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Men who have sex with men or Males who have sex with Males (MSM) refer's to men who engage in sexual activity with other men, beyond those who would identify as gay, or bisexual.[1][2][3][4][5] This term was defined in the 90's, by epidemiologist in order to study the spread of disease among any and all biological males who have sex with other biological males.[2]

The term is intended to reference a particular category of males who are at higher risk for sexually-transmitted diseases such as HIV.[2][3] MSM is considered a behavioral category, not any kind of identiy.[2][3][4][5] It's primary use is in terms of studying the spread of the HIV virus. [2]

MSM's use in research literature

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Young and Meyer (2005) note that the term has been in use within the public health discourse since 1990 or earlier,[6] but that the coining of the initialism by Glick et al. (1994) "signaled the crystallization of a new concept."[7]

They trace the emergence of this behavioural concept to two very distinct academic perspectives. First, it was pursued by epidemiologists seeking behavioral categories that would offer better analytical concepts for the study of disease risk than identity-based categories (such as "gay", "lesbian", or "straight", because a man who self-identifies as gay or bisexual is not necessarily sexually active with men). Second, its usage could in part be explained by the criticism of sexual identity terms prevalent in the "social construction" literature, which typically rejected the use of identity-based concepts across different cultural and historical contexts.

As a risk category, MSM are not limited to small self-identified and visible sub-populations, such as gay men and male sex workers. "MSM" and "homosexual" refer to different things: behaviors and social identities. "MSM" refers to the sexual relationships between men, whether or not they identify as homosexual, or bisexual. "Homosexuality" refers to more than the sexual relationship and may extend to broader relationships with the same sex, i.e., lifestyle, sexuality, etc. It's precise definition has varied with regard to transwomen.[2][3][4][5] With some sources considering tranwomen to be MSM, [3], Others considering transwomen "along side" MSM,[2] while still others are internally inconsistent (Defining transgender women to be MSM in one place but referring to "MSM and transgender" in another.)[5]. In their assessment of the knowledge about the sexual networks and behaviors of men who have sex with men in Asia, Dowsett, Grierson and McNally concluded that the category of MSM does not correspond to a single social identity in any of the countries they studied. [8]

"The literature reveals that there are no socially or self-defined groups of men that fit into an overarching category of MSM. What the review shows is that there are just men!! Fishermen, students, factory workers, military recruits, truck drivers, and men who sell sex, and so on: all these categories of men are to be found in the studies and programmes reviewed."[8]

There were no similar traits in all of the MSM population studied other than them being men, and engaging in sex with other males.[8]

Sexually transmitted diseases

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Men who have sex with men are more likely to get HIV in the modern West,[9] in Japan,[10] India,[11] and Taiwan[12] as well as other developed countries than among the general population.[13] In the US, their HIV prevalence is 60 times higher than the general population,[14] An estimated 62% of adult and adolescent American males living with HIV/AIDS got it through sexual contact with other men. This compares to an estimated 13% of American males who get HIV from sexual contact with a female who is known to have, or is at high risk for, HIV infection.[15]

Infection with the Hepatitis B virus is about 5-6 times more common and Hepatitis C virus infections are about 2 times more common in men who have sex with other men than in the general population. They also have an increased incidence and prevalence of Human Herpes Virus-8, which causes a cancer called Kaposi's sarcoma in immunocompromised individuals.[14] In 2006, 64% of the reported syphilis cases in the United States were among men who have sex with men.[16] Men who have sex with men are 17 times more likely to develop anal cancer than heterosexual men,[17] probably due to a higher risk of Human papillomavirus.[18][19] Many people become infected with HPV soon after becoming sexually active.[20]

Growth rate

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HIV infection is increasing at a rate of 12 percent annually among 13 to 24 year old American men who have sex with men.[21][22][23] During the last 10 years, syphilis outbreaks among men who have sex with men have been recorded in countries across Europe.[24] This follows the general increase in STDs among men who have sex with men.[25] This increase in cases among young Western males may have to do with the new generation being relaxed because of new treatments and being not personally affected by the initial AIDS breakout in the 80s.[21] In developing countries, HIV infection rates are skyrocketing among men who have sex with men.[26]

Explanations

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One reason for higher prevalence is that engaging in receptive anal intercourse carries a higher risk than other forms of penetrative sex,[27] which is more common in homosexual sex than heterosexual sex.[28]

