Top 10 Health Tips that M2M should discuss with their Health Care Providers

The following are the health issues the Gay Lesbian Medical Association healthcare providers have identified as most commonly of concern for men who have sex with men. While not all of these items apply to everyone, it's wise to be aware of these issues.

1. HIV/AIDS, Safe Sex

The fact that men who have sex with men are at an increased risk of HIV infection is well known, but the effectiveness of safe sex in reducing the rate of HIV infection is one the gay community's great success stories.  However, in recent years there has been an increase in many unsafe sex practices. While effective HIV treatments may be available and more in development, there is no substitute for preventing infection. Safe sex is proven to reduce the risk of receiving or transmitting HIV.

2. Substance Use

Many men use substances and not just in larger communities such as Toronto, Vancouver and Montreal. These include a number of substances ranging from amyl nitrate (poppers), marijuana, ecstasy, and amphetamines. The long-term effects of many of these substances are unknown; however current wisdom suggests potentially serious consequences as we age.

3. Depression/Anxiety

Depression and anxiety appear to affect men who have sex with men at a higher rate. The likelihood of depression or anxiety may be greater, and the problem may be more severe for those men who remain 'closeted' and/or do not have adequate social supports. Adolescents and young adults may be at particularly high risk of suicide because of these concerns.

4. Hepatitis Immunization

Men who have sex with men are at an increased risk of sexually transmitted infection with the viruses that cause the serious condition of the liver known as hepatitis. These infections can be potentially fatal, and can lead to very serious long-term issues such as cirrhosis and liver cancer. Fortunately, immunizations are available to prevent two of the three most serious viruses. Universal immunization for Hepatitis A Virus and Hepatitis B Virus is recommended for all men who have sex with men. Safe sex is effective at reducing the risk of viral hepatitis, and is currently the only means of prevention for the very serious Hepatitis C Virus.

5. STI's

Sexually transmitted infections (STI's) occur in sexually active M2M at a high rate. The includes STI's for which effective treatment is available (syphilis, gonorrhea, chlamydia, public lace, and others), and for which no cure is available (HIV, Hepatitis A, B and C virus, Human Papilloma Virus (HPV), etc). There is absolutely no doubt that safer sex practices reduce the risk of STI's.

6. Prostate, Testicular and Colon Cancer

M2M may be at risk for death by prostate, testicular or colon cancer. Screening for these cancers occurs at different times across the life cycle, and access to screening services may be negatively impacted because of issues and challenges in receiving culturally sensitive care for M2M. All M2M should undergo these screenings routinely as recommended for the general population.

7. Alcohol

Although more recent studies have improved our understanding of alcohol use among M2M, it is still thought that M2M have higher rates of alcohol dependence and abuse than straight men. One drink daily may not adversely affect health, however, alcohol-related illnesses can occur with low levels of consumption.

8. Tobacco

Recent studies seem to support the notion that M2M use tobacco at higher rates than straight men, reaching nearly 50 percent in several studies. Tobacco-related health problems include lung disease and lung cancer, heart disease, high blood pressure, and a whole host of other serious problems.

9. Fitness (Diet & Exercise)

Problems with body image are more common among M2M than their straight counterparts, and M2M are much more likely to experience an eating disorder such as bulimia or anorexia nervosa. While regular exercise is very good for cardiovascular health and in other areas, too much of a good thing can be harmful. The use of substances such as anabolic steroids and certain supplements can adversely affected health. At the opposite end of the spectrum, overweight and obesity are problems that also affect a large subset of M2M. This can cause a number of health problems, including diabetes, high blood pressure, and heart disease.

10. Anal Papilloma

Of all the sexually transmitted infections M2M are at risk for, human papilloma virus - which cause anal and genital warts - is often thought to be little more than an unsightly inconvenience. However, these infections may play a role in the increased rates of anal cancers in M2M. Some health professionals now recommend routine screening with anal Pap Smears, similar to the test done for women to detect early cancers. Treatments for HPV do exist, but recurrences of the warts are very common, and the rate at which the infection can be spread between partners is very high.

*This information was taken from GLMA's Top Ten Issues to Discuss with your Healthcare Provider. Their website is http://www.glma.org.  Author: Vincent M.B. Silenzio, MD, MPH, Former Member Board of Directors, GLMA and Former Co-Editor, Journal of the Gay and Lesbian Medical Association.


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