People who are lesbian, gay, bisexual, or transgender (LGBT) are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the country. The perspectives and needs of LGBT people should be routinely considered in public health efforts to improve overall health of every person and eliminate health disparities. In addition to considering the needs of LGBT people in programs designed to improve the health of entire communities, there is also a need for culturally competent medical care and prevention services that are specific to this population. Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats. Members of the LGBT community are at increased risk for a number of health threats when compared to their heterosexual peers. Differences in sexual behavior account for some of these disparities, but others are associated with social and structural inequities, such as the stigma and discrimination that LGBT populations experience. Gay and Bisexual Men Gay and bisexual men and other men who have sex with men (MSM) represent an incredibly diverse community. Gay and bisexual men have both shared and unique experiences and circumstances that affect their physical health and mental health needs as well as their ability to receive high-quality health services. Gay and bisexual men, like all men, need to be aware of the ways they can protect their health through all stages of life. For all men, the leading causes of death are heart disease and cancer. However, among men who have sex with men (MSM), there are higher rates of HIV and other sexually transmitted diseases (STDs), tobacco and drug use, and depression compared to other men. Sexual health—the state of physical, emotional, mental, and social well being in relation to sexuality—is an important part of your overall health. The idea of sexual health emphasizes health and wellness as well as the avoidance of negative health outcomes that result from unhealthy sexual behaviors and attitudes. For gay and bisexual men, HIV, hepatitis, and other STDs are of particular concern. For example, the rate of new HIV diagnoses among MSM is more than 44 times that of other men, while the rate of primary and secondary syphilis among MSM is more than 46 times that of other men.   Buy Zithromax for treating bacterial infections, skin infections, sexually transmitted infectious diseases, urethritis. medicstar.com Buy Propecia Propecia is used to treat hair loss. Propecia is not addictive. www-medic.com Buy Brand Viagra Viagra is applied for the treatment of erectile dysfunction in men. Buy Viagra Super Force Buy Amoxicillin one of the best antibiotic. Amoxicillin used to treat infections caused by certain bacteria. medicstar.com Many factors contribute to the higher rates of HIV and STDs among gay and bisexual men compared to the general population of men. These factors include high prevalence of HIV and other STDs among MSM, which increases the risk of disease exposure, and limits access to prevention services. Other factors are complacency about HIV risk, particularly among young gay and bisexual men; difficulty of consistently maintaining safe behaviors with every sexual encounter over the course of a lifetime; and lack of awareness of syphilis symptoms and how it can be transmitted (e.g., oral sex). Additionally, homophobia and stigma can prevent MSM from seeking and getting appropriate health services. Getting tested for HIV and STDs is a first step in protecting your health. Knowing you are infected allows you to get the care that you need to stay healthy and take steps to protect your partners. What tests are recommended to help ensure the sexual health of gay and bisexual men? As an individual, you can do a lot to protect your health. CDC recommends the following laboratory testing for gay and bisexual and other MSM: HIV (at least annually) Syphilis Chronic Hepatitis B infection Hepatitis C for men who engage in risky behaviors, such as rough sex or sex with multiple partners. Genital Herpes if directed by your health care provider. Chlamydia and Gonorrhea testing of the throat is needed if you have had receptive oral sex in the past year. Chlamydia and Gonorrhea testing of the penis (urethra) is needed if you have had insertive anal or oral sex in the past year. Chlamydia and Gonorrhea testing of the rectum is needed if you have had receptive anal sex in the past year. Visit hivtest.org or findstdtest.org to finding testing locations. You may want to get tested more often—every three to six months—if you have multiple or anonymous partners, have sex in conjunction with drug use, use methamphetamine, or have sex partners that participate in these activities. What vaccinations does CDC recommend for gay and bisexual men? Hepatitis A and Hepatitis B vaccinations are recommended by CDC and the Advisory Committee on Immunization Practices (ACIP) because of higher rates of infection among gay and bisexual men. Two doses of the Hepatitis A vaccine are needed for lasting protection and the doses should be given at least six months apart. A series of three or four doses of the Hepatitis B vaccine are usually given providing long-lasting protection. Seasonal flu and the H1N1 flu vaccinations are also recommended. Each vaccine is a single dose shot given before the start of the flu season in the fall. HPV vaccine is also available for gay and bisexual men up to 26 years of age to prevent genital warts and other HPV-associated diseases and conditions. The HPV vaccine is given as a three-dose