Men who have sex with men
Men who have sex with men (MSM) are at increased risk of some STIs, especially blood borne viruses (HIV and hepatitis). Research suggests that one in seven gay men on the London gay scene has HIV. However in remote and rural areas the risk is likely to be lower. In these areas, many men are not ‘out’ to their family, friends and workmates, and this can make having sexual health checks difficult.
Research by Stonewall shows that:
- 26% of gay and bisexual men have never been tested for sexually transmitted infections (STIs)
- More than two in five gay and bisexual men have never discussed STIs with a healthcare professional
- Three in ten gay and bisexual men have never had an HIV test
Many men are put off revealing their sexuality by their doctor or nurse assuming they are heterosexual.
As a man who has sex with men, you need to know:
- How HIV and other STIs are transmitted
- Your HIV status
- That you are vaccinated against hepatitis B
- How often and where to get tested for HIV and STIs
- About PEP and when you need to take it
Gay Men and HIV
The number of people with HIV in the UK is rising, and gay men are one of the highest risk groups.
Around 35,000 gay men in the UK are living with HIV. According to the Health Protection Agency, around a quarter of them don’t know they have it. There are HIV-positive men in every part of the UK and that there are HIV-positive men of every age and nationality.
But wouldn’t a partner tell me if they were HIV positive?
In most cases, when gay men have sex with someone new they will not know the HIV status of their partner. The majority of men in the UK living with HIV will probably not have any visible symptoms and so you will not be able to tell by looking at them.
Remember, about a quarter of gay men with HIV have not been diagnosed and so do not know that they are HIV-positive. It is unrealistic to expect someone to tell you their HIV status. According to research, about three quarters of gay men expect HIV-positive men to disclose their status before sex. But in fact only about one in five HIV positive men ALWAYS disclose their HIV status to their casual partners.
Many HIV-negative men tend to think that if someone is willing to have unprotected sex with them, they will also be HIV-negative. And many HIV-positive men believe that if someone is willing to have unprotected sex with them, it's because they are also HIV-positive. This is how HIV is often transmitted.
The riskiest activity is having anal sex without a condom. If you are sexually active and have taken even small risks in the past, the only way to be sure of your status is to have an HIV test.
See more at: www.gmfa.org.uk
Gay Men and Hepatitis B
Hepatitis is inflammation of the liver. Hepatitis B is an infection caused by a virus which attacks the liver. There are other types of hepatitis which can produce a similar illness, but hepatitis B is the most common among gay men and can have potentially serious long term effects.
Like the HIV virus, the Hep B virus is present in all body fluids of someone who is infected. But the Hep B virus is more infectious than HIV and as well as being present in blood and semen (cum), it can also be passed on through saliva and from wet kissing (there is a greater risk if you have bleeding gums or mouth ulcers).
You can be tested for Hepatitis B using a simple blood test and the infection can be prevented by a vaccination. The Hep B virus cannot be caught from coughs and sneezes - or door knobs - or toilet seats. And it’s very unlikely that you could get Hepatitis B from sharing a glass or a cigarette.
Gay men and other STIs
The most common sexually transmitted infections in gay and bisexual men are Chlamydia and Gonorrhoea. Many people can carry these infections without symptoms. We would recommend you are tested if you are planning to stop using condoms with a regular partner or if you have unprotected sex with a new partner.
These infections can also be carried in the anus and throat. You can be tested by taking a swab from the penis, throat or anus, or by passing a sample of urine.
Safer sex advice for Gay and Bisexual Men
What is safer sex?
‘Safer sex’ is sex that doesn’t allow body fluids to go from one person into another. Safer sex is very good at stopping the spread of HIV. It also lowers the risk of other sexually transmitted infections. Sex without penetration is also ‘safer sex’. Examples of safer sex include mutual masturbation, and frottage (rubbing against one another to the point of orgasm). Kissing is very safe.
Withdrawing before orgasm (cumming) makes little difference to the chances of catching HIV and other STIs.
Use condoms and lubricant
Using a condom helps protect against HIV and cuts the risk of getting many other STIs.
- Standard Strength Condoms, used properly, are just as reliable for anal sex as the thicker ones. The most important thing is to use them properly with plenty of lubricant. Please see our Condoms section for more information
- Spermicides - Studies have found that condoms with nonoxynol-9 (N-9), a spermicidal lubricant, can irritate the lining of the rectum. This could lead to an increased risk of HIV transmission if a condom burst. Most condom manufacturers in the UK have stopped using N-9, but it's easy to buy condoms coated with N-9 online or when you are abroad, so it's worth checking. If you are not sure, avoid any condoms that are described as 'spermicidally lubricated'.
- Other Lubricants - Use plenty of lubricant on the outside of the condom for anal sex. Not using enough lubricant makes it more likely for the condom to slip off. Water-based and silicone-based lubes work well with condoms. Water-based lubes include K-Y, Wet Stuff and ID Glide. Silicone-based lubes include Eros Bodyglide and Liquid Silk. Oil-based lubricant is bad for latex and can cause condoms to break. Don't use products such as Crisco and Elbow Grease (creams), baby oil, cooking oil, butter, moisturisers and sun lotions Don't use saliva (spit) with condoms, as it will dry up and increase the chance of your condom tearing.
Hepatitis B vaccination
Gay and bisexual men are at increased risk of Hepatitis B infection. See our Hepatitis page for more information.
Hepatitis B can cause a chronic infection which damages the liver. Luckily there is a vaccine available. If you would like vaccination, please come to see us at the Nordhaven Clinic and we can arrange this for you. Hepatitis B vaccination is also available from your GP surgery.
We would recommend that you are also vaccinated against Hepatitis A and are up to date with Tetanus vaccinations.
Men aged 45 and under are also entitled to HPV Vaccination.
We recommend that you have a STI and HIV test each time you have a new sexual partner or if you want to stop using condoms with a regular partner. If you have multiple partners, you need to have a check up every 3 months. If you are concerned that you may have been at risk from a past sexual encounter, we can also offer you STI Testing.
For more information on men who have sex with men please visit; Gay Men's Health - which is a Scottish charity for Gay men who offer counselling, information and advice to Gay Men.