MSM health issues

1/ MSM and heterosexual youngsters and high-risk sex

MSMs are men who have sex with men and identify as homosexual, bisexual, or other. They tend to engage in high-risk sexual behaviours. For Brook (leading national sexual health charity for young people), heterosexual males and females are starting to do the same. They are now engaging in ‘a wider range of sexual practices’, tutored by such as NHS-endorsed youth sexual health sites as Respect Yourself (for 13s+). (1)  

2/ Elevated risk for shorter life expectancy for MSMs

According to one US study, ‘These findings suggest that men with minority sexual orientation may experience elevated risk for premature death from multiple causes.’ (2011) [National Center for Biotechnology Information]

3/ Vaginal and anal sex and vulnerability to infection  

‘Studies have also shown that women who have unprotected anal sex with an HIV-infected man even one time are about 30 times more likely to get HIV than if they had unprotected vaginal sex once,’ NYC Vital Signs (Feb 2010).

4/ Ineffective protection by condoms in anal sex

Even when MSMs use condoms, according to the BMJ (8 August 2015, 28), HIV transmission has been reduced by 64% and that of other STIs by 42%.    

5/ STI overrepresentation in MSM community   

MSMs comprise around 2% of the population (ONS 2017).

MSMs accounted for 53% of new HIV cases. (2017)

MSMs accounted for 48% of increasingly hard-to-treat new Gonorrhoea and 78% new Syphilis cases. (2017)

6/ Generic health issues for MSM according to the Sandyford Protocols 

Sandyford is the Greater Glasgow Sexual Health Service Provider for the MSM community.

-A-  MSM are at risk for the following infections and diseases: HIV; Syphilis (‘now endemic in MSM community, involving most major metropolitan areas in UK’); Gonorrhoea (pharyngeal and rectal); NGU; Rectal Chlamydia; Prostatitis; UTI; Peri-anal Herpes; Hepatitis A (‘Epidemics in MSM reported from N America, Australasia and London and often linked to anonymous/group sex’); and Hepatitis B, also, Hepatitis C, especially for HIV+ MSM.   

-B-  Under ‘Conditions Found Particularly in MSM’, there are many infections acquired anally and faecal-orally; also there are various non-infectious causes related to rough penetrative sex, use of foreign objects (dildos) and drugs.

-C-  Under ‘Chronic Injury’, ‘There is no published evidence that anal incontinence is caused by anal intercourse, but it is more common in MSM than men who have sex with women, and women… Anal trauma and anal fistulae are established causes which are also more common in MSM’.

-D-  Under ‘Anal Sphincter Disruption’, the symptoms are ‘faecal leakage; moist seepage; not normally caused by anal sex unless fisting’ [emphasis added: Respect Yourself tacitly promotes fisting and ‘sunflowering’ (2)]. Treatment includes ‘local measures – hygiene, incontinence aids [i.e. nappies, which are starting to be worn by young adult males in public]; ‘various surgical procedures, results often disappointing’ [emphasis added].  (2015)

7/ HIV+ MSM and anal cancer

According to one US study, ‘MSMs and bisexual men with HIV are 100 times more likely to have anal cancer than HIV-negative men who exclusively have sex with women’. (2017)

8/ HIV+ and cardiovascular problems

‘HIV-fighting drugs help prevent the development of AIDS but don’t eliminate HIV from the body. Cardiovascular events, such as heart attacks and strokes, are a common complication of long-term HIV infection. People living with HIV are up to twice as likely as those without HIV to experience cardiovascular events, even when the virus is controlled.’  (2017)

9/ Drugs to relax the anal sphincter for easier sex                                                                                     

-A- According to the UK’s leading gay men’s sexual charity, GMFA, MSMs use drugs, and in particular, those from the alkyl nitrite family, or ‘poppers’, to relax the anal sphincter.    

GMFA partners with the NHS and Public Health England.; (2018)

-B- Risk factors of poppers  

Getting HIV (if penetrated by an HIV+ partner); stress upon the chest and heart. Those with anemia or glaucoma are warned against using poppers.  Using poppers with other drugs is highly discouraged.      

10/ More generically, using drugs to enhance and prolongue sex

GHB/GBL, Mephedrone and Crystal meth are three of the main chemsex drugs for MSMs (also they are illegal).

RSE Review is grateful to Dr Lisa Nolland for providing this report.


[This website is currently unavailable. See the Respect Yourself entry on RSE Review.]

See, for instance, Respect Yourself’s entry under felching:  “During sex, after a guy has ejaculated inside his partner leaving his semen inside them… either in their vagina or  anus… felching is when you tidy up by licking and sucking your fluids back out of your partner… Sounds a bit icky and disgusting but then sex generally is…!”

2/  (sunflowering) (fisting)

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