Men who have sex with men

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Men who have sex with men (MSM) generally refers to men who have same-sex sexual contact with other men. Similarly, there is the term women who have sex with women (FSF or WSW) . The formulations arose out of the need, regardless of sexual identity , to talk about a person's sexual contacts and to avoid terms that are often perceived as judgmental and ideologically charged.

Not all persons with same-sex sexual contacts have a homo- or bisexual identity and some also refuse to refer to their same-sex sexual contacts as "homosexual sexual contacts". In addition, it should be avoided that one has incorrect ideas about people designated as “homosexual or bisexual” or, depending on the definition, groups of relevant people are excluded. This is of particular importance in research on sexually transmitted diseases, for which the term was originally developed.

use

The terms are used irrespective of any possible self-definition of the test persons as homosexual , bisexual or heterosexual ; they serve to avoid stereotypical ways of thinking about the people described. Similar to “ same-sex ”, they describe behaviors in different cultures and historical contexts. They are mainly used in the field of epidemiology , but also in sociology , anthropology and interdisciplinary sexology .

The most difficult to reach for AIDS prevention work are MSM people who define themselves as heterosexual. Often they want nothing to do with the “ scene ”. Anonymous meeting places such as cruising areas (parks, lakes), flaps , sex cinemas and motorway parking lots are promising , where some projects try to cautiously carry out prevention work on site.

The following exemplary studies do not claim to be representative and are only intended to give an approximate indication of the order of magnitude. In a study from New York City , carried out in 2003 and published in 2006, approximately one in ten men said they were straight and had sex with men in the past year. 70% of these men were married to the opposite sex. About 10% of men married to a woman had confirmed that they had sex with a man within the past year. The telephone interviews were conducted in nine different languages ​​and straight men who have sex with men are more often of foreign origin than gay men. Men who described themselves as heterosexual also use a condom less often than men who defined themselves as homosexual. In a 1992 Australian study of older men over 50 who had sex with men for the past 5 years, 28.5% identified themselves as bisexual and 3.9% as heterosexual. Even Alfred Kinsey took account of both mental and physical experiences, recognized before 1948, how difficult it is to categorize the sexual behavior of men. As an aid, he developed the Kinsey scale , which represents a continuum between the two extremes, heterosexual and homosexual , and defined all levels in between as bisexual. He also saw no reason to speak of "the homosexual". Other researchers set the limits at other points. This does not cause much problem as long as one is aware that any demarcation is artificial and arbitrary and must be understood that way (see Sexual Orientation ). After Stonewall , more and more men were calling themselves homosexual, gay or bisexual. This was also initiated by the socio-political pressures in order to act as a group against the oppression.

History and background

After AIDS was discovered , questionnaires were designed in various countries to record the possible risk of infection for the people to be tested. In the beginning, people were often simply asked whether they were gay, and the questioned person was divided into the infection risk categories “homosexuality” or “heterosexuality”, depending on the situation. Only over time did the scientists realize that not everyone has to have self-defined gay contacts and that many men with same-sex sexual contacts do not define themselves as gay. Thereupon the question was changed whether one had had "homosexual contacts". Yet even then, many felt that it did not include their same-sex activities, especially if they were also having opposite-sex relationships. The question was changed again, asked about “homosexual or bisexual contacts” and three categories were provided on the questionnaire. And there were still many men who did not refer to “homosexual” as referring to their own sexual contacts with men, and others who rejected the label “bisexual” - despite documented or admitted sexual contacts with women and men. So the question was formulated more simply and asked separately about sexual contact with women and men. In the questionnaire, however, the three categories "heterosexual", "bisexual" and "homosexual" were still available. In addition, two categories were automatically added to “homosexual or bisexual men” and never “heterosexual or bisexual men”. Under the influence of the US Center for Disease Control and Prevention (CDC), the combined category "homo / bi" was introduced worldwide.

Over time it became clear to some researchers that they lumped together very different behaviors that were epidemiologically differently relevant and also important in prevention work. For example, "bisexual" could mean:

  1. An otherwise “loyal” husband uses the services of a prostitute .
  2. A prostitute who has several customers and friends at the same time every day.
  3. A staunch gay man who has long been known in sexology and who occasionally has sexual relations with women, including lesbians.
  4. A “heterosexual swinger” who “accepts” same-sex contacts when swapping partners.
  5. A sexually adventurous youth.
  6. A long-time (heterosexual) prisoner.

