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First, it was pursued by epidemiologists seeking behavioral categories that would offer better analytical concepts for the study of disease-risk than identity-based categories such as "gay", " bisexual ", or "straight" , because a man who self-identifies as gay or bisexual is not necessarily sexually active with men, and someone who identifies as straight might be sexually active with men. Second, its usage is tied to criticism of sexual identity terms prevalent in social construction literature which typically rejected the use of identity-based concepts across cultural and historical contexts. MSM and gay refer to different things: MSM refers to sexual activities between men, regardless of how they identify, whereas gay can include those activities but is more broadly seen as a cultural identity. Gay is a social identity and is generally the preferred social term, whereas homosexual is used in formal contexts, though the terms are not entirely interchangeable. Men who are non-heterosexual or questioning may identify with all, none, a combination of these, or one of the newer terms indicating a similar sexual, romantic, and cultural identity like bi-curious. In their assessment of the knowledge about the sexual networks and behaviors of MSM in Asia, Dowsett, Grierson and McNally concluded that the category of MSM does not correspond to a single social identity in any of the countries they studied. In some countries, homosexual relationships may be illegal or taboo, making MSM difficult to reach. Gay sexual practices Historically, anal sex has been popularly associated with male homosexuality and MSM. However, many MSM do not engage in anal sex, and may engage in oral sex , frotting or mutual masturbation instead. You may improve this article , discuss the issue on the talk page , or create a new article , as appropriate. January Learn how and when to remove this template message Since LGBT people began to organize for their social and legal rights[ examples needed ], access to equal health care[ clarification needed ] has remained an important but often not primary issue. LGBT-specific health organizations have been formed, including charities educating on specific issues, health clinics, and even professional organizations for LGBT people and their allies. The ACA also provided funding for community-based preventive health programs and measures to combat HIV-related health disparities. Much literature on mental health and homosexuals centered on examples of their depression, substance abuse , and suicide. Although these issues exist among non-heterosexuals, discussion about their causes shifted after homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders DSM in Instead, social ostracism, legal discrimination, internalization of negative stereotypes, and limited support structures were regarded as indications of the issues faced by homosexuals in Western societies in the late 20th century, which often adversely affected their mental health. Sexually transmitted disease A study reported that two large population surveys found "the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women. Also, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky. According to a federal study, one in five men who have sex with men are HIV positive and nearly half don't realize it. The increase may also be because of new treatments. The disease has caused epidemics in parts of Asia and Africa, and it is endemic in China. Possible forms of transmission include but are not limited to unprotected sexual contact, blood transfusions , re-use of contaminated needles and syringes, and vertical transmission from mother to child during childbirth. HBV can also be transmitted between family members within households, possibly by contact of non-intact skin or mucous membrane with secretions or saliva containing the virus. In some people, ASA may cause autoimmune infertility. Men who have sex with men blood donor controversy Many countries impose restricting on donating blood for men who have had sex with men, as well as their female sex partners—see the maps. Most national standards require direct questioning regarding a donor's sexual history, but the length of deferral varies. Blood donation policies for men who have sex with men Men who have sex with men may donate blood; No deferral Men who have sex with men may donate blood; No deferral, except for blood transfusions Men who have sex with men may donate blood; Temporary deferral Men who have sex with men may not donate blood; Permanent deferral No Data Female sex partners of men who have sex with men may donate blood; No deferral Female sex partners of men who have sex with men may donate blood; Temporary deferral Female sex partners of men who have sex with men may not donate blood; Permanent deferral No Data. Gayman sex

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