Just like all other men, gay, bisexual, and other men who have sex with men need to know how to protect their health throughout their life. For all men, heart disease and cancer are the leading causes of death. However, compared to other men, gay, bisexual and other men who have sex with men are additionally affected by:
Higher rates of HIV and other sexually transmitted diseases (STDs);
Tobacco and drug use;
Depression.
There are many reasons why gay, bisexual, and other men who have sex with men may have higher rates of HIV and STDs. Some of them are:
Prevalence of HIV among sexual partners of gay, bisexual, and other men who have sex with men is 40 times that of sexual partners of heterosexual men;
Receptive anal sex is 18 times more risky for HIV acquisition than receptive vaginal sex;
Gay, bisexual, and other men who have sex with men on average have a greater number of lifetime sexual partners.
Other factors that can negatively impact your health and ability to receive appropriate care:
Homophobia;
Stigma (negative and usually unfair beliefs);
Discrimination (unfairly treating a person or group of people differently);
Lack of access to culturally- and orientation-appropriate medical and support services;
Heightened concerns about confidentiality;
Fear of losing your job;
Fear of talking about your sexual practices or orientation.
These reasons and others may prevent you from seeking testing, prevention and treatment services, and support from friends and family.
In fact, gay, bisexual, and other men who have sex with men make up more than half of the people living with HIV in the United States and experience two thirds of all new HIV infections each year. Further, young gay, bisexual, and other men who have sex with men 13-24 had over 72% of the estimated new HIV infections in 2010. In 2012, 75% of reported syphilis cases were among gay and bisexual men.
The large percentage of gay, bisexual, and other men who have sex with men who have HIV and STDs means that, as a group, they have a higher chance of being exposed to these diseases. Too many men don’t know their HIV or STD status (if they have a disease or not), which means they may not get medical care and are more likely to unknowingly spread these diseases to their sexual partners.
Most gay, bisexual, and other men who have sex with men get HIV by having anal sex, which is the riskiest type of sex for getting or spreading 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, bottoming without a condom puts you at much greater risk for getting HIV than topping. If you are HIV-positive, being on the top without a condom is riskier for giving HIV to your partner.
Sexual relationships between members of the same sex expose gays, lesbians and bisexuals to extreme risks of Sexually Transmitted Diseases (STDs), physical injuries, mental disorders and even a shortened life span. There are five major distinctions between gay and heterosexual relationships, with specific medical consequences.
They are:
Levels of Promiscuity
Prior to the AIDS epidemic, a 1978 study found that 75 percent of white, gay males claimed to have had more than 100 lifetime male sex partners: 15 percent claimed 100-249 sex partners; 17 percent claimed 250-499; 15 percent claimed 500- 999; and 28 percent claimed more than 1,000 lifetime male sex partners. Levels of promiscuity subsequently declined, but some observers are concerned that promiscuity is again approaching the levels of the 1970s. The medical consequence of this promiscuity is that gays have a greatly increased likelihood of contracting HIV/AIDS, syphilis and other STDs.
Similar extremes of promiscuity have not been documented among lesbians. However, an Australian study found that 93 percent of lesbians reported having had sex with men, and lesbians were 4.5 times more likely than heterosexual women to have had more than 50 lifetime male sex partners. Any degree of sexual promiscuity carries the risk of contracting STDs.
Physical Health
Common sexual practices among gay men lead to numerous STDs and physical injuries, some of which are virtually unknown in the heterosexual population. Lesbians are also at higher risk for STDs. In addition to diseases that may be transmitted during lesbian sex, a study at an Australian STD clinic found that lesbians were three to four times more likely than heterosexual women to have sex with men who were high-risk for HIV.
Mental Health
It is well established that there are high rates of psychiatric illnesses, including depression, drug abuse, and suicide attempts, among gays and lesbians. This is true even in the Netherlands, where gay, lesbian and bisexual (GLB) relationships are far more socially acceptable than in the U.S. Depression and drug abuse are strongly associated with risky sexual practices that lead to serious medical problems.
Life Span
The only epidemiological study to date on the life span of gay men concluded that gay and bisexual men lose up to 20 years of life expectancy.
Monogamy
Monogamy, meaning long-term sexual fidelity, is rare in GLB relationships, particularly among gay men. One study reported that 66 percent of gay couples reported sex outside the relationship within the first year, and nearly 90 percent if the relationship lasted five years.
Encouraging people to engage in risky sexual behavior undermines good health and can result in a shortened life span. Yet that is exactly what employers and governmental entities are doing when they grant GLB couples benefits or status that make GLB relationships appear more socially acceptable.
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