Health for men

Men who have sex with men may identify themselves as homosexual, bisexual, or even heterosexual. No matter what label is used, the fact is that these men are at increased risk for sexually transmitted diseases (STDs) such as human immunodeficiency virus (HIV) infection, anal cancer, and psychologic and behavioral disorders.1
The rate of men who had sex with men in the previous year was thought to be 1.7 to 2 percent. However, surveys from 1996 to 2000 indicate that the rate is at least 3.1 to 3.7 percent.2 This discrepancy indicates that male-male sexual behavior often is underreported, and that previous estimates of the number of men who have sex with men may be too low. Therefore, a typical family physician can expect 3 percent or more of his or her male patients to be men who have had sex with men in the previous year.
Recent trends indicate a resurgence in risky behaviors that expose men who have sex with men to HIV infection and other STDs. The reported prevalence of men engaging in un-protected anal intercourse increased from 37 percent in 1993-1994 to 50 percent in 1996-1997.3 Disease risk frequently is not assessed, especially in younger men, in part because of numerous impediments to adequate care under the current health care system.4
Family physicians need an efficient system to identify and assess risk in men who have sex with men, so that appropriate screening and counseling interventions may occur. This article presents an organized risk-based preventive health assessment for men who have sex with men.