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.
- 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)
MSM and HIV/AIDS
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.
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