Gay Men's Sexual Health

There are a number of sexual health, mental health and generic health issues that affect Gay and Bisexual men, and men who have sex with men i.e. those men that have sexual relations with other men but who do not identify as Gay or Bisexual.

Sexual Health

In recent years, the number of heterosexual men infected with HIV in Britain has increased, There is also a high prevalence of other sexually transmitted infections, for example syphilis. HIV is still an issue of major concern for Gay and Bisexual men.

Findings have shown that gay men are having more unsafe sex despite the continuing threat of HIV, unprotected anal sex is recognised as a high risk route for contracting HIV infection. New treatments for HIV have shown reduced concern about HIV infection. Around 80% of new infections of HIV are occurring through sex between men, In the UK, gay and bisexual men are affected by HIV, more than any other population group.

Sexual health should be of great importance to every gay man. Gay men's health organisations work hard to promote safer sex amongst the most at risk groups and assist with improvements to sexual health services getting the correct information to those at risk. striving to keep well informed. The message of safe sex should be targeted across all ages, especially the younger gay men who it seams are just not as interested in safe sex, or lack the knowledge concerning safe sex practices, or shun campaigns aimed at safe sex.

Sexually transmitted infections can be passed on to others, some people may be unprepared, or off their guard, such as after drinking excess alcohol, or taking drugs, it is important to have an awareness of symptoms and changes that may occur, for example, spots, rashes or blisters, any change in sensation like pain, itchiness, or burning when passing urine, or after passing urine, blood in urine, or semen, discharge, or having to urinate more frequently.

To reduce the risk of contracting a sexually transmitted infection, its recommended always use condoms. They are not 100% safe, notably genital warts can still be contracted from a contact with warts. Warts are caused by a virus, can be easily treated, it is best to have a check-up once warts appear on the skin, as they can increase in size and number if left untreated. Some sexually transmitted infections can be present without signs or symptoms, or an infection can come and go, but a sexual health check-up may eventually be needed.

Infections associated with homosexual activity

  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Syphilis
  • HIV
  • Chlamydia
  • Gonorrhoea
  • Non-specific urethritis (NSU)
  • Crabs and Scabies
  • Molluscum Contagiosum
  • Warts (HPV)
  • Shigella
  • Trichomonoasis

Testing, treatment, and contact tracing is the same as in the heterosexual community

  • Full Screen for sexually Transmitted Infections
  • Rectal Swab for Chlamydia and Gonorrhoea
  • Urine Test for Chlamydia
  • Blood Test for Syphilis, HIV, Hepatitis B, Hepatitis C
  • Immunization for Hepatitis A and B

Further concerns related to Gay Well Men

Erectile dysfunction

Erectile dysfunction is being seen increasingly in HIV positive men in the late stage of the infection, although this is not clear whether its an effect of the HIV drugs or of the virus. This can be discussed with the Doctor at a consultation.

Anal Warts (Condyloma Acuminata)

These are warts around or inside the back-passage or bottom, the wart virus can be passed on during oral or anal sex with an infected person, correct use of condoms reduces the risk, but does not eliminate the risk.

Roughly 90% of all anal warts are caused by the human papilloma virus (HPV) types 6 and 11. Anal warts are usually transmitted through direct sexual contact with someone who is infected with condyloma acuminata anywhere in the genital area, including the penis and vagina. Studies have shown that roughly 75% of those who engage in sexual contact with someone infected with condyloma acuminata can develop warts within three monthsof contact.

Gay Men May seek Advice for some of the following:

Amount of Semen Produced

The volume of semen is often related to how often you ejaculate. Two things can happen: If you refrain from ejaculation, your semen will build up over a few days and then you can produce more ejaculate. Or if you ejaculate often, the ejaculate can be small initially, but over time your body will compensate and return to normal.

Oral sex

While a recognised route of transmission for some sexually transmitted infections, it is considered low risk for HIV.

