common STDs. The only way to know your STD status is to get tested (you can search for a testing site). Having an STD (like gonorrhea) makes it easier to get HIV, so it's important to get tested to protect your health and the health of your partner. CDC recommends sexually active gay and bisexual men test for:
- Hepatitis B
- Hepatitis C (among gay men born from 1945 to 1965 or with risk behaviors)
- Chlamydia and gonorrhea of the rectum if you’ve had receptive anal sex, or been a “bottom” in the past year;
- Chlamydia and gonorrhea of the penis (urethra) if you have had insertive anal or oral sex in the past year;
- Gonorrhea of the throat if you’ve performed oral sex (i.e., your mouth on your partner’s penis, vagina, or anus) in the past year;
- And sometimes your health care provider may suggest a herpes blood test.
Gay and bisexual men who have multiple or anonymous partners should be screened more frequently for STDs (i.e., at 3-to-6 month intervals). Your health care provider can offer you the best care if you discuss your sexual history openly. Talk with your provider about getting vaccinations for hepatitis A and B, and HPV. You should have a provider you are comfortable with. CDC’s Lesbian, Gay, Bisexual and Transgender Health Services page has resources that can help you find health services that are gay-friendly.
What vaccinations does CDC recommend for gay and bisexual men?
- Hepatitis A and Hepatitis B vaccinations are recommended by CDC and the Advisory Committee on Immunization Practices (ACIP) because of higher rates of infection among gay and bisexual men.
- Two doses of the Hepatitis A vaccine are needed for lasting protection and the doses should be given at least six months apart.
- A series of three or four doses of the Hepatitis B vaccine are usually given providing long-lasting protection.
- Seasonal flu and the H1N1 flu vaccinations are also recommended.
- Each vaccine is a single dose shot given before the start of the flu season in the fall.
- The human papillomavirus (HPV) vaccine is also available for gay and bisexual men up to 26 years of age to prevent genital warts and other HPV-associated diseases and conditions.
- The HPV vaccine is given as a three-dose series over a six month time period. It is best to be vaccinated before the first sexual contact, but later vaccination will protect those who have not been exposed to HPV.
How do I lower my risk for STDs?
For anyone, choosing to be sexually active means you are at risk for STDs. However, there are many things you can do to protect your health. You can learn about how STDs are spread and how you can reduce your risk of getting infected.
Get Vaccinated: Gay, bisexual and other MSM are at greater risk for hepatitis A, hepatitis B, and HPV. For this reason, CDC recommends that you be vaccinated against hepatitis A and hepatitis B. The HPV vaccine is also recommended for men up to age 26.
Be Safer: Getting tested regularly and getting vaccinated are both important, but there are other things you can do to reduce your risk for STDs.
- Get to know someone before having sex with them and talk honestly about STDs and getting tested—before you have sex.
- Use a condom correctly and use one every time you have sex.
- Think twice about mixing alcohol and/or recreational drugs with sex. They can reduce your ability to make good decisions and can lead to risky behavior—like having sex without a condom.
- Limit your number of partners. You can lower your risk for STDs if you only have sex with one person who only has sex with you.
Know Your Status: If you know your STD status, you can take steps to protect yourself and your partners.
What other steps can I take to protect my health?
- Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables.
- Maintain a healthy weight. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC's Assessing Your Weight website. Or visit CDC's Healthy Weight website.
- Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. Visit CDC's Physical Activity site.
- Don't smoke. Cigarette smoking greatly increases your risk for heart disease, cancer, and stroke. So, if you don't smoke, don't start. If you do smoke, quitting will lower your risk for heart disease.
- Limit alcohol use. Avoid drinking too much alcohol, which can cause a variety of health problems (high blood pressure, cancer) and increase your risk of injury. Visit CDC's Alcohol and Public Health website.
- Cholesterol screenings. The National Cholesterol Education Program recommends that adults aged 20 years or older have their cholesterol checked every five years.
- Cancer screenings. Ask your health care provider for guidance on screening for prostate, testicular, colon, and anal cancers.
- Check your blood pressure. Getting your blood pressure checked is important because high blood pressure often has no symptoms.
- Get checkups. Ask your doctor or nurse how you can lower your chances for health problems.
How do I learn more?
- Talk to your health care provider.
- Call your local or state health department or contact an LGBT Health Clinic.
- Contact CDC at 800-232-4636 (800-CDC-INFO) or firstname.lastname@example.org