We all want the best possible health we can have, for as long as we can have it. For some, this seems like a large obstacle but we have broken it down into three (3) simple steps to get you on track and keep you there.

Gay Male Health

As gay males, we have higher risk factors for certain illnesses and diseases than the general population. Here are the top ten that you should look out for.

  1. HIV/AIDS
  2. Anal Papilloma(HPV)
  3.  Hepatitis Immunization
  4.  Substance Use
  5. Depression and Anxiety
  6. Sexually Transmitted Diseases (STDs)
  7. Prostate, Testicular, and Colon Cancer
  8. Alcohol
  9. Tobacco
  10. Body image problems and obesity

Black/Latino Gay Male Health

Sorry guys, besides the added risks associated with being gay, you still need to look out for medical issues that are more race specific:

Black Latino

  • Heart disease
  •  respiratory diseases
  • Unintentional injuries and accidents
  • Liver disease
  • Diabetes
  • Influenza and pneumonia
  • Skin cancer

Once a year, we all should get a thorough physical examination from a licensed medical professional. Some of you may already need to do this for school or for your job, but others can quickly get forgetful or busy and then years go by. This check-up is necessary to make sure you are in proper shape and weight for your age and height as well as test for basic and not so basic illnesses such as diabetes and heart disease.

This is also the exam where they SHOULD check your prostate and your testes, depending on your age and risk for cancer. Having a doctor you trust is good as communication about your sex life is very important. Gay guys who are anal sex receptive are more at risk for anal/rectal cancer than others.

18-39 years old:

PHYSICAL EXAM

  • Your blood pressure should be checked at least every 1 to 2 years.
  • Your height, weight, and BMI should be checked at every exam.

During your exam, your provider may ask you about:

  • Depression
  • Diet and exercise
  • Alcohol and tobacco use
  • Safety, such as use of seat belts and smoke detectors

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked at least once every 2 years. If the top number (systolic number) is between 120 and 139 or the bottom number (diastolic number) is between 80 and 89 mm Hg or higher. Then have it checked every year.
  • If the top number is greater than 140, or the bottom number is greater than 90, schedule an appointment with your provider.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often, at least once a year.
  • Watch for blood pressure screenings in your neighborhood or workplace. Ask your provider if you can stop in to have your blood pressure checked.

CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION

  • Recommended starting ages for cholesterol screening are between 20 and 35 for men. Men with normal cholesterol levels do not need to have the test repeated for 5 years.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.

DIABETES SCREENING

  • If your blood pressure is 140/80mm Hg or higher, your provider may test your blood sugar level for diabetes.
  • If you have a body mass index (BMI) greater than 25 and have other risk factors for diabetes, you should be screened. Having a BMI over 25 means that you are overweight. Asian Americans should be screened if their BMI is greater than 23.
  • If you have other risk factors for diabetes, such as a first degree relative with diabetes or history of heart disease, your provider will likely screen you for diabetes.

IMMUNIZATIONS

  • After age 19, you should have a tetanus-diphtheria and acellular pertussis (Tdap) vaccine once as part of your tetanus-diphtheria vaccines if you did not receive it as an adolescent. You should have a tetanus-diphtheria booster every 10 years.
  • You should get a flu shot each year.
  • Talk with your provider about getting the human papilloma virus (HPV) vaccine series if you have not already had it.
  • You should receive two doses of varicella vaccine if you never had chickenpox or the varicella vaccine.
  • Your provider may recommend other immunizations if you have certain medical conditions, such as diabetes.

40-64 years old:

PHYSICAL EXAM

  • Your blood pressure should be checked at least every year.
  • Your height, weight, and body mass index (BMI) should be checked at every exam.

During your exam, your provider may ask you about:

  • Depression
  • Diet and exercise
  • Alcohol and tobacco use
  • Safety, such as use of seat belts and smoke detectors

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked at least once a year. If the top number (systolic number) is between 120 to 139 mm Hg or the bottom number (diastolic number) is between 80 to 89 mm Hg, then continue to have it checked every year.
  • If the top number is greater than 140 or the bottom number is greater than 90, schedule an appointment with your provider.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often.
  • Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked.

CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION

  • Your cholesterol should be checked every 5 years.
  • If you have a high cholesterol level, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
  • Some men should consider taking aspirin to prevent heart attacks. Ask your provider before you start aspirin because aspirin may increase your risk for bleeding.

DIABETES SCREENING

  • If you are age 45 or older, you should be screened every 3 years.
  • If you are overweight, ask your provider if you should be screened at a younger age. Asian Americans should be screened if their BMI is greater than 23.
  • If your blood pressure is above 140/80 mm Hg, or you have other risk factors for diabetes, your provider may test your blood sugar level for diabetes.

COLORECTAL CANCER SCREENING

If you are under age 50, talk to your health care provider about getting screened. You should be screened if you have a strong family history of colon cancer or polyps. Screening may also be considered if you have risk factors such as a history of inflammatory bowel disease or polyps.