Mutual masturbation

It is very rare that sexually transmitted infections like herpes or genital warts are transmitted via mutual masturbation. This is generally considered to be safer sex and carries a very, very low risk for HIV gonorrhea, chlamydia or syphilis, but is always advisable to know you don't have a STI, so regular STI check-ups every six months if you're sexually active can be reassuring

Curved Penis

This may be due to Peyronie's disease. One of the main characteristics of this disease is the development of a stiff, fibrous deposit of scar tissue that frequently builds up under the skin of the upper or lower side of the penis. This can result in painful erections and can make sex extremely difficult, often creating frustration and strain for both the sufferer and their partner.
The symptoms associated with this condition can occur overtime, but they may also occur overnight. In mild cases the inflammation that occurs may subside with time, which means the pain will subside and the bending may not be permanent.

Fisting

Fisting or receiving a hand or fist up the anus and into the rectum is a sexual activity that can cause trauma to the rectum. Good hygine is necessary to help prevent the transmission of enteric infections like hepititis A, shigella, giardia and amoebiasis.

Hemorrhoids

A common problem. Most men and women will get them as they get older. Certainly, trauma to the anus during anal sex and any type of straining can make hemorrhoids worse. There are treatments available using creams, ointments, lasers, and surgery.

Risks from Penis Rings

The risks of wearing a penis ring while having sex depends for example how long the rings should one be worn, some worry about what damage rings may cause
Overall there are no great risks in wearing or having sex with a ring as long as you remove it after sex. But you can do damage to your penis if it is too tight and stays on too long. A too tight ring will produce numbness to the penis, discoloration, prolonged swelling and finally severe pain. It is important that rings have some kind of fastener which can be loosened or opened completely if need be (Velcro, elastic, snaps, etc.). If a combination of drugs such as Viagra or crystal meths is used with irremovable penis ring, this can cause problems, as the blood in your penis could get restricted, sent back into the body, and trapped in the penis. Using such drugs can be a risk , and this can also increase risks of getting an STI or HIV anywhere from 3-5 times.

Tearing During Anal Sex

Two thirds of Gay Men have anal sex and this may cause a tear or persistent soreness after sex. A couple of factors may exist in having sex before your sphincter muscle is relaxed enough to allow it. Lack of lubrication , or a medical condition such as a tear, hemorrhoid, or fissure can cause this, discuss your concerns with the Doctor where an examination will be needed to rule out medical concerns. Good communication should occur with partners/contacts around this issue, especially regarding pain, and using alternatives to anal sex while seeking a medical check-up. The Doctor will advise on treatment and follow-up care needed for example if there are hemorrhoids or fissures present. Painful Sex can be a sign of infection, or other problem warranting a check up.

Safer sex is important in any new relationship. knowing the sexual history of any partner/contact can be difficult and don't always presume they are negative.

Mental Health

As a result of homophobia prejudice and discrimination against Gay men, heterosexism assuming that everyone is heterosexual and that being heterosexual is superior to being Gay, and internalised homophobia where Gay men believe that being Gay is wrong, Gay and Bisexual men, and men who have sex with, can often experience a number of mental health problems, and young Gay men in particular suffer from higher levels of depression, deliberate self-harm (suicide attempted), and actual suicides. Discuss any problems or worries with the Doctor at consultation.

You can make an appointment at any clinic, outside the area and outside working hours where ever you live. What happens there is strictly confidential, no one will be told about your visit, even your doctor or your family unless you specifically give your permission. Of course you may be asked for details of contacts so that others can be traced and treated, but you are not compelled to give them. Any contacts you do name will not be told the source of the information, nor will anyone else.

The Sunshine Clinic provides a rapid comprehensive confidential service for those concerned about sexual health issues.

Dr Prabhat Sood

Consultant Physician
Genitourinary and HIV Medicine

24 Hour appointment booking service

0845 505 0552

Weekend Appointments Available

Sunshine Clinic

West Midlands Hospital
Colman Hill
Halesowen
West Midlands
B63 2AH