'Men who have sex with men' originated during the HIV pandemic to focus on behavior rather than identity – but not everyone thinks the term helps

Since the global monkeypox outbreak started to spread this past spring, more people are seeing the term “men who have sex with men,” or MSM, in the news and public health messages. You may have also heard this term in places like HIV prevention campaigns or at the doctor’s office.

I am a behavioral scientist who focuses on reducing health disparities and improving health equity for sexual and gender minority populations at highest risk for poor outcomes. At the most basic level, men who have sex with men is a term that was originally intended to describe the risk of HIV transmission associated with sex between two men. But in reality, MSM describes a diverse group of behaviors and identities, bringing with it a complex web of social, political and cultural considerations about how it’s used.

Why use MSM?

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

The acronym MSM, however, 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 based on their sexual identity as gay. Community advocates criticized this approach for excluding Black and Latino men who have sex with men who were affected by the pandemic but did not identify as gay, homosexual or bisexual. MSM was considered to be a more inclusive, less stigmatizing term that could be used to reach a broader range of people.