If you are between ages 50 to 75, you should be screened for colorectal cancer. There are several screening tests available:

You may need a colonoscopy more often if you have risk factors for colorectal cancer, such as:

  • Ulcerative colitis
  • A personal or family history of colorectal cancer
  • A history of growths called adenomatous polyps

IMMUNIZATIONS

  • You should get a flu shot every year.
  • Your provider may recommend other vaccinations if you have certain medical conditions, such as diabetes.
  • You should have a tetanus-diphtheria booster vaccination every 10 years. If you have not received a tetanus-diphtheria and acellular pertussis (Tdap) vaccine as one of your tetanus-diphtheria vaccines, you should have it once.
  • You may get a shingles or herpes zoster vaccination once after age 50.

OSTEOPOROSIS SCREENING

  • If you are between ages 50 to 70 and have risk factors for osteoporosis, you should discuss screening with your provider.
  • Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, having a fracture after age 50, or a family history of osteoporosis.

PROSTATE CANCER SCREENING

  • Most men age 50 or older should discuss screening for prostate cancer with their provider. African American men and those with a family history of prostate cancer in a first degree relative younger than age 65 should discuss screening at age 45.
  • The potential benefits of PSA testing as a routine screening test have not been definitively shown to outweigh the harms of testing and treatment. If you choose to be tested, the PSA blood test is most often done every year.
  • Prostate examinations are no longer routinely done on men with no symptoms.

LUNG CANCER SCREENING

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults ages 55 to 80 years who:

  • Have a 30 pack-year smoking history AND
  • Currently smoke or have quit within the past 15 years

65+ years old

In addition to the basic examination repeated above:

ABDOMINAL AORTIC ANEURYSM

Abdominal aortic aneurysm (AAA) occurs in 5 to 10 percent of men 65 to 79 years of age. The mortality rate after dissection and rupture approaches 80 percent for men who reach the hospital and 50 percent for men who undergo emergent surgical repair. Risk factors include smoking, hypertension, dyslipidemia, family history, and atherosclerosis.

Smoking is the risk factor most strongly associated with AAA (odds ratio = 5.1) and accounts for 75 percent of all aneurysms at least 4.0 cm in diameter.Twelve to 19 percent of first-degree relatives of men with an AAA will develop an aneurysm. Only 30 percent of asymptomatic AAAs are discovered on physical examination, with sensitivity and specificity of 68 and 75 percent, respectively.3

The USPSTF recommends a one-time ultrasound screening for AAA in men 65 to 75 years of age who have ever smoked, because randomized trials have shown that the benefits of screening and surgical repair in this high-risk group outweigh the harms. One trial found a number needed to screen of 349 to prevent one AAA-related death over 4.3 years.3

OSTEOPOROSIS

Although the USPSTF found insufficient evidence to recommend screening for osteoporosis in men, it states that if the relative benefits and harms of therapy for osteoporosis are similar in men and women, the men most likely to benefit from screening would have 10-year risks for osteoporotic fracture equal to or greater than those of 65-year-old white women who have no additional risk factors. The National Osteoporosis Foundation recommends bone mineral density testing in all men 70 years or older and in men 50 to 69 years of age who have additional risk factors. The Institute of Medicine recommends that men 19 to 70 years of age aim for a dietary intake of 1,000 mg of calcium and 600 IU of vitamin D3 daily, whereas men 71 years and older should consume 1,200 mg of calcium and 800 IU of vitamin D daily, using supplements if dietary intake falls short of these goals.39Although the USPSTF found insufficient evidence to recommend screening for osteoporosis in men, it states that if the relative benefits and harms of therapy for osteoporosis are similar in men and women, the men most likely to benefit from screening would have 10-year risks for osteoporotic fracture equal to or greater than those of 65-year-old white women who have no additional risk factors. 

The National Osteoporosis Foundation recommends bone mineral density testing in all men 70 years or older and in men 50 to 69 years of age who have additional risk factors. The Institute of Medicine recommends that men 19 to 70 years of age aim for a dietary intake of 1,000 mg of calcium and 600 IU of vitamin D3 daily, whereas men 71 years and older should consume 1,200 mg of calcium and 800 IU of vitamin D daily, using supplements if dietary intake falls short of these goals.

The National Osteoporosis Foundation recommends bone mineral density testing in all men 70 years or older and in men 50 to 69 years of age who have additional risk factors. 

The Institute of Medicine recommends that men 19 to 70 years of age aim for a dietary intake of 1,000 mg of calcium and 600 IU of vitamin D3 daily, whereas men 71 years and older should consume 1,200 mg of calcium and 800 IU of vitamin D daily, using supplements if dietary intake falls short of these goals.

HIV+ EXAM

Those living with HIV should see their medical providers at least twice a year for check-ups, blood work and mental/emotional health screenings. Guys living with this virus should definitely STOP SMOKING and reduce all drug and alcohol usage, if not stop completely. During this visit medications should be reviewed for effectiveness and/or renewed.

DENTAL EXAM

With our very busy lives and electric tooth brushes it is easy to skip the twice yearly dental exams. Some studies have suggested every two years, but dental issues can be painful and costly if left to wait.

  • Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.

EYE EXAM

  • If you have vision problems, have an eye exam every 2 years, or more often if recommended by your provider.
  • Have an eye exam at least every year if you have diabetes.

STD SCREENINGS

All sexually active gay males should be screened for HIV and other STDs every three months. A lot can happen during this time and infections can go without symptoms in 50% of males.

PrEP USERS

Every three months PrEP users should be following the screening schedule for HIV and STD infections as well as blood work to determine kidney and liver health and function as well as any possible medication side effects.

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