Common conditions and diseases in HIV-positive men who have sex with men

Key take-home messages

HIV-positive men who have sex with men who experience many physical health conditions at significantly higher rates than their peers who are HIV-negative and the general population, including:

• Human papillomavirus (HPV). Human papillomavirus is an independent risk factor for HIV infection. Oncogenic HPV types may cause anal, penile and oral tract cancers.
• Hepatitis C (HCV). The incidence of HCV in populations of HIV-positive men who have sex with men is increasing.
• Lymphogranuloma venereum. Almost all cases of lymphogranuloma venereum occur in HIV-positive men who have sex with men. HIV infection is the strongest risk factor for anorectal lymphogranuloma venereum.
• Syphilis, gonorrhea and chlamydia.
• Recurrences of herpes. While there is no significant difference in the rates of infection with herpes simplex virus in HIV-positive men who have sex with men, HIV-negative men who have sex with men or the general population, HIV-positive men who have sex with men are more likely to experience recurrences.
• Drug and alcohol use. Drug and alcohol use may be a barrier to antiretroviral adherence. Serious drug interactions can also result from concurrent use of drugs and antiretroviral medications.

Differences in prevalence also exist in the area of mental health:

• Mental health issues experienced by HIV-positive men who have sex with men are similar to the types of issues reported in the general population. Common mental health disorders associated with HIV include: adjustment disorders, mood disorders, anxiety disorders, substance-related disorders, and HIV-associated dementia or AIDS dementia complex.
• Body image is a concern for many men who have sex with men. Studies are needed to determine whether HIV-positive men who have sex with men experience issues with body image at a higher rate than their HIV-negative counterparts.

Given the high rates of sexually transmitted infections (STIs), substance use and mental health iissues experienced by people living with HIV, care providers should be aware of these risks and offer immunization, screening, treatment, counseling and other services to protect and improve the health of HIV-positive men who have sex with men.

• Population(s)
  • Men who have sex with men
  • General HIV+ population
• Substance Use
  • Alcohol
  • Nonmedicinal drugs
• Mental Health
  • Neurocognitive disorders
  • Psychiatric disorders
• Co-infections
  • Hepatitis B, C
  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Other