For some guys, regular testing is already part of a well managed sexual health regime. For others, knowing how often, or whether to test at all might be big considerations. With improved access to testing services — including free and anonymous ones in some areas — more and more of us are connecting with healthcare providers. If you’re wondering what’s best for you, here’s some guidance to help you test, take charge and stay healthy.
Data from 2015 shows that nationally 66 per cent of HIV negative men who have sex with men tested at least once for HIV, and 44 per cent had comprehensive STI testing in that year. Even though this indicates a third of HIV negative guys didn’t test for HIV, testing coverage in Australia has increased moderately over the past five years.
Testing is the only way to know for sure if you do or don’t have HIV or other STIs, because not everyone gets noticeable symptoms. Knowing about any STIs and your HIV status means you can be in charge of keeping yourself and others healthy. And the sooner an HIV diagnosis is made and treatment is commenced, the better the chances of continuing to live a long and healthy life.
Should I test?
If you’re a man who’s had sex with other men (including trans men), then yes — sexual health tests are certainly worth doing. Why? Because knowledge is power, and getting tested empowers you to be in charge of your long term wellbeing as an individual, as well as looking after the people you enjoy having sex with.
Sexual health tests are relevant for all of us, no matter what your HIV status is. And testing for HIV isn’t the only thing a sexual health check up can involve because STIs can still happen to any of us.
Remember that test results are confidential. All testing in private and public clinics is governed by Australian Privacy Law. At some clinics you won’t need Medicare, and in some, you don’t even have to give your real name if you’d prefer not to. You can contact a GP or clinic in advance to discuss any of this with them in confidence.
How often should I test?
Whatever your HIV status, figuring out how often to test depends on how popular and affectionate you are. If you only had one sexual partner in the last six months, it’s still recommended you test at least twice a year as standard. If you’re someone who’s a little busier than that with 10 or more sexual partners in the last six months, testing at least four times a year is recommended.
“Whatever your HIV status, figuring out how often to test depends on how popular and affectionate you are.”
Use the frequency calculator at Ending HIV to help you plan your testing schedule. If you’d like to be reminded when it’s time for you to test, use the free ‘Remind Me’ service at The Drama Downunder.
But this doesn’t apply to me because…
I’m in a monogamous relationship: Monogamy is a wonderful relationship dynamic for some of us, but it’s not an infallible HIV or STI prevention strategy. One in four new HIV infections occurs in men in a regular relationship. Because while it may be difficult to imagine, sometimes sex happens — even without you.
I always use a condom: Even if you’re using condoms every time you have sex, remember that they’re not completely fail-safe. They’re a great tool for helping to reduce your risk of HIV and STIs, but they don’t eliminate it completely.
I only fuck neg guys: Fucking guys who believe or say they’re HIV negative is not the same as fucking guys who are definitely HIV negative. The truth is that more HIV transmissions come from guys who don’t know they have the virus than guys who do. If you’d like to know more about what it means to choose sexual partners based on HIV status, check out Serosorting: How’s that for a fucking strategy?
I only do oral: Whatever your HIV status, you can still pick up STIs from giving or receiving blow jobs, rimming, and even kissing because condoms and dams don’t always fully cover affected areas. And let’s be real — are you using them for oral sex at all?
“Ignorance may be bliss in some situations, but when it comes to your health, ignorance can be brutal.”
I don’t have any symptoms: Not having symptoms doesn’t necessarily mean you haven’t acquired HIV or other STIs. Many of us don’t experience any noticeable symptoms at all when we have an STI. Testing is the only way to be absolutely sure.
I use PrEP: If you’re using PrEP as a highly effective HIV prevention strategy, it’s still important to go for comprehensive sexual health and other routine medical tests every three months as part of your managed program. If you’ve been taking your PrEP daily, you can be more confident about receiving a negative HIV test result every time.
I already know I’m HIV positive: If you’re living with HIV, viral load and CD4 tests will help you monitor your viral load and the health of your immune system. But it is still important to ensure you have a comprehensive sexual health test as the viral load test will not pick up any STIs. If you’re on treatment for HIV, regular testing will make sure it’s working to help you maintain an undetectable viral load (UVL). Doing so for at least six months means there’s effectively zero chance of sexually transmitting the virus. If you’d like to know more, check out UVL 101: Undetectable = Safe.
I’d rather not know: Ignorance may be bliss in some situations, but when it comes to your health, ignorance can be brutal. Over a quarter of new HIV diagnoses in 2015 were in people with highly compromised immune systems, meaning it’s likely they had been living with untreated HIV for at least four years before getting tested. And having condomless sex while HIV is left untreated increases the chance of passing the virus on to sexual partners. What’s important to know is the sooner HIV is diagnosed and treated, the better the long term health outcomes. Early, if not immediate, HIV treatment increases life expectancy, improves health and prevents serious illness by more than 50 per cent compared to people who delay starting treatment.
What to test for
You can also discuss options to test for other STIs such as Hepatitis A, B and C. Vaccinations are available for Hepatitis A and B, and there are new treatments that can cure Hepatitis C on the PBS (Pharmaceutical Benefits Scheme) — that’s the list of government subsidised medications available to everyone with Medicare.
Remember that most common STIs are straight forward to treat. And although we don’t yet have a cure for HIV, there are many highly effective, convenient and well tolerated treatment options as well as support groups and services. If you’re in need of support after testing positive for HIV, peer-run community group The Institute of Many (TIM) provide resources online, and via the TIM Facebook group, or contact one of your local HIV positive organisations.
Where to test
There are places you can go to test all over Australia. Every major city has one or more testing services, and there’s coverage for regional and rural areas too.
You can find your nearest sexual health testing service using Emen8’s interactive map.
Alternatively, contact your local AIDS council or LGBTI health organisation in your state or territory to find out more about testing services, including LGBTI friendly ones, and services operated specially by and for other LGBTI people.