Gay Men, Bisexual Men and Other Men Who Have Sex with Men
Gay men, bisexual men and other men who have sex with men (MSM), including transgender men, may experience poorer health outcomes than heterosexual men due to stigma, discrimination, homophobia and transphobia. If you understand these health disparities, you can take the steps necessary to feel empowered and lead a healthy life.
Find Affirming Health Care
You have the right to honest and judgment-free health care. This means your health care provider affirms who you are and does not make assumptions about your sexual orientation, gender identity or gender expression.
For help finding LGBTQ-knowledgeable providers, visit the NYC Health Map.
Sexual Health and Anal Health
Your sexual health is not just about the prevention and treatment of HIV and other sexually transmitted infections (STIs). Sexual health and pleasure involve open communication with your partner(s). That includes talking about all aspects of your physical and emotional health.
To stay sexually healthy:
- Have open and honest conversations with your health care provider about your sex life, including the gender(s) of your sex partner(s) and the kinds and quality of your sexual experiences.
- Use condoms for genital or anal sex. Consistent use prevents HIV, other STIs, and unplanned pregnancy if you also have sex with people who can conceive.
- Learn about other ways to prevent HIV if you can’t or don’t always use condoms. If you do not have HIV, ask your health care provider if PrEP or PEP are right for you.
- Get tested regularly for STIs, including HIV. Do not wait until you experience symptoms to get tested. Many people with STIs do not feel sick or experience any symptoms.
- If you are living with HIV, get and stay on treatment. HIV treatment keeps you healthy and prevents transmission of the virus to your partner(s).
- Check yourself for signs and symptoms of other health conditions. You know your body best. If you find anything concerning, see a health care provider rather than self-diagnosing online.
- Visit an NYC Sexual Health Clinic for timely testing and screenings, regardless of your immigration status or ability to pay.
- Make sure your health care provider swabs the sites you use for sex. This is sometimes called three-site STI testing. It includes swabbing your throat and anus and taking a urine sample.
- Stay up to date on your vaccinations. In addition to standard vaccinations, MSM who have sex should get vaccinated against meningococcal disease, hepatitis A and hepatitis B. Additionally, adolescents and young adults through age 26 should receive the human papillomavirus (HPV) vaccination if they did not get all recommended doses when younger. Some adults ages 27 through 45 who did not get all recommended doses when they were younger might decide to get the HPV vaccine based on discussion with their clinician.
- For transgender men (PDF), it is important to get regular chest exams, pelvic exams and pap smears.
Anal Sex
Keep the below tips in mind:
- Use lubrication and condoms as often as possible to both reduce your chance of injury and minimize the risk of transmitting infections during anal sex.
- As with all sexual activity, the key to ensuring everyone experiences pleasure is clear and open communication with your partner(s).
Toys and Pegging
When you find a toy that is right for you, follow manufacture instructions for storage, use and cleaning. You can avoid injuries by checking for any damage before and after use.
Fingering and Fisting
Fingering and fisting are not likely to result in the transmission of HIV or other STIs, unless there are injuries. You can reduce the risk of injury or infection by using lubricant, finger condoms and gloves.
Rimming
Mouth-to-anus contact will not usually result in the transmission of HIV or other STIs. However, contact with feces may lead to diarrheal infections.
Learn what you can do to avoid diarrheal infections.
Douching
Douching in preparation for anal sex is a common practice. Douching may cause injury to the lining of the rectum increasing the risk of some STIs, including HIV, hepatitis B and hepatitis C. It can also put you at higher risk for more common bacterial STIs, such as gonorrhea, chlamydia, syphilis and HPV. To avoid these risks, use enemas that are available in stores and avoid douching every day or multiple times per day.
Other Anal Health Conditions
Hemorrhoids
If you are experiencing discomfort and believe you have a hemorrhoid, see your health care provider or visit a local urgent care center.
Anal sex does not cause hemorrhoids, but it can irritate the area and make the condition worse.
Learn more about the symptoms and causes of hemorrhoids.
Rectal Prolapse
Rectal prolapse is when the rectum loses its normal attachments inside the body and slips through the anus. This can happen for various reasons. If you believe you are experiencing rectal prolapse, see your health care provider or visit a local urgent care center.
Mental Health
Stigma, homophobia and discrimination can have negative effects on the mental health and well-being of MSM. If you or someone you know could benefit from counseling or other mental health services, contact 988 for free confidential support.
A traumatic incident can include verbal harassment, physical violence or sexual assault. If you or someone you know has experienced trauma and are looking for help, speak with a health care provider, or contact 988 or local authorities.
Tobacco and other Drugs
Stigma, isolation and stress can lead to tobacco use and the misuse of other drugs. Substance misuse can have both immediate and long-term health effects.
If you are a smoker, quitting smoking is the single most important thing you can do for your health. If you are ready to quit, check out our resources to help you drop the habit.
If you or a friend use methamphetamines (also referred to as “meth”, “tina” and “crystal”) or opioids (such as heroin, prescription pain killers and fentanyl) and are looking for help, speak with your health care provider and learn about Naloxone. You can also contact Re-Charge and schedule a time to meet with a staff member.
Other harmful drugs that are commonly used by MSM include steroids, to enhance physical appearance outside of medical supervision, and poppers (alkyl nitrates). In the short term, poppers can cause low blood pressure, dizziness, fainting and headaches. Possible long-term effects of the drug include the loss of eyesight.
Learn more about the risks of alcohol and drug misuse.
Drug Use During Sex
Some people use drugs to enhance their sexual experience. This is often called “party and play,” “PnP,” "partying" or "chemsex." Drug use can impair your decision-making abilities. This can lead to needle sharing, higher alcohol consumption and sex without condoms. These behaviors increase your risk of getting HIV and other STIs.
One form of chemsex is “booty bumping,” or putting a drug (such as crystal meth or cocaine) in the anus to speed up absorption into the bloodstream. Drugs inserted into the anus may cause irritation, bleeding or inflammation, making it easier to pass STIs and HIV.
You can reduce the risk of irritation by diluting the substance with water before inserting it. If you are using a needleless syringe to insert drugs into the anus, always use a clean syringe and do not share syringes.
If you use drugs during sex, use condoms, PrEP, PEP or HIV treatment to minimize the risk of HIV transmission. People who have chemsex should get tested for HIV and other STIs once every three months.
Just as with any other sexual activity, it is important to have consent before engaging in chemsex.
Domestic Violence
If you or someone you know is experiencing violence in a relationship, help is available.
If you are in an emergency situation, call 911. For other situations, call 311 and ask to be connected to an NYC Family Justice Center near you. You can also call the City's 24-hour Domestic Violence Hotline at 800-621-HOPE (800-621-4673), or visit NYC Hope to learn about immediate safety planning, shelter assistance and other resources.