A comparison study of HIV-infected men found that those who had sex with men were especially unlikely to receive HIV preventative services even though they were more likely to report unprotected sexual intercourse with seronegative and unknown serostatus casual partners.[9] This can lead to the rapid transmission of HIV among small clusters of gay men.[29]

A 1990 study of The Social Organization of Sexuality, showed that men who had at least one male sexual partner in the previous 5 years had an average of 16.7 sexual partners during that time period, while men who only had sex with women had an average of 4.8 sexual partners during that time. [30] New York Health Commissioner Thomas Frieden said "We are very concerned about the increase in HIV among young men who have sex with men... Unless young men reduce the number of partners they have, and protect themselves and their partners by using condoms more consistently, we will face another wave of suffering and death from HIV and AIDS."[23][31]

However, the persistence of disparities in HIV between heterosexual individuals and MSM in the United States cannot be explained solely by differences in risky sexual behavior between these two populations.[32]

Critics charge that political correctness has led to the association of MSM and HIV being downplayed.[33][34]

In developing countries, homosexual relationships may be illegal, making MSM difficult to reach.[1][35] Studies have found that less than 5 percent of MSM in Africa, Asia and Latin America have access to HIV-related health care.[26]

See also

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References

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  1. ^ a b MSM in Africa: highly stigmatized, vulnerable and in need of urgent HIV prevention
  2. ^ a b c d e f g "UNAIDS:Men who have sex with men" (asp). UNAIDS. Retrieved 24 July2008. {{cite web}}: Check date values in: |accessdate= (help); Cite has empty unknown parameter: |coauthors= (help)
  3. ^ a b c d e Greenwood, Cseneca (9 April2004). "African American Community and HIV (Slide 14 mentions TG women)" (ppt). East Bay AIDS Education and Training Center. Retrieved 24 July2008. {{cite web}}: Check date values in: |accessdate= and |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); line feed character in |title= at position 27 (help)
  4. ^ a b c Don, Operario; Burton, Jennifer (January), Men Who Have Sex with Transgender Women: Challenges to Category-based HIV Prevention, vol. 12, Number 1, pp. 18–26, doi:10.1007/s10461-007-9303-y {{citation}}: Check date values in: |year=, |date=, and |year= / |date= mismatch (help)CS1 maint: year (link)
  5. ^ a b c d Don, Operario; Burton, Jennifer (21 April), "HIV-Related Tuberculosis in a Transgender Network --- Baltimore, Maryland, and New York City Area, 1998--2000", MMWR, 49 (15): 317–320 {{citation}}: Check date values in: |year=, |date=, and |year= / |date= mismatch (help)CS1 maint: year (link)
  6. ^ Young, R M & Meyer, I H (2005) The Trouble with "MSM" and "WSW": Erasure of the Sexual-Minority Person in Public Health Discourse American Journal of Public Health July 2005 Vol. 95 No. 7.
  7. ^ Glick, M Muzyka, B C Salkin, L M Lurie, D (1994) Necrotizing ulcerative periodonitis: a marker for immune deterioration and a predictor for the diagnosis of AIDS Journal of Periodontology 1994 65 p. 393-397.
  8. ^ a b c A review of knowledge about the sexual networks and behaviors of men who have sex with men in Asia. Dowsett, Grierson and McNally.[1]>
  9. ^ a b Steward, Wayne T. (June 2008). "Receipt of Prevention Services Among HIV-Infected Men Who Have Sex with Men". Vol 98 (No. 6). American Journal of Public Health. {{cite journal}}: |number= has extra text (help); |volume= has extra text (help); Cite journal requires |journal= (help)
  10. ^ Statistics from the Ministry of Health, Labor and Welfare
  11. ^ High HIV prevalence and risk behaviors in men who have sex with men in Chennai, India
  12. ^ Increased Risk for Entamoeba histolytica Infection and Invasive Amebiasis in HIV Seropositive Men Who Have Sex with Men in Taiwan
  13. ^ UNAIDS 2006 report on the global AIDS epidemic, Chapter 05, June 2006
  14. ^ a b FDA Policy on Blood Donations from Men Who Have Sex with Other Men
