First, it was pursued by epidemiologists seeking behavioral categories that would offer better analytical concepts for the study of disease-risk than identity-based categories (such as "gay", "bisexual", or "straight"), because a man who self-identifies as straight may nonetheless be sexually active with other men; similarly, a man who self-identifies as gay or bisexual is not necessarily sexually active with other men.Men who are non-heterosexual or questioning may identify with all, none, a combination of these, or one of the newer terms indicating a similar sexual, romantic, and cultural identity like bi-curious.[6] There were no similar traits in all of the MSM population studied, other than them being males and engaging in sex with other men.[7][8] The term's precise use and definition has varied with regard to transgender and intersex people, who do not fall neatly into binary sex categories.[10] In the U.S., among men aged 15 to 44, an estimated 6% have engaged in oral or anal sex with another man at some point in their lives, and about 2.9% have had at least one male sexual partner in the previous 12 months.[38] Studies have found that less than 5% of MSM in Africa, Asia, and Latin America have access to HIV-related health care.[38] Pre-exposure prophylaxis (PrEP) is the use of medication to prevent HIV transmission in people who have not yet been exposed to the virus.[39] As of 2018[update], numerous countries have approved the use of PrEP for HIV/AIDS prevention, including the United States, South Korea,[40] France, Norway,[41] Australia,[42] Israel,[43] Canada,[43] Kenya, South Africa, Peru, Thailand, the European Union[44][45] and Taiwan.[51][52] Genital human papillomavirus (HPV) is a common virus that most sexually active people in the U.S. will have at some time in their lives.[53][55][56] Though not commonly classified as an STI, giardiasis can be transmitted between gay men,[57] and it can be responsible for severe weight loss and death for individuals who have compromised immune systems, especially HIV.[61] Most national standards require direct questioning regarding a donor's sexual history, but the length of deferral varies.