References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Men who have sex with men (MSM) face specific STI risks and benefit from targeted sexual health services. Most bacterial STI treatments are the same as for everyone, but MSM often need additional screening sites (throat and rectum), vaccinations (HPV, hepatitis A and B, mpox) and access to PrEP for HIV prevention. UK sexual health clinics offer tailored services for MSM.
Here’s an overview.
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Common STIs in MSM
| STI | Relevance for MSM |
|---|---|
| Chlamydia and gonorrhoea | Common at urethral, throat and rectal sites |
| Syphilis | Rising rates; routine testing recommended every 3 months for higher-risk |
| HIV | Disproportionately affects MSM; PrEP is a key preventive tool |
| Hepatitis A and B | Vaccination recommended for MSM |
| LGV | Particularly prevalent in MSM networks |
| Hepatitis C | Rising rates in MSM, especially with HIV co-infection |
| Mpox | Vaccination available for higher-risk groups |
Treatment Principles
Treatment for bacterial STIs is the same for MSM as for anyone:
- Chlamydia — doxycycline 7 days (21 days for LGV)
- Gonorrhoea — ceftriaxone injection
- Syphilis — penicillin injection
- Mycoplasma — doxycycline + azithromycin or moxifloxacin
- Hepatitis C — direct-acting antivirals (curative)
Multi-Site Testing
Standard urine testing misses throat and rectal infections. MSM who have oral or anal sex should ask for:
- Throat swabs for chlamydia and gonorrhoea
- Rectal swabs for chlamydia (including LGV), gonorrhoea and mycoplasma
- Blood for HIV, syphilis and hepatitis
PrEP
PrEP is highly effective at preventing HIV for MSM and is free on the NHS through sexual health clinics. Options:
- Daily PrEP — most reliable
- Event-based (2-1-1) PrEP — for MSM only
Vaccinations
- HPV — free for MSM up to age 45
- Hepatitis A — free for MSM
- Hepatitis B — free for MSM
- Mpox — for higher-risk groups
DoxyPEP
Doxycycline taken within 72 hours of sex reduces bacterial STI rates for MSM. Availability in the UK is expanding through sexual health clinics. Ask at your local clinic.
Testing Frequency
- Every 3 months for MSM at higher risk
- Every 6 months for lower-risk MSM
- More frequently after any specific exposure or symptom
Where to Get Care
- NHS sexual health clinics (many have dedicated MSM services)
- Online sexual health services with postal testing
- Clinics like 56 Dean Street (London) and others with MSM focus
Read more: PrEP | Chlamydia in MSM | DoxyPEP
Frequently Asked Questions
Do MSM need different STI tests?
Yes — throat and rectal swabs in addition to standard testing.
Is PrEP really effective?
Yes. Over 99% effective at preventing HIV when taken as prescribed.
Should MSM test more often?
Every 3 months is standard for those at higher risk.
Related reading
- A to Z of Sex: Sexual Health Terms Explained
- Alcohol and HIV: What You Need to Know
- Anxiety and HIV: Coping and Getting Support
- Are All STIs Curable?
- Blood Problems and HIV: Anaemia, Low Platelets and More
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