series over a six month time period. It is best to be vaccinated before the first sexual contact, but later vaccination will protect those who have not been exposed to HPV. How do I lower my risk for STDs? There are three critical ways to protect yourself from STDs and HIV: Don't have sex (i.e. anal, vaginal, or oral) Be in a long-term, mutually monogamous sexual relationship with a partner you know has the same HIV status as you. Use a condom every time you have anal, vaginal, or oral sex. Consistent and correct use of the male latex condom reduces the risk of STD and HIV transmission. It is especially important to always use a condom during anal sex, since anal sex carries a much higher risk of HIV transmission. It is also important to be honest and open with your doctor about your sexual behaviors so that he or she can give you the best and most appropriate care. What other steps can I take to protect my health? Eat a healthy diet. Choosing healthful meal and snack options can help you avoid heart disease and its complications. Be sure to eat plenty of fresh fruits and vegetables. Maintain a healthy weight. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). If you know your weight and height, you can calculate your BMI. Exercise regularly. Physical activity can help you maintain a healthy weight and lower cholesterol and blood pressure. Don't smoke. Cigarette smoking greatly increases your risk for heart disease, cancer, and stroke. So, if you don't smoke, don't start. If you do smoke, quitting will lower your risk for heart disease. Limit alcohol use. Avoid drinking too much alcohol, which can cause a variety of health problems (high blood pressure, cancer) and increase your risk of injury. Cholesterol screenings. The National Cholesterol Education Program recommends that adults aged 20 years or older have their cholesterol checked every five years. Cancer screenings. Ask your health care provider for guidance on screening for prostate, testicular, colon, and anal cancers. Check your blood pressure. Getting your blood pressure checked is important because high blood pressure often has no symptoms. Get checkups. Ask your doctor or nurse how you can lower your chances for health problems. Stigma and Discrimination Homophobia, stigma, and discrimination persist in the United States and negatively affect the health and well-being of gay, bisexual, other men who have sex with men (MSM), and other members of the LGBT community. Homophobia, stigma, and discrimination are social determinants of health that can affect physical and mental health, whether MSM seek and are able to obtain health services, and the quality of the services they receive. Such barriers to health need to be addressed at different levels of society, such as health care settings, work places, and schools in order to increase opportunities for improving the health of MSM. Homophobia and stigma persist in the United States even though acceptance of same-sex relationships has been steadily increasing. For example, a Gallup poll conducted in May 2010 found that more than half (52%) of Americans believed that gay and lesbian relationships were acceptable. Forty-three percent of Americans believed that gay and lesbian relationships are not morally acceptable. Free Your Mind: The Book for Gay, Lesbian, and Bisexual Youth and Their Allies Always My Child: A Parent's Guide to Understanding Your Gay, Lesbian, Bisexual, Transgendered or Questioning Son or Daughter Queers in History: The Comprehensive Encyclopedia of Historical Gays, Lesbians and Bisexuals GLBTQ: The Survival Guide for Queer and Questioning Teens The Effects of Negative Attitudes About Homosexuality Negative attitudes about homosexuality can lead to rejection by friends and family, discriminatory acts and violence that harm specific individuals, and laws and policies that adversely affect the lives of many people; this can have damaging effects on the health of MSM and other sexual minorities. Homophobia, stigma and discrimination can: Limit MSM's ability to access high quality health care that is responsive to health issues of MSM Affect income, employment status, and the ability to get and keep health insurance Contribute to poor mental health and unhealthy behaviors, such as substance abuse, risky sexual behaviors, and suicide attempts Affect MSM's ability to establish and maintain long-term same-sex relationships that reduce HIV & STD risk Make it difficult for some MSM to be open about same-sex behaviors with others, which can increase stress, limit social support, and negatively affect health The effects of homophobia, stigma and discrimination can be especially hard on adolescents and young adults. Young MSM and other sexual minorities are at increased risk of being bullied in school. They are also at risk of being rejected by their families and, as a result, are at increased risk of homelessness. A study published in 2009 compared gay, lesbian, and bisexual young adults who experienced strong rejection from their families with their peers who had more supportive families. The researchers found that those who experienced stronger rejection were: 8.4 times more likely to have tried to commit suicide 5.9 times more likely to report high levels of depression 3.4 times more likely to use illegal drugs 3.4 times more likely to have risky sex Reducing the Effects of Stigma and Discrimination MSM and their family and friends can take steps to reduce the effects of homophobia, stigma