Diarrheal Infections in Gay Men and Other Men Who Have Sex with Men

Gay men and other men who have sex with men have a high risk of getting a diarrheal infection. This type of infection spreads easily from any contact with feces (stool).

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During oral/anal sex play, stool can come into contact with a person’s mouth. Just a small amount of stool can make another person sick.

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The following sexual activities can increase your risk for getting a diarrheal infection:

Fingering
Rimming
Fisting
Using anal toys

Avoiding Infection

Here are some tips for reducing your risk of getting a diarrheal infection from sex:

Do not have any type of sex if you or your partner had diarrhea in the past two weeks.
Before and after sex, wash your hands, penis, buttocks and sex toys with soap and water.
Get vaccinated for hepatitis A.
For effective protection while rimming, use dental dams, household plastic wrap, latex gloves or non-lubricated condoms split lengthwise down the middle.
Use condoms with sex toys and discard the condoms after use.

Symptoms

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Common symptoms of diarrheal infections include:

Diarrhea
Fatigue
Severe stomach pain
Nausea
Bloating
Fever
Yellowing of the skin or eyes (jaundice), which may be a sign of a hepatitis A infection

If you are experiencing these symptoms, see your health care provider or visit an urgent care facility.

Common Types of Diarrheal Infections in Men Who Have Sex with Men

Parasites, viruses, and bacteria can all cause diarrhea. The most common causes include:

Amebiasis. The majority of reported cases in NYC with this parasite involve men ages 20-59. This parasite can sometimes lead to serious infections, such as a liver abscess.
Cryptosporidiosis. Cryptosporidiosis normally causes acute watery diarrhea. It is especially dangerous for people with end-stage AIDS, as there is no cure for people who are severely immunosuppressed.
Giardiasis. Giardiasis is the most common parasite reported in NYC. It is most frequently identified in men ages 20-59.
Hepatitis A. Since 2017, there has been an ongoing outbreak of hepatitis A among gay men and other men who have sex with men in New York City.
Shigellosis. Increasing antibiotic resistance of Shigella infections has been observed in New York City, particularly among gay men and other men who have sex with men.

Additional Resources

Hepatitis A FAQ (PDF) Other Languages: Español
Tongue in Cheek Postcard (PDF) Other Languages: Español | Русский | 繁體中文 | 简体中文 | Kreyòl ayisyen | 한국어 | বাংলা | Italiano | Polski | Português | العربية | Français | ײִדיש | اردو
Health Alert (September 25, 2017): Update: Increase in Hepatitis A Among Men Who Have Sex with Men (PDF)