The CDC definition was even more serious in the case of same-sex women. A woman was considered a lesbian “if she has sexual contact with women and has not had sexual contact with a man since 1977.” This excluded both the majority of those who define themselves as lesbian and the large number of those who consider themselves to be the same Define behavior as non-lesbian. From 1990 at the latest, possibly a little earlier, the terms “MSM” and “WSW” were first used in the health discourse. Even the otherwise experienced health department in San Francisco recognized - in contrast to the local sexologists who nobody asked - only in 1993, more than ten years after the discovery of AIDS, that the "homosexual" and "bisexual" thought patterns lead to wrong conclusions about the risk of infection led by women, and proclaimed the insight that had hitherto been suppressed:

“Women who have sexual contact with women display a variety of sexual identities, personal traits and behaviors that put them at risk for HIV infection. The terms 'lesbian' or 'bisexual' are usually used to describe these women, but their choice of partner and their sexual behavior by no means always match such descriptions of identity. There are self-defined lesbians who have sexual contact with men, even for money, and there are women who define themselves as heterosexual and still have female sexual partners. Women who have sexual contact with women can have few or many partners, they can be mothers, drug addicts, academics, street prostitutes, homeless people or prisoners. Despite these differences, the current HIV statistics can lead you to believe that there is little or no risk of infection. "

- Department of Public Health : HIV Risk Among Women Who Have Sex with Women, 1993

And one came to the conclusion:

“The facts outlined here show that it is problematic to use broad categories of identification instead of focusing on specific behaviors that pose a risk of HIV infection. Our public health efforts to reduce infection with HIV and other sexually transmitted diseases will be inadequate as long as we remain unable to speak clearly to all segments of the population about specific behaviors ”

- Department of Public Health : HIV Risk Among Women Who Have Sex with Women, 1993

The traditional questionnaires turned out to be too simple and in some countries new questionnaires were developed which had a greater differentiation and completely dispensed with culturally or ideologically “biased” terms. These basics are also sometimes important in order to get a realistic picture of the sexual behavior of the client or the client couple in the case of a sexual history before medical treatment or non-medical therapy or sexual and marriage counseling. The coining of the abbreviations by Glick et al. in 1994 signaled the establishment of the new concept.

Web links

Individual evidence

  1. UNAIDS: Men who have sex with men . UNAIDS . Archived from the original on June 21, 2013. Retrieved October 10, 2014.
  2. Daniel J. DeNoon: Many Straight Men Have Gay Sex WebMD Medical News, September 18, 2006
  3. Paul Van de Ven, Pamela Rodden, June Crawford, Susan Kippax: A comparative demographic and sexual profile of older homosexually active men ( Memento from July 9, 2012 in the web archive archive.today ), Journal of Sex Research , Fall 1997, at Findarticles .com
  4. a b c d Erwin J. Haeberle: Bisexualities - History and Dimensions of a Modern Scientific Problem , published in:
    EJ Haeberle and R. Gindorf: Bisexualities - Ideology and Practice of Sexual Contact with Both Sexes , Gustav Fischer Verlag, Stuttgart 1994, p. 1-39
  5. ^ SY Chu, JW Buehler, PL Fleming, RL Berkelman: Epidemiology of Reported Cases of AIDS in Lesbians, United States 1980-1989 , in: American Journal of Public Health , 1990; Vol. 80, pp. 1380-1381
  6. RM Young, IH Meyer: The Trouble with "MSM" and "WSW": Erasure of the Sexual-Minority Person in Public Health Discourse , American Journal of Public Health , July 2005, Vol. 95, no. 7th
  7. ^ A b Department of Public Health: HIV Risk Among Women Who Have Sex with Women , in: San Francisco Epidemiologic Bulletin, Vol. 9, No. 4, April 1993, p. 25 and 27
  8. Glick M., Muzyka BC, Salkin LM, Lurie D., Necrotizing ulcerative periodonitis: a marker for immune deterioration and a predictor for the diagnosis of AIDS , Journal of Periodontology , 1994, pp. 393-397