Men who have sex with men (MSM): how much to assume and what to ask?

In Australia, about 150 000 men aged 16–59 years identify as gay or bisexual, while a similar number identify as heterosexual but have some history of same-sex sexual contact. Pitts, Couch and Smith advise that the clinical implications for these men include more than sexual health concerns. They suggest several consultation skills that can help doctors to recognise these men and better meet their needs.

Human sexual practice is diverse. In response to the need to better understand that diversity in the face of the HIV epidemic, a fact became widely known that had previously been understood by few: a significant population of men who do not self-identify as “gay” or “bisexual” sometimes have sexual contact with other men. It was recognised that a descriptor for behaviour, rather than an assertion of social identity, was needed, and the term “men who have sex with men”, and its acronym MSM, came into being.