Safer Sex Considerations for Young Men in Same-Sex Relationships

There is a lot of information out there about safer sex – but not all the information is necessarily tailored for people in same-sex relationships. TeenHealthFX has already given information on Safer Sex Considerations for Young Women in Same-Sex Relationships – so now we will address safety concerns for gay men.

FX wants to first dispel the myth that there are diseases that result from being gay – that is absolutely not true. However, there are some health risks that tend to be more prevalent for men who are having sexual relationships with other men (MSM), so it is important to educate yourself about the risks and what you can do to prevent them.

Risks and special considerations for MSM:

  • MSM have higher rates of STDs
  • MSM have higher rates of Hepatitis.
  • MSM have higher rates of HIV/AIDS. In fact, the rate of HIV diagnosis for MSM is 44 times the rate of HIV diagnoses of other men.

Some general facts about STDs

  • The more partners you have, the higher your chance of being exposed to HIV and other STDs.
  • The only way to protect yourself 100% from the transmission of STDs is abstinence.
  • Sometimes early in a sexually transmitted infection there may be no signs or symptoms, or symptoms could be confused for another illness. This means you or a partner (or potential partner) might not even know you have an STD.
  • You cannot tell by looking at someone whether that person is infected with HIV or any other STD.
  • Using drugs and alcohol increases your chances of getting STDs because it could affect your judgment in terms of using condoms as well as your ability to use them correctly.
  • If you or your partner has had unprotected sex, it is possible to have an STD and not even know it.
  • If left untreated, STDs can have long-term consequences such as infertility, long-term pain and even cancer.

Getting Tested:

Testing can feel scary, but it is one of the most important things you can do to help prevent the spread of STDs. Since many STDs are asymptomatic (there are no symptoms), and you can’t tell if someone has an STD just by looking at them, you can’t just assume that you and your partner (or a potential partner) are in the clear. Plus it’s easier to enjoy your sexual experience if you are not feeling plagued with anxiety that you will catch something or pass something on. So there are several benefits to testing.

When should you get tested?

  • Talk to your doctor about you and a potential partner each getting tested prior to any sexual activity.
  • Talk to your doctor about testing if you had unprotected sex.
  • Talk to your doctor about STD testing if you and your partner are in a long-term, monogamous relationship and are thinking about not using condoms any longer (although FX does not recommend this for teens).
  • Talk to your doctor about testing if you are sexually active and have any of the following symptoms:
  • Discharge from the penis or rectum
  • Pain during sex or while urinating
  • Pain in the testicles or in the buttocks and legs.
  • Blisters, open sores, warts, rash, or swelling in the genital area, anal area, or in or around the mouth.
  • Persistent flu-like symptoms including fever, headache, aching muscles, or swollen glands as these symptoms sometimes come before STD symptoms.

Getting vaccinated

Some facts:

  • Anal cancer is on the rise and is often linked to HPV, the most commonly diagnosed STD.
  • Twenty million Americans have HPV and 6 million new cases are diagnosed every year.
  • Every year in the U.S. 1,500 men will be diagnosed with HPV-associated anal cancer and 400 will be diagnosed with HPV-associated penile cancer.

A recent study conducted at the National Institute of Health found that not only could vaccines protect against cervical cancer, but anal cancer as well. Cervarix (a new vaccine created by the same company that makes Gardasil), was found to prevent 77% of HPV-related cervical cancer and 62% of HPV-related anal cancers.

You can talk to your doctor about whether vaccination might be right for you. 

Safer sex – What to use:

Two important things MSM should be using when sexually active in same sex relationships are lubricants and condoms.


  • Be sure to use silicone or water-based lubricants with condoms as oil based lubricants can break down the latex material in condoms.
  • If you are using lubricants with sex toys, be sure not to use silicone toys with silicone-based lubricants as this will negatively affect the toy. Use a water-based lubricant instead.


  • Condoms are second best to abstinence when it comes to preventing the spread of STDs, so definitely use condoms for oral and anal sex.
  • Keep in mind that certain STDs, such as HPV, can still be spread even if you use condoms regularly.
  • Keep in mind that more strain is placed on the condom during anal intercourse. You can use stronger condoms which are thicker, but standard condoms can be just as effective if they are used properly and with plenty of lubricant.
  • Condoms with a lubricant containing nonoxynol-9 should not be used for anal sex as this chemical damages the lining of the rectum, which increases the risk for HIV and STD transmission.

For more general information on lubricants and condoms, read Using Condoms Correctly, as well as Using Condoms, Condom Types and Sizes.

A note about sex toys: Never share your sex toys. If you do, clean the toy with warm water and mild soap. Even if you don’t share your toy, wash it on a regular basis to prevent the build-up of bacteria.

Ranking sexual activities:

Unsafe sexual activities include:

  • Unprotected anal sex
  • Using pre-ejaculate fluid as a lubricant prior to anal intercourse
  • Sucking ejaculate from the anus
  • Any activities involving shaving or razors as this could cause bleeding, and blood is one of several bodily fluids that can spread various infections (including HIV).

Safe sexual activities:

  • Kissing
  • Cuddling
  • Stroking and massage
  • Mutual masturbation

Safer sex suggestions:

  • Oral sex, with a condom and no semen or pre-ejaculatory fluids in the mouth
  • Protected anal intercourse with a condom and water-based lubricant
  • Penetration of the anus with the fingers or fist with the use of a latex glove and when there are no cuts or abrasions on the fingers, hand or arm.
  • Use of dental dam for anal-oral contact (also known as “rimming”)
  • Use of condoms on anal sex toys. Follow the appropriate care of sex toys as outlined above.


Your relationships status:

Researchers through the Northwestern University Feinberg School of Medicine say that gay men are more likely to practice safer sex with causal partners than they are with partners in a serious relationship. They found that there is a misconception that men who are in a serious relationship don’t need to protect themselves from STDs. They also found that 80% of gay young men who are HIV positive don’t know it because they aren’t being tested frequently enough.

So what does this mean? It means don’t assume you or your partner are in the clear whether it’s a new partner or someone you’ve been with for a long time. Talk to your doctor about getting tested before having sex with a new partner, continue to use protection even when in a long-term relationship, and if you are thinking about discontinuing the use of condoms because you are in a long-term, monogamous relationship (although this is generally not recommended by TeenHealthFX) speak to your doctor about how safe of an idea this is for you, and get tested for HIV and other STDs at least two times before stopping the use of condoms.


Finding a doctor and talking to your healthcare provider about your sexual orientation:

TeenhealthFX thinks that it is important for you to feel safe and comfortable enough with your doctor to be open and honest about your sexual orientation and sexual history. That way your doctor can have a better understanding of your health needs and you can feel more comfortable to ask any questions that you might have.

To find a healthcare provider who will be sensitive to your needs, consider the following:

  • Ask trusted family member or friends for referrals to reputable healthcare providers.
  • Meet with a couple of different healthcare providers to determine which one is right for you.
  • Look at online databases, such as the GLMA Physician Reference Program to find a healthcare provider in your area that is particularly sensitive to the needs of gay teens.
  • If you don't have a doctor and live in northern New Jersey, you can call the Adolescent/Young Adult Center for Health at 973-971-5199 for an appointment with an adolescent medicine specialist or contact your local teen health center or Planned Parenthood. You can also contact your insurance company for a list of in-network providers.