User talk:Hfarmer/sandbox

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

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

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. With some sources considering tranwomen to be MSM,, Others considering transwomen "along side" MSM, while still others are internally inconsistent (Defining transgender women to be MSM in one place but referring to "MSM and transgender" in another.). ''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.

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

Sexually transmitted diseases
Men who have sex with men are more likely to get HIV in the modern West, in Japan, India, and Taiwan as well as other developed countries than among the general population. In the US, their HIV prevalence is 60 times higher than the general population, 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.

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. In 2006, 64% of the reported syphilis cases in the United States were among men who have sex with men. Men who have sex with men are 17 times more likely to develop anal cancer than heterosexual men, probably due to a higher risk of Human papillomavirus. Many people become infected with HPV soon after becoming sexually active.

Growth rate
HIV infection is increasing at a rate of 12 percent annually among 13 to 24 year old American men who have sex with men. During the last 10 years, syphilis outbreaks among men who have sex with men have been recorded in countries across Europe. This follows the general increase in STDs among men who have sex with men. 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. In developing countries, HIV infection rates are skyrocketing among men who have sex with men.

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

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. This can lead to the rapid transmission of HIV among small clusters of gay men.

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. 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."

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.

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

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