  15. ^ Estimated numbers of persons living with HIV/AIDS at the end of 2006, by race/ethnicity, sex, and transmission category—33 states with confidential name-based HIV infection reporting, Center for Disease and Control Prevention
  16. ^ Syphilis & MSM (Men Who Have Sex With Men) - CDC Fact Sheet, Centers for Disease Control and Prevention
  17. ^ "STD Facts - HPV and Men". Retrieved 2007-08-17.
  18. ^ Frisch M, Smith E, Grulich A, Johansen C (2003). "Cancer in a population-based cohort of men and women in registered homosexual partnerships". Am. J. Epidemiol. 157 (11): 966–72. doi:10.1093/aje/kwg067. PMID 12777359. However, the risk for invasive anal squamous carcinoma, which is believed to be caused by certain types of sexually transmitted human papillomaviruses, notably type 16, was significantly 31-fold elevated at a crude incidence of 25.6 per 100,000 person-years.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  19. ^ Chin-Hong PV, Vittinghoff E, Cranston RD; et al. (2005). "Age-related prevalence of anal cancer precursors in homosexual men: the EXPLORE study". J. Natl. Cancer Inst. 97 (12): 896–905. doi:10.1093/jnci/dji163. PMID 15956651. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)
  20. ^ Tuller, David (January 30, 2007). "New Vaccine for Cervical Cancer Could Prove Useful in Men, Too". New York Times. {{cite news}}: Check date values in: |date= (help)
  21. ^ a b Paddock, Catharine (27 June 2008). "HIV Rising Among Young Gay Men In The US". Medical News Today. {{cite news}}: Check date values in: |date= (help)
  22. ^ "Trends in HIV/AIDS Diagnoses Among Men Who Have Sex with Men --- 33 States, 2001--2006." A Mitsch, MPH, X Hu, MS, K McDavid Harrison, PhD, T Durant, PhD, Div of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. MMWR Weekly, June 27, 2008 / 57(25);681-686.
  23. ^ a b NEW HIV DIAGNOSES RISING IN NEW YORK CITY AMONG YOUNG MEN WHO HAVE SEX WITH MEN
  24. ^ Risky Sexual Behavior Among MSM In Europe Increasing Number Of Syphilis Cases, Health Officials Say
  25. ^ STD Surveillance 2006: Men Who Have Sex With Men, Center for Disease Control
  26. ^ a b HIV rates skyrocketing among men who have sex with men
  27. ^ Stuttaford, Thomas and Suzi Godson, "Blown out of proportion; Agony and ecstasy; Sex advice; Sex", Times (UK) (December 23, 2006), 22.
  28. ^ ABC of sexual health Homosexual men and women
  29. ^ Hayward, Peter (May 2008). "Rapid HIV transmission in men who have sex with men". Volume 8 (Issue 5). The Lancet Infectious Diseases. {{cite journal}}: |issue= has extra text (help); |volume= has extra text (help); Cite journal requires |journal= (help)
  30. ^ Laumann, Edward O. (1994). The Social Organization of Sexuality: Sexual Practices in the United States. University of Chicago Press. p. 315.
  31. ^ New York City Records Increasing Number Of HIV Cases Among MSM Younger Than Age 30
  32. ^ Biological and demographic causes of high HIV and sexually transmitted disease prevalence in men who have sex with men.
  33. ^ James Chin, “The risks in hiding the HIV/AIDS truth”, Business Day (March 12, 2007), 9.
  34. ^ "The people punish Mr Blair", Daily Mail (UK) (May 6, 2005), 14.
  35. ^ Criminalising high-risk groups such as MSM

Further reading

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  • UNESCO Guidelines on Language and Content in HIV and AIDS-Related Materials. [2]
  • Assessment of sexual health needs of males who have sex with males in Laos and Thailand. Naz Foundation International [3]
  • Sexual Identity Among Men Who Have Sex with Men in Shanghai. Sun Zhongxin, James Farrer, Kyung-hee Choi. China Perspectives n°64, March - April 2006, page n°2 [4]
  • Playing Back the Nation: Waria, Indonesian Transvestites [5]
  • Gay Guise: What To Do When Your Client Has Sex with Men and is not Gay, 2007 July/August Psychotherapy Networker [6]
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[[Category:Sexual orientation and identity]] [[Category:Same-sex relationship]] [[Category:Sexual orientation and science]] [[Category:Sexual orientation and society]] [[Category:Public health]] br:MSM (revelezh) de:Männer, die Sex mit Männern haben no:Menn som har sex med menn sv:Män som har sex med män zh:男男性接触者

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