[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-405243-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-405243-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","primary-care-for-men-who-have-sex-with-men","Primary Care for Men Who Have Sex with Men","","Clinical Practice article focused on primary care for men who have sex with men, using a case vignette to frame a common clinical problem and to guide HIV prevention decisions. It reviews evidence and, when available, formal guideline recommendations, then closes with practical clinical counsel. 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Providers should ask directly and also document relevant data in electronic health records when possible.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which vaccinations and preventive measures are highlighted for men who have sex with men?",{"text":68,"@type":64},"Vaccinations should include hepatitis A, hepatitis B, human papillomavirus for men age 26 and under, and in certain regions Neisseria meningitidis. Men at increased HIV risk should be offered preexposure prophylaxis to reduce acquisition risk.",{"name":70,"@type":61,"acceptedAnswer":71},"How often should sexually transmitted infection testing be performed?",{"text":72,"@type":64},"Testing for sexually transmitted infections should occur once or twice a year, depending on the patient’s ongoing sexual activity.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},405243,1790642342,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":116,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","The new e ngla nd jou r na l of m e dicine  \nClinical Practice  \nCaren G. Solomon, M. D., M. P. H., Editor  \nPrimary Care for Men Who Have Sex with Men  \nTimothy Wilkin, M. D., M. P. H.  \nThis Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist.  \nThe article ends with the author’s clinical recommendations.  \nFrom Weill Medical College of Cornell University, New York, NY. Address reprint requests to Dr. Wilkin at the Division of Infectious Diseases, Weill Medical College of Cornell University, 53 W. 23rd St. , 6th Fl. , New York, NY 10010.  \nN EnglJ Med 2015;373:854-62 .  \nDOI: 10.1056/NEJMcp1401303  \nCopyright © 2015 Massachusetts Medical Society.  \nAn audio version of this article is available at  \n[NEJM.org](NEJM.org)  \n854  \nA 43-year-old gay man presents to a physician’s office for primary care. He has one long-term partner who is not infected with the human immunodeficiency virus (HIV) and with whom he has anal sex without condoms. He reports having had occasional anal sex with two other men during the past 6 months, with inconsistent use of condoms. He reports no tobacco or drug use and has one alcoholic drink daily. The patient has received vaccinations against infection with hepatitis A virus (HAV) and hepatitis B virus (HBV). A test for HIV infection is negative. What additional tests would be appropriate, and what would you advise the patient to help him reduce his risk of HIV infection?  \n\n| T he Cl inica l Probl em |\n| --- |\n| en who have sex with men, many of whom identify themselves\u003Cbr>Mas gaycondit,iaronesa1,2diSstoce,t pbopuut nattol, thatof thsatecinocreasnditios sr fodirreccerttlyarineleaedltt\u003Cbr>sexual behavior. HIV infection continues to be the major health problem affecting men who have sex with men. In this population, the HIV infection rate increased by 12% between 2009 and 2013, with nearly 31,000 new infections annually.3\u003Cbr>One goal of the Healthy People 2020 campaign, sponsored by the Department of Health and Human Services, is to “improve the health, safety, and well-being of lesbian, gay, bisexual, and transgender individuals.”4 As is the case for other populations, the population of men who have sex with men have health issues that are influenced by age, race and ethnic group, educational level and socioeconomic status, and geographic location. These factors can influence the experience of “coming out,” societal acceptance, and the likelihood of discrimination, all of which modulate a patient’s physical and mental health.5 Such psychosocial factors have been proposed as drivers of the overlapping health problems of HIV and other sexually transmitted infections and the mental health issues in men who have sex with men.6 This review discusses the unique set of health considerationsin the primary care setting for men who have sex with men. |\n| St rat egies a nd Ev idence |\n\nSexual History  \nIt is not possible to provide health care that is appropriate for men who have sex with men without eliciting a history of same-sex sexual activity or same-sex attraction. This discussion should include questions about a patient’s sexual identity  \nn eng l j med 373;9 [nejm.org](nejm.org) August 27, 2015  \nThe New England Journal of Medicine  \nDownloaded from nejm.org at Oregon Health & Science University Library on June 28, 2021. For personal use only. No other uses without permission.  \nCopyright © 2015 Massachusetts Medical Society. All rights reserved.  \nClinical Practice  \nKey Clinical Points  \nPrimary Care for Men Who Have Sex with Men  \n• Providers should identify men who have sex with men so that appropriate medical care can be administered.  \n• The vaccinations provided for men who have sex with men should include those against the hepatitis A virus, hepatitis B virus, human papillomavirus (in men ≤26 years of age), and in certain regions, Neisseria meningit","cbCaiv84ayfhtTrn","https://ap.wps.com/l/cbCaiv84ayfhtTrn","pdf",521895,"English","# Key Clinical Points\n## Sexual History\n## Strategies and Evidence","[{\"question\":\"Why is a sexual history essential in primary care for men who have sex with men?\",\"answer\":\"Because appropriate care requires understanding sexual identity and, especially, sexual behavior, including the sex of partners. Providers should ask directly and also document relevant data in electronic health records when possible.\"},{\"question\":\"Which vaccinations and preventive measures are highlighted for men who have sex with men?\",\"answer\":\"Vaccinations should include hepatitis A, hepatitis B, human papillomavirus for men age 26 and under, and in certain regions Neisseria meningitidis. Men at increased HIV risk should be offered preexposure prophylaxis to reduce acquisition risk.\"},{\"question\":\"How often should sexually transmitted infection testing be performed?\",\"answer\":\"Testing for sexually transmitted infections should occur once or twice a year, depending on the patient’s ongoing sexual activity.\"}]","Primary Care for Men Who Have Sex with Men | PDF",1790555637,23]