Notice how basic this sounds , yet so few people were ever told: get tested properly, prevent smartly, and treat openly. Gay and bisexual men in the UK and beyond are finally getting a concise checklist that covers three-site STI testing, PrEP and injectable options, doxyPEP, key vaccines, anal health, and mental wellbeing , because these things change outcomes.

Essential Takeaways

  • Three-site testing matters: Throat and rectal swabs catch infections urine tests miss; ask for self-swabs if that helps.
  • PrEP options have multiplied: Daily pills and long-acting injectable cabotegravir make prevention practical for different lifestyles.
  • DoxyPEP reduces common STIs: Short-course doxycycline after sex can cut syphilis and chlamydia by about 70%, but resistance is a consideration.
  • Vaccines are high-value: HPV, hepatitis A and B, and mpox vaccination prevent cancers and severe illness , check your status.
  • Anal and mental health count: Anal screening and open conversations about mood, drugs and sexual function are part of good sexual healthcare.

Why three-site STI testing should be your new routine

Missed infections feel invisible , literally. Rectal and throat chlamydia and gonorrhoea are often symptom-free, so a urine test alone will let a lot slip through. CDC guidance recommends screening at every site of exposure , urethra, rectum, throat , at least annually, more often for people with multiple partners. Self-collected swabs are validated and can make the moment less awkward. Practically, ask your clinic for three-site testing and specify exposure locations; it’s the single most useful change you can make to your screening routine.

PrEP today: more than a tablet in a bathroom cabinet

If you're sexually active with men and not on PrEP, it’s worth discussing. Daily oral PrEP remains excellent, but injectable cabotegravir offers a no-pill alternative that suits people who struggle with adherence. Any PrEP start requires a negative HIV test first and regular follow-ups. According to public health guidance, clinicians should offer PrEP proactively , low uptake reflects gaps in care, not personal failure. Think about what fits your life: daily habit, quarterly clinic visits, or an injection every couple of months.

DoxyPEP: a newer prevention tool with nuance

DoxyPEP , a 200 mg dose of doxycycline taken within 72 hours after condomless sex , has shown substantial reductions in syphilis and chlamydia and roughly half the gonorrhoea in trials. The CDC recommends offering it to people who’ve had an STI in the past year and engaging in shared decision-making about benefits and risks. Important caveats: it’s not a licence to skip testing , you still need STI checks every 3–6 months , and antibiotic resistance, especially in gonorrhoea, is a real clinical concern. Talk it through with a clinician who will weigh your history and local resistance patterns.

Vaccines: the quiet wins for long-term health

Vaccination is low effort and high return. HPV vaccine prevents cancers linked to sexual exposure and is recommended up to age 26 and considered up to 45 in discussion with your clinician. Hepatitis A and B vaccines are standard recommendations for men who have sex with men if you’re not already immune. For mpox, a two-dose JYNNEOS course is advised for people with recent STI diagnoses, multiple partners, or attendance at large sexual venues. If you started but didn’t finish a series back in 2022, go back and complete it , immunity matters more than regret.

Anal health: screening, symptoms and why it’s not embarrassing

Anal cancer is rare in the general population but far more common among men who have sex with men, especially those with HIV. The ANCHOR trial showed treating high-grade anal lesions cuts progression to cancer significantly, which has shifted screening thinking. Guidance now supports targeted screening for people with HIV and recommends clinicians perform digital anorectal exams and consider cytology or high-risk HPV testing where appropriate. If you’ve got bleeding, persistent pain, new lumps or discharge, see someone , proctitis and other treatable conditions can mimic minor annoyances but need proper testing and care.

Mental health and sexual function: the missing checklist items

Sexual health isn’t only about microbes and injections; mood, stress and substance use change desire, performance and risk-taking. Research links higher rates of anxiety, depression and substance use among gay and bisexual men to worse sexual functioning and satisfaction. If sex feels off, a conversation with a clinician or counsellor can be as important as a prescription. Integrating mental health screening into sexual health visits makes care more complete and helps address root causes of risky behaviour or diminished pleasure.

It's a small set of actions that makes a big difference , get tested properly, consider prevention options, keep vaccinations up to date, look after your anus and your head.

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