and discrimination and protect their physical and mental health. One way to cope with the stress from stigma and discrimination is social support. Some studies show that gay men who have good social support—from family, friends, and the wider gay community—have: higher self-esteem, a more positive group identity, and more positive mental health. Whether you are gay or straight, you can help reduce homophobia, stigma and discrimination in your community and decrease the negative health effects. Even small things can make a difference, such as supporting a family member, friend, co-worker. HIV/AIDS Consistent and Correct Use of Condoms To achieve maximum protection by using condoms, they must be used consistently and correctly. The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use, rather than product failure. Gay and bisexual men of all races continue to be most severely affected by HIV in the United States. They are the only risk group in the U.S. in which the annual number of new HIV infections is increasing, accounting for more than half of all new HIV infections in the U.S. annually. The rate of new HIV diagnoses among gay and bisexual men is more than 44 times that of other men (range: 522–989 per 100,000 MSM vs. 12 per 100,000 other men). See Estimates of New HIV Infections, 2006, by Race/Ethnicity, Risk Group, and Gender. How is HIV spread? HIV is spread primarily by: Having unprotected sex with someone who has HIV Sharing needles, syringes, or other equipment used to prepare illicit drugs for injection Being born to an infected mother What are the signs and symptoms of HIV? Within a few weeks of being infected with HIV, some people develop flu-like symptoms that last for a week or two, but others have no symptoms at all. After initial infection, people may have no symptoms for years. How can I prevent HIV? Be smart about HIV. Here's what you can do: Get the facts—Arm yourself with basic information: How is HIV spread? How can you protect yourself? How can you protect your partners? Take control—You have the facts; now protect yourself and your loved ones. There are three essential ways to reduce your risk: 1. Don't have sex (i.e., anal, vaginal, or oral). 2. Only have sex (i.e., anal, vaginal, or oral) if you're in a mutually monogamous relationship with a partner you know has the same HIV status as you. 3. Use a condom every time you have anal, vaginal, or oral sex. Correct and consistent use of the male latex condom is highly effective in reducing HIV transmission. If you are HIV-positive, let potential sex partners know your status before you have sex. Put yourself to the test—CDC recommends that gay and bisexual men be tested for HIV at least annually. Men with multiple partners or anonymous partners, and men who have sex while using drugs (including meth) or whose partner engages in these activities, should be tested more frequently (every 3-6 months). Knowing and rechecking your HIV status is a critical step toward stopping HIV transmission, because if you know you are infected, you can take steps to protect your HIV-negative partners or only select partners who have the same status as you. Also, if you are infected, the sooner you find out, the sooner you can receive life-extending treatment. Call 1-800-CDC-INFO to find HIV testing locations near you. Start talking—Talk to everyone you know about HIV—friends and family, coworkers and neighbors. Have ongoing and open discussions with your partners about HIV testing and risk behaviors. Talking openly about HIV can reduce the stigma that keeps too many from seeking the testing, prevention and treatment services, and support they need. Suicide and Violence Prevention Violence is a serious public health problem in the United States. It affects all types of people in all stages of life. Those who survive violence are often left with permanent physical and emotional scars. Gay, bisexual, and other MSM are at increased risk of violence that is the result of homophobia, harassment, and violent acts directed towards gay persons. Males in the United States are more likely to take their own life at nearly four times the rate of females and represent 79% of all U.S. suicides. Suicide is the seventh leading cause of death for males in the United States. Men who have sex with men are at even greater risk for suicide attempts, especially before the age of 25. Some risk factors are linked to being gay or bisexual in a hostile environment and the effects that this has on mental health. Intimate partner violence (IPV) occurs between two people in a close relationship, including current and former partners. IPV can range from a single episode of violence to ongoing battering. IPV includes four types of behavior: Physical violence, sexual violence, threats of physical or sexual violence, and emotional abuse. Studies have estimated that 11% to 44% of men who have sex with men surveyed experienced IPV in same-sex relationships. Sexual violence refers to sexual activity where consent is not obtained or freely given. The person responsible for the violence is usually someone known to the victim. Sexual violence does not only include physical contact between the victim and the perpetrator (person who harms someone else), it also includes sexual harassment, threats, peeping, and taking nude photos. Other sexual violence, including unwanted touching and rape, does include physical contact. go to Part II - Lesbian Health go to Part III Transgender Health