What regular tests should men who have sex with men (MSM) undergo?

From the Guidelines

Men who have sex with men (MSM) should undergo regular STI testing every 3-6 months, including HIV, syphilis, gonorrhea, and chlamydia, as recommended by the most recent guidelines 1. Testing should include throat, rectal, and urethral samples for comprehensive screening. Specifically, recommended tests include:

• HIV antibody/antigen testing
• Syphilis screening (RPR or VDRL)
• Nucleic acid amplification tests (NAATs) for gonorrhea and chlamydia
• Hepatitis B and C screening For sexually active MSM, more frequent testing (every 3 months) is advised, especially for those with multiple partners. Additionally, vaccination against HPV, hepatitis A, and hepatitis B is recommended if not already immune. Regular testing is crucial because many STIs can be asymptomatic while still being transmissible and potentially causing long-term health complications if left untreated. Early detection allows for prompt treatment, preventing both complications and further transmission. Pre-exposure prophylaxis (PrEP) should also be discussed for HIV prevention in high-risk individuals, with appropriate monitoring every 3 months while on this medication, as supported by other studies 1.

Some key points to consider:

• The CDC recommends that MSM and transgender women who have had a bacterial STI diagnosed in the past 12 months should receive counseling on the use of doxycycline postexposure prophylaxis (doxy PEP) to prevent these infections 1.
• Persons who are prescribed doxy PEP should undergo bacterial STI testing at anatomic sites of exposure at baseline and every 3–6 months thereafter 1.
• HIV screening should be performed for HIV-negative MSM and transgender women according to current recommendations 1.
• The importance of regular testing and screening for STIs in the HIV care setting is highlighted by recent trends indicating a rise in syphilis and gonorrhea among some HIV-infected persons, particularly MSM 1.

Overall, regular STI testing and screening are essential for the health and well-being of MSM, and healthcare providers should prioritize these services in their clinical practice.

From the Research

Regular Tests for Men Having Sex with Men

Regular testing is crucial for men who have sex with men (MSM) to prevent and detect sexually transmitted infections (STIs) and HIV. The following tests are recommended:

• HIV testing: annual testing for sexually active MSM, with more frequent testing for those who engage in high-risk behaviors 2
• STI testing: regular screening for gonorrhea, chlamydia, and syphilis 3, 4
• Hepatitis B and C testing: regular screening for MSM 4
• Human papillomavirus (HPV) vaccination: offered to MSM to prevent anal cancer 4
• Anal cancer screening: digital anal rectal examination, although the optimal screening strategy has yet to be determined 4

Testing Frequency

The frequency of testing depends on the individual's risk factors, such as:

• Number of sexual partners: MSM with multiple partners should be tested more frequently 2
• High-risk behaviors: MSM who engage in high-risk behaviors, such as unprotected sex or sex with multiple partners, should be tested more frequently 2
• Previous STI or HIV diagnosis: MSM who have previously been diagnosed with an STI or HIV should be tested more frequently 3

Importance of Regular Testing

Regular testing is essential to:

• Prevent the transmission of STIs and HIV 3, 5
• Detect STIs and HIV early, when they are more treatable 3, 4
• Reduce the risk of complications and long-term health problems 4
• Monitor the effectiveness of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) 5