There are a variety of reasons that men who have sex with men (MSM), regardless of how they identify (as gay, bisexual, or otherwise), are at higher risk for STD infections. These risk factors include population-level and individual-level factors.
Population Factors
According to the Center for Disease Control, social factors play a role in STD transmission between MSM. Overlapping sexual and social circles can mean that men share multiple partners, increasing the risk of transmission.
Race and ethnicity compound these risks. The CDC also reports that Hispanic men, due to social oppression and isolation, are at greater risk than other ethnic groups. The New York Times Magazine recently reported that African-American gay and bisexual men have a one in two chance of being infected with HIV–compared to a one in 99 chance for all Americans.
Geography also plays a role in HIV and STD risk. The NY Times also reports that while Southern states account for 37 percent of the nation’s population, it is also home to 54 percent of all new HIV diagnoses.
Individual Factors
Risk factors are also present at the individual level. For instance engaging in higher risk sexual behavior, such as anal sex, can increase the risk of transmission of some STDs, particularly HIV. The risk is increased whether or not the person is performing anal sex (“topping”) or receiving it (“bottoming”).
Having multiple sexual partners can also increase the risk of STD transmission simply because it means more potential exposure to infection. Frequency of unprotected sex is also a factor.
Co-infection in Men who Have Sex with Men
Because of the inflammation different infections can cause, having one infection can increase the risk of receiving another. The CDC reports that chlamydia and gonorrhea infections often overlap, as do syphilis and HIV infection.
Prevention
Education about safe sexual practices, regular STD testing, and communication about safe sex and one’s sexual history with potential partners are key to breaking the stigma around sex between men and diminishing the rate of infection in this population.
