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. The information in this section is a courtesy of the Centers for Disease Control and Prevention (CDC).*
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, the rate of new HIV diagnoses among MSM is more than 44 times that of other men, while the rate of primary and secondary syphilis among MSM is more than 46 times that of other men.
Many factors contribute to the higher rates of HIV and STDs among gay and bisexual men compared to the general population of men. These factors include high prevalence of HIV and other STDs among MSM, which increases the risk of disease exposure, and limits access to prevention services. Other factors are complacency about HIV risk, particularly among young gay and bisexual men; difficulty of consistently maintaining safe behaviors with every sexual encounter over the course of a lifetime; and lack of awareness of syphilis symptoms and how it can be transmitted (e.g., oral sex). Additionally, homophobia and stigma can prevent MSM from seeking and getting appropriate health services. Getting tested for HIV and STDs is a first step in protecting your health. Knowing you are infected allows you to get the care that you need to stay healthy and take steps to protect your partners. (http://www.cdc.gov/msmhealth/)
PrEP Care Program
Talk to your partners and friends about PrEP. Pre-exposure prophylaxis (PrEP) is an HIV prevention option that works by taking one pill every day. When taken daily it can greatly reduce your risk of getting HIV. You can protect yourself even more if you use condoms and other prevention tools.
People at very high risk for HIV take HIV medicines daily to lower their chances of getting infected. PrEP can stop HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV if used as prescribed, but it is much less effective when not taken consistently. And remember, PrEP protects you against HIV but not against other STDs.
Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.
There are more HIV prevention options than ever before. Learn more about PrEP to decide if it is right for you. CDC info about PrEP.
Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.
When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently. (CDC-2017)
PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.
PrEP Care Program line 214-540-4477, please call for appointments and fees. PrEP Care Program hours are Monday, Friday and Saturday, 9 a.m.-5 p.m. Se habla español.
What tests are recommended to help ensure the sexual health of gay and bisexual men?
As an individual, you can do a lot to protect your health. CDC recommends the following laboratorytesting for gay and bisexual and other MSM. All of the following tests are offered at Nelson-Tebedo Clinic:
- HIV (at least annually).
- Chronic Hepatitis B infection.
- Hepatitis C for men who engage in risky behaviors, such as rough sex or sex with multiple partners.
- Genital Herpes if directed by your health care provider.
- Chlamydia and Gonorrhea testing of the throat is needed if you have had receptive oral sex in the past year.
- Chlamydia and Gonorrhea testing of the penis (urethra) is needed if you have had insertive anal or oral sex in the past year.
- Chlamydia and Gonorrhea testing of the rectum is needed if you have had receptive anal sex in the past year.
You may want to get tested more often—every three to six months—if you have multiple or anonymous partners, have sex in conjunction with drug use, use methamphetamine, or have sex partners that participate in these activities.
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.
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 (http://www.cdc.gov/hpv).
- 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.
What vaccinations does CDC recommend for gay and bisexual men? How do I lower my risk for STDs?
There are three critical ways to protect yourself from STDs and HIV:
- Don't have sex (i.e. anal, vaginal, or oral)
- Be in a long-term, mutually monogamous sexual relationship with a partner you know has the same HIV status as you.
- Use a condom every time you have anal, vaginal, or oral sex. Consistent and correct use of the male latex condom reduces the risk of STD and HIV transmission. It is especially important to always use a condom during anal sex, since anal sex carries a much higher risk of HIV transmission.
It is also important to be honest and open with your doctor about your sexual behaviors so that he or she can give you the best and most appropriate care.
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 at http://www.cdc.gov/healthyweight/assessing/index.html. 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.
*Adapted from “For Your Health – Gay and Bisexual Men’s Health” by the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (last updated by CDC on May 15, 2014).