What exactly is MSM?

Men who have sex with men (MSM) is a term used to classify male persons who engage in sex with other males, regardless of whether they self-identify as gay, bisexual, or heterosexual. the term has been in use within the public health discourse since 1990 or earlier (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.)The term is intended to reference a particular category of people as a risk-group for HIV, and is considered a behavioural category. As this label can only be reliably applied where the sex of individuals is unambiguous, this term should be avoided for transsexuals, transgendered individuals and intersexuals, except in cases where it is clear that they engage in risk behaviors similar, or equivalent to the risk behaviors of unambiguous men having sex with unambiguous men. Since risk factors can and do vary between cultures, the application of this group should also be avoided in cases where this specific risk behavior is no longer a significant category for the contraction of HIV or other STDs.

MSM groups include:

  • Sexually active gay males
  • Bisexual males who are sexual active with other males.
  • Men on the down-low
  • Glory holers
  • Sex workers (commercial or not)
  • Female-to-male transsexuals, who engage in sex with men
  • Males who engage in sex with transgendered individuals, or transsexuals with behaviors similar or equivalent to other MSM
  • Transgendered individuals, or transsexuals who engage in sex with men with behaviors similar or equivalent to other MSM

MSM as a construct

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 social identities. ‘MSM’ refers to the sexual relationships between men, whether or not they identify with same-sex sexual desire. ‘Homosexuality’, however, refers to more than the sexual relationship and may extend to broader relationships with the same sex, i.e. lifestyle, sexuality, etc.

In their assessment of the knowledge about the sexual networks and behaviours of men who have sex with men in Asia, Dowsett, Grierson and McNally observed that using MSM as a category does not always work. From the material they have reviewed there is not any clearly identifiable group of men who can be labelled MSM in any of the countries that they investigated.

“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.”

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

Non-exhaustive list of people who are not MSM

  • Any woman, including post-operative male-to-female transsexuals, regardless of any other factors
  • Men, including female-to-male transsexuals, who engage in sex exclusively with women, regardless of any other factors
  • Any intersexual person, who does not engage in risk behaviors similar or equivalent to sex between MSM, regardless of self-identity, genital appearance, or social assignment.
  • Any transgendered or transsexual individual, who does not engage in risk behaviors similar or equivalent to sex between MSM, regardless of self-identity, genital appearance, or social assignment.
  • A man who is raped by another man
  • A man who participates in a sexual act with another person; unknowing that their partner may otherwise satisfy some particular individual criteria typically asserted to be exclusive to males (for example: genetically, a woman with Androgen Insensitivity Syndrome; genitalia: a pre-op transsexual; gonads/hormones: transgendered individual)


In many developed countries AIDS is more prevalent among MSM than among the general population. In the United States, MSM accounted for 49 percent of new HIV diagnoses reported in 2005. In some Western cities, more than one in ten gay men are infected with HIV. One reason for higher prevalence is that engaging in receptive anal intercourse carries a higher risk than other forms of penetrative sex. Critics charge that political correctness has led to the association of MSM and HIV being downplayed.

Thanks to Wikipedia



  1. Good to hear post ICAAP conference in Colombo that MSM is being dropped in favour of the term Mens Sexual Health. As your article suggests a much more appropriate label. Keep up the good work equal ground 🙂

  2. ICAAP time in Colombo and the airwaves were thick with the sounds of MSM, Condoms, safer sex, antiretroviral and other HIV related jargon. So what exactly is MSM? Men having Sex with Men supposedly. And here I was under the impression that this is known as homosexuality. But the powers that be – read major HIV/AIDS donors and INGOs ala UN, USAID, World Bank etc – felt the need to sterilise the LGBT movement by constructing a term that was less ‘offensive’ to them and the governments of the countries they work in.

    The argument is that not everyone identifies as gay or lesbian. Well, in that case, they choose to be in the closet…pure and simple. Or they are Bi-sexual…nothing wrong with that. But we haven’t fought hard and long for governments, INGO’s and donors to undermine the LGBT movement by sanitising our identity.

    Too many brave Lesbian, Gay, Transgender and Bi activists have been beaten, raped, tortured and have given their lives for the struggle for equality, daring to identify themselves as who they truly are: Lesbians, Gay men, Bisexuals and Transgenders (LGBT). Standing proud amidst terrible oppression, they are still fighting for our rights while the MSMs and WSW’s of this world get their rocks off clandestinely. It is an insult to the LGBT community and all of the activists who have fought so hard to gain some measure of acceptance and human rights, that there are a bunch of people who want the sex, but are not able to or are unwilling to take on the responsibility of the identity. Isn’t it so easy to say-“Oh! We choose not to label ourselves” – who is fooling who?

    At the end of the day, Men having Sex with Men (and Women having Sex with Women – WSW) whittles everything down to just the sexual act. It says nothing about the spiritual and emotional relationship – it says nothing about love and passion and lasting bonds. It dismisses the love and spiritual bonding between two men or two women as just an act of sex. And where does it leave our transgender kindred? Out in the cold with their gender and their sexuality in question is where.

    So pass out the condoms USAID – and strangle our struggle for freedom. Strangle the voices that cry out against oppression and violation. Out universal right to freedom and equality is being shown the door and unfortunately, some LGBT organisations, especially in the developing world, shamelessly sell out to big donors and are now in the business of MSM – just for the bucks. They cannot see pass the dollar signs. If they could, they would realize this is diluting and fragmenting the LGBT struggle. They are chasing us back into the closets and into heterosexual marriages because being Out and Proud is offensive to their sensibilities. Is your big house and fancy car worth the lives of your brothers and sisters?

    Many activists agree this is a travesty. However many are afraid to voice their concerns in case they are branded as politically incorrect. I am saying to hell with that. Let’s call a spade a spade. Its time we reclaimed out identity and our spirit from those who are trying to bury it.

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