MSM should receive the same immunizations routinely recommended for other patients, as well as for hepatitis A and B viruses. Family physicians must be prepared to ask explicit questions about sexual activities to determine risk levels for STIs. Health issues that have a disproportionate impact on MSM include mental health and behavioral problems, smoking and illicit substance use, and sexually transmitted infections (STIs). Barriers include a lack of a welcoming clinical environment, lack of adequate health insurance, and sexual minority stress. Because current medical practice does not always facilitate discussion of sexual behaviors, this group of men may face barriers to receiving culturally competent, comprehensive health care, including preventive services. MSM may describe themselves as gay, bisexual, or heterosexual. On a farm with my grandfather and grandmother and two uncles.Men who have sex with men (MSM) comprise at least 4% of males in the United States. My grandfather was hard working man and a proper man. So when my mom became pregnant with me when she was 14 he was furious. He let her stay of course but things were never the same. 2 years later my mom became pregnant again. My sisters and I never did know who our father was, my mother didn’t like to talk about it and it made her very depressed so I didn’t press the issue too much. Unfortunately when my mother became pregnant her father had enough and kicked her out of the house. My mother as she later told me expected this. She said she never expected to have my sisters or me but was never mad that she did.
She told me that she only had sex twice and consequently paid the price for it. When we were thrown out my grandfather was kind enough to give her some money. As I was only 2 at the time I was unable to help when mom built a small shack in the forest for us to live. She would make bags and other small items, as she did not want to leave us alone being so young. She could not afford babysitters or any luxuries. Using whatever money we had for food, clothes and survival.īy the time I was 7 I was able to help out more. I did not go to school but did get an education. Albeit not to the standards of other kids. My mom bought my sisters and I books and notepads and taught us from what she had learned. Every morning and night my sisters and I would practice math and English. During the day I would look after my sisters while my mom left us for work in town. When I was 10 our family finally came into some good luck. My mom met a man who she served while working at the diner she had found employment. A romance started and he took us all in with open arms. His name was Ted and he was by all means a nice guy. He was rich by “normal” people’s standards and incredibly wealthy by ours. When I was 11 we were living with him but still now married.
He would take trips and be gone for long periods of time. One day while doing the laundry my mom took his wallet out to wash his pants. She tossed the wallet onto a side table as she put the pants in the washer. The walled fell open to show pictures of his family. That night when he got home there were fireworks. He got scared and paid mom a considerable sum to forget he existed. Considering the circumstances she accepted. My mom had always been a country girl and that had been cut short when her father threw her out. So with our new found wealth we left the city and bought some land and set up a farm. By the time I was 14 we had built a reasonably well functioning farm, we were able to afford some luxuries but not many. And this is where the story really begins.