Physical and mental health conditions in men who have sex with men: a global umbrella review of meta-analyses

Men who have sex with men (MSM) face a disproportionate burden of health problems. Prior syntheses among MSM have not comprehensively addressed key areas such as non-communicable diseases, mental health, and comorbidities. This umbrella review aimed to synthesize and evaluate meta-analytic evidence on the burden of physical and mental health conditions in MSM. Five electronic databases (Web of Science, PubMed, PsycINFO, Embase, and Scopus) were systematically searched from inception through May 31, 2025, to identify meta-analyses reporting the prevalence or incidence of physical and mental health conditions in MSM. Meta-analyses that investigated health conditions in specific clinical subgroups were excluded. Data were extracted from published meta-analyses, and estimates were synthesized and stratified by anatomical site, age, country income level, and time period. Heterogeneity, small-study effects, excess significance, and risk of bias were also assessed for each study finding. The study was registered with PROSPERO (CRD420251050816). The systematic search identified 4,146 citations for screening. After excluding 2,411 articles, 192 full-text articles were assessed for eligibility, ultimately resulting in the inclusion of 17 meta-analyses published between 2012 and 2025. The only identified meta-analysis regarding non-communicable diseases focused on overweight and obesity, with a prevalence of 35.6% (95% CI: 32.1–39.3) and 20.0% (18.6–21.6), respectively. For communicable disease, anal human papillomavirus infection was most prevalent among MSM (78.4%; 95% CI: 75.6–81.0). The HIV/syphilis co-infection prevalence was 3.0% (1.7–4.3), and the HIV prevalence in older MSM was 26% (18–33). Depression and intimate partner violence were the most prevalent mental health conditions, with prevalence rates of 35% (31–39) and 33% (28–39), respectively. Overall, the quality of the evidence was limited by high heterogeneity and small-study effects. MSM experience a wide range of physical and mental health conditions, especially for sexually transmitted infections, depression, and violence. Chronic diseases and comorbidities in this population deserve greater public health attention. Future research should prioritize conducting high-quality meta-analyses for health outcomes where the existing evidence is of low quality, and for important outcomes that have not yet been synthesized through meta-analysis.