By Matthew Hodson | @matthew_hodson


The latest STI figures from Public Health England make for some pretty grim reading. Once again gay and bisexual men are one of the groups most affected by sexually transmitted infections. 

Gay and bisexual men probably account for less than 3% of the population but we punch way above our weight as a proportion of all STIs. The latest figures show that 90% of new syphilis diagnoses were among gay and bisexual men.

At the lower end of the scale, we’re only 9% of diagnoses of genital warts and 12% of genital herpes. But we account for more than two out of every three cases of gonorrhoea. 

Why are we such over-achievers? Here are five reasons why gay and bisexual men are topping the STIs charts. 

First of all the good news: some of that rise is due to more tests being carried out. There’s still some way to go before we get handed gold stars but we gay men are generally better at getting ourselves checked out on a regular basis than our hetero brothers. And GUM clinic staff have got better about asking the right questions and checking in the right places – anal gonorrhoea can easily go undetected unless they know to check your bum. Whoop!

Less likely to get the Daily Mail running up to shake our hands and congratulate us though is reason number two. One of the main reasons for our domination in this field is that we’re more likely than our hetero brethren to have lots (and possibly LOTS) more sexual partners. 

Yes, I’m pretty certain right now some of you are shaking your fist at the screen or saying “Not me”. Well bully and congrats for you. Of course there’s considerable diversity in the number of sexual partners that gay men have but, even if it’s not your own behaviour that’s creating the challenge, the challenge remains. In recent years it has become much easier for us to meet other gay men and to have sex with lots of them. Dating apps and chem-fuelled sex parties mean that infections can be spread efficiently to large numbers of men in a very short time. Maybe the proportion of us who have lots of sexual partners hasn’t changed, but if sexual variety rather than sexual fidelity is your particular bag, it’s got that much easier. 

Thirdly, for a long time, we’ve been looking the other way. Since the mid 1980s, our sexual health has been popularly defined in terms of HIV. When there was no effective treatment and thousands of gay men were dying of AIDS it felt as though none of the other STIs was that important. What’s more, a perception that HIV was pretty much the worst thing that could happen to your sexual health, may have inadvertently led to men diagnosed with HIV feeling that there was no longer anything significant for them to protect themselves from. 

Over half of the syphilis diagnoses in the latest figures were among men living with HIV. A man living with HIV man who only has condomless sex with other HIV-positive men is risking transmission of a wide range of STIs, including syphilis and gonorrhoea.

Fourthly, gay men are disadvantaged when it comes to STIs because of other disadvantages that we may face. We’re fighting hard to get LGBT inclusive Sex and Relationships Education into every school but we’re not there yet. Young gay men still regularly encounter prejudice, bullying and homophobic violence, making it harder for us to ask the questions which are most pertinent to our own lives and our own risks. 

Finally, do we care enough? I’m not sure that we do. The battle to prevent HIV infections led to a lot of work being done within the community (including the founding of GMFA) but the broader battleground of gay men’s health inequality has not had the same resonance. 

These issues aren’t insignificant. Most other STIs are far easier to pick up than HIV. There are STIs which aren’t HIV that are also incurable (herpes). There are STIs which aren’t HIV that can be fatal if not treated (syphilis). There are STIs which are becoming resistant to the drugs that we use to treat them (gonorrhoea). 

The good news is that syphilis is very treatable. Unfortunately it’s easy not to notice the symptoms, which is why it’s vital that all sexually active gay men get tested at least once a year, or every couple of months, if you have sex without condoms with new partners.

It’s a major shift for us to be worrying about STIs which aren’t HIV. Unless we’re happy to continue to be the minority group with the majority of STI infections we need to look at what we do, why we do it and how we can make it better and safer for all of us. 


Matthew Hodson is the Executive Director of NAM


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