“Men’s” arose during the HIV pandemic to focus on behavior rather than identity — but not everyone thinks the term helps

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(The Conversation) Since the global outbreak of monkeypox began spreading last spring, more people are seeing the term “men who have sex with men,” or men who have sex with men, in news and public health messages. You may also have heard the term in places like HIV prevention campaigns or at the doctor’s office.

I am a behavioral scientist focused on reducing health disparities and improving health equity for sexual and gender minorities who are at the highest risk of poor outcomes. At the most basic level, MSM is a term that was originally intended to describe the risk of sexually related transmission of HIV between two men. But in reality, MSM describes a variety of behaviors and identities, bringing with them a complex web of social, political, and cultural considerations about how they are used.

Why do we use MSM?

HIV researchers have used the term “men who have sex with men” since at least 1988 as a way to describe a specific type of sexual behavior that may affect health.

However, the acronym MSM was introduced in 1994 as a new concept by some researchers and community advocates in response to public health research and prevention efforts early in the HIV/AIDS pandemic. These efforts almost exclusively targeted men on the basis of their homosexual gender identity. Community advocates have criticized this approach to excluding black and Latino men who have sex with men who have been affected by the pandemic but who are not identified as gay, lesbian, or bisexual. MSM was seen as a more comprehensive and less stigmatizing term that could be used to reach a wider range of people.

From a scientific perspective, the use of an identity-free term as MSM allows medical providers and public health practitioners to transcend the complexities of the social, cultural, and political context of sexual orientation. Instead, they can then focus on behavior that may put a person at risk for infection such as HIV or monkeypox. This approach aims to help increase the likelihood of screening, diagnosing and treating those most at risk.

Prevention strategies that target people based on “what you do” rather than “who you are” reach more people who may be affected by public health concerns, including heterosexual men who have sex with men, rather than limiting access to those who do. They identify as gay or bisexual. It provides more men with the opportunity to understand the risks they are exposed to and take steps for protection or treatment. It also helps reduce stigma for those who identify as gay or bisexual.

MSME limits

Despite its usefulness in some contexts, the term MSM has been hotly debated by scholars and community advocates since its coining. The controversy over its use usually rests on three arguments.

The first is that the term is ambiguous. Some researchers argue that distilling MSM to “sex between two men” is too simplistic. First, there are a number of nuances and factors that influence the amount of risk associated with sex between two men, such as how they have sex and who and how many partners in their sexual network. There is also confusion about how often or how often someone has sex to be considered MSM. There is no consensus on whether transgender men who have sex with men should be considered MSM.

A second criticism is that the term undermines the identities of sexual minority group members, especially people of color. Many public health researchers use MSM as a neutral term to respond to the idea that there is only one legitimate identity for gays. However, some have criticized the term for erasing other sexual identities such as queer, psychic, and same-sex loving by being the default term used in the research, although participants describe themselves otherwise.

Finally, the third argument is that the term hides the social, political, and cultural dimensions of health that are important to public health research and intervention. One of the greatest advantages of MSM is that it is grounded in concrete behaviors that researchers can target for health promotion and prevention efforts. But sexual health is affected by a host of factors, and focusing on behavior alone is often not enough to fully protect against disease.

Besides sexual behaviour, discrimination and social marginalization put sexual minorities at significant risk of poor health outcomes. These can take the form of structural factors, such as anti-gay legislation, and societal factors, such as discrimination and stigmatization. Personal factors such as relationship abuse and individual factors such as internal stigma also play a role. These factors increase the risk of mental illness, such as depression and suicidal thoughts, as well as health-risk behaviors, such as having sex without a condom or under the influence of drugs.

In the nearly 30 years since its introduction, the term MSM has become increasingly ubiquitous in both the medical and public health fields. But it has limitations. Looking at the social and political context of whether MSM should be used, rather than by default, can help support the self-determination of those from historically marginalized communities.

This article has been republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/men-who-have-sex-with-men-originated-during-the-hiv-pandemic-to-focus-on-behavior-rather-than-identity-but-not-everyone- Think-Term-Helps -189619.