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Undiagnosed or untreated STIs may increase the risk of both acquiring and transmitting HIV. The CDC recommends that all sexually active MSM be tested annually for these STIs 8. For sexually active MSM, the most effective ways to prevent HIV and many other sexually transmitted infections (STIs) such as syphilis, gonorrhea, and chlamydia, are to avoid unprotected anal sex and always use condoms 7. Unprotected receptive anal sex is the sexual behavior that carries the highest risk for HIV acquisition 6. Sexual risk behaviors account for most HIV infections in MSM 5.Negative attitudes about homosexuality (including complacency), discriminatory acts, and bullying and violence can make it difficult for some MSM to be open about same-sex behaviors with others, which can increase stress, limit social support, and negatively affect health. Stigma, homophobia, and discrimination put MSM of all races and ethnicities at risk for multiple physical and mental health problems and affect whether MSM seek and obtain high-quality health services 4.Persons who do not know they have HIV do not get medical care and can unknowingly infect others.
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Low awareness of HIV status among young MSM may reflect several factors: recent infection, underestimation of personal risk, fewer opportunities to get tested, or belief that HIV treatment minimizes their risk of acquiring or transmitting HIV 2 – 3.