Dear Dr. Know,
What (if any) special concerns should I have if I am a gay man?
Patient in PA
Yes, gay straight and bi men who have sex with men should observe the following health care screening:
HEALTH CARE SCREENING FOR MEN WHO HAVE SEX WITH MEN
- Physical exam: every 3 to 5 years
- Family history. This should be reviewed/updated at every physical exam.
- Lab screening: fasting glucose, cholesterol particularly
- Be honest about your sexual practices: are you top, bottom, versatile? Are you monogamous in your relationship? In what sexual practices do you engage? If your physician is uncomfortable with these issues, find another physician.
- HIV test every 3 to 6 months depending on your sexual practices. Do you practice safe sex? If not, get screened more often.
- Syphilis test every 3 to 6 months. Syphilis is rampant in this community, and condoms may not protect you. This goes for herpes and venereal warts.
- Venereal wart immunization. Unfortunately, this immunization is approved only for men up to the age of 26, and it is very expensive: $200 a shot for 3 shots. 60 to 75 % of men who have sex with men have venereal warts, and they can be anal, so you don’t necessarily know that you have them.
- Anal pap smear if you have ever bottomed, no matter how remotely. Anal cancer is more common in men who have sex with men than cervical cancer is in women.
- Venereal wart anal screening for exposure to the strains of the venereal wart virus that are known to cause cancer.
- Gonorrhea and Chlamydia screening: as needed based on symptoms and sexual practices
- Hepatitis A and B immunizations. Get screened first. Screening should also include hepatitis C. Many of my patients have had hepatitis A, B and/or C and never knew it. You don’t neeed the immunizations if you have already had the infection. If you are HIV positive, you should receive a double dose of hepatitis B vaccine. Ten percent of people infected with hepatitis B become chronic carriers, and can infect their partners; and a small percentage of the chronic carriers will develop liver cancer.
- Herpes 2 screening. Are you positive for exposure? A simple blood test will answer the question.
- Evaluation of nicotine use
- Evaluation of drug and/or alcohol use
- Screening for depression
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