Men who have sex with men (MSM)


Text last Updated 22 January 2017

Links last updated 22 January 2017


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What this is about

If they aren’t gay, then who are men who have sex with men?

The term Men Who Have Sex with Men (MSM) has come into use as researchers have discovered that not all men who have sex with men are gay. Sometimes they are referred to as SMSM (straight men who have sex with men).

Men in this group are mainly attracted to women. They are heterosexual men who for a variety of reasons engage in sexual behaviour with other men. They are not gay or bisexual. They do not see themselves as gay or bisexual. They seem to have always been part of the spectrum of human sexuality, and are found in all continents – not just western society, which indicates that the labels of straight, bisexual and gay do not fully reflect the reality of human sexuality.

Why do some straight men might have sex with other men? There seem to be many reasons:

MSM behaviour is about physical release and sexual behaviours, not about attraction or desire for another man. They want a quick sexual release but do not want to engage emotionally or risk their heterosexual identity. Often they want to convince themselves that they are straight.

The attraction is toward the act or the body (or body parts) of the male, not the other man himself.


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MSMs often have high sex drives and are easily aroused sexually. Images of naked men do not attract them. They want to experiment or act out fantasies or fetishes.

They may be very interested in gay sexual experiences like anal intercourse or fellatio, and seek out gay men, whom they perceive as less judgmental than women and more open to sexual experimentation without commitment.

Some may be preoccupied with the possibility that they might be homosexual and engage in certain behaviours that make them think that they are gay when in truth they are straight.

Some do not enjoy the sexual contact with men, but are driven to participate in homosexual relations.

Some are trying to defuse and desensitize retained emotional pain. They may have been abused in the past. These heterosexual men are not homosexually oriented; their homosexual activity has nothing to do with their sexual and romantic identities.

Others are sexually addicted and are looking for new ways to add to their sexual shame, excitement, and thrills with other men. Some enjoy fantasing about, seeing or knowing their wives and girlfriends are having sex with other men. They may be sexually aroused by being humiliated like that.

Researchers on all continents are trying to find out more about MSMs who it is estimated comprise around 7% of the male population but form a significant percentage of all men living with HIV. The incidence of sexually transmitted infections among men who have sex with men can be more than 40 times higher than among other men or women.

The National Aids Trust reports similar findings for the UK, where men who have sex with men figure largely in the number of straight people who are living with HIV/Aids.

In New York in 2006 research found that nearly one in 10 men said they were straight and have sex only with other men. 70% of these straight-identified men having sex with men were married.

The World Health Organisation estimates that median HIV prevalence in men who have sex with men ranges from 4.3% in South East Asia to 14.9% in the African region (2015 data).

Men who have sex with men are treated the same as gay men by the Blood Transfusion Service for the purposes of donating blood – they were previously banned outright from donating blood but now are subject to a 12 month fixed period deferral from the latest relevant sexual contact.

WHO notes that in some countries, criminalisation of consensual, adult same-sex behaviour, stigma, discrimination and violence against men who have sex with men has created an environment which compromises people’s human rights and where they are less likely to access essential HIV and health services.

Men who have sex with men frequently approach gay organisations and services primarily focussed on the gay community. They are entitled to equality in treatment and to be served with as much dignity, confidentiality and respect as everyone else.

Home Pages

The DC Center Toolkit for men who have sex with men
Avert UK – Men who have sex with men
World Health Organisation: MSM


India, National Institute of Health, October 2012: Men who have sex with men in India: A diverse population in need of medical attention
National Aids Trust, 2012: Statistics – Men who have sex with men
National Institute for Health and Care Excellence, March 2011: Increasing the uptake of HIV testing among men who have sex with men
Terrence Higgins Trust, Undated: Men who have sex with men
Huffington Post, 30 July 2013: Why Some Straight Men Are Romantically or Sexually Attracted to Other Men
LGBTQ Nation, October 2011: Why do straight guys have sex with men
Undated: JoKort



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