Getting tested for STDs and, if you’re HIV negative, HIV, is an important part of sexual health. If you’re sexually active, getting tested every three months is a great way to make sure that you don’t give anything to your partner…other than a smile. The information below has important information on what kinds of tests to get, when, and how to find them. You can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
Talking to a Provider
There are many free and low-cost HIV testing sites across the United States. To find a place to get tested, visit the CDC’s website here.
You and your healthcare provider will decide which STDs you should get tested for. But know ahead of time what you’re being tested for, since gay men often need different services than straight men. You might need to advocate for yourself and for the care you need if your health care provider isn’t an expert in gay men’s health.
Here are some things to keep in mind:
Be open and honest with your health care provider. Does your provider know you have sex with other men? Don’t be afraid to be honest about the number of partners you have or the kinds of sex you have. Your health provider is there to help you, not judge you. If you feel like your provider isn’t supporting you in ways that help you be healthy, it may be time for you to find a gay-friendly health provider.
In addition to drawing some of your blood and asking you to pee in a cup, your provider should also swab your butt, and your throat. That’s because men who have anal and oral sex can get infections in their throat and butt, in addition to their penis. A simple guideline to follow is: wherever a dick has gone – your butt or throat – you should get tested there. In fact, the majority of infections can be missed by not swabbing your throat or butt.
Before you walk out of your provider’s office, make sure you know how you’ll get your results. Will they be online? Will they be mailed to you? Or do you have to call the office in a few days to check? If you don’t get your results after a few days, call your provider’s office to check on them.
Get tested on a regular basis. Figure out with your provider how often it makes sense for you to get tested. If you’re having regular sex with more than one partner, it might make sense for you to get tested every three months.
Below are some questions that your doctor may ask you. While they may seem personal, by answering these questions you provide your doctor with information that may help you lower your risk of STDs, including HIV. In some cases, your doctor may not ask you these questions, so you should be prepared to offer this information on your own. These questions could include:
Are you currently sexually active?
In the last three to six months, how many sexual partners have you had?
Do you have sex with women, men, both, transgender persons, or all of the above?
Have you had unprotected anal, oral or vaginal sex?
Have you ever had an STD test where your doctor took a q-tip like swab of the back of your throat or rectum?
Have you had a positive test result for HIV or other STDs? If yes, were you treated at that time?
Do you or your partner engage in recreational drug use like shooting up or using club drugs?
You should also come to your doctor visits with any additional questions that you have about your sexual health and well-being.
Another part of having a conversation with your doctor is being able to talk about any sexual health issues or concerns you may have, including sexual assault or domestic violence. Although your doctor might not have all the resources to help you, s/he should be able to direct you to a trained professional who can assist with these concerns.
If you’re giving blow-jobs, or bottoming, you need more than a blood test and urine sample for STDs. Ask your doctor to swab your mouth and butt to find out for sure!
When it comes to sexually-transmitted diseases, most men only think about their dick: if it’s working right, if it hurts when you pee, if there’s a sore or a rash on it, or if it’s leaking weird fluid. These are all signs that you may have an STD, and you should see your doctor to get checked out.
A lot of the time STDs in your throat or butt don’t show any symptoms, but you can still be passing them on to your partners and they can be quietly causing harm to your body. The only way to know for sure is to get tested.
If you give blowjobs, you can get an STD in your throat. And if you like to be an anal bottom, you can get an STD up your butt, too, even if you use a condom. Also, the presence of any STD will increase the chances that you will get infected with HIV if you have sex with someone who is HIV positive.
Here’s good news. Many of these STDs that can live in your throat and butt are easily treatable with a shot or a prescribed medication by a doctor. But first you need to talk to your doctor and make sure they test you for two important STDs (gonorrhea and chlamydia) that may be living in your throat or butt. It’s done by collecting two swabs: one from your throat and one from your butt. Swabs may feel awkward – but they’re pretty quick and easy. To be safest, get a test every three months. And if you have symptoms, get tested right away.
Physical exam – Your health care provider may examine you for any signs of an infection, such as a rash, discharge, sores, or warts.
Urine sample – You may be asked to pee into a cup at your clinic/doctor’s office. Urine samples can be used to test for chlamydia and gonorrhea.
Discharge, tissue, cell or oral fluid sample – Your provider will use a swab to collect samples that will be looked at under a microscope. These samples can test for certain STDs, like chlamydia, gonorrhea, herpes, or HIV.
Blood sample – Your provider may take a blood sample, either with a needle or by pricking the skin to draw drops of blood. These can be used, for example, to test for syphilis, herpes, or HIV.
If you test positive, remember that the effects and health outcomes of many STDs can be treated and many STDs are curable. There are different treatments for different STDs. For some STDs, there are several treatment options.
CDC recommends sexually active gay, bisexual, and other men who have sex with men test for:
HIV (at least once a year);
Hepatitis C if you were born between 1945 to 1965 or engage in certain high-risk behaviors (see “how is hepatitis C spread”);
Chlamydia and gonorrhea of the rectum if you’ve had receptive anal sex (been a bottom) in the past year;
Chlamydia and gonorrhea of the penis (urethra) if you’ve had insertive anal sex (been a top) or received oral sex in the past year
Gonorrhea of the throat if you’ve given oral sex (your mouth on your partner’s penis, vagina/front-hole, or anus) in the past year.
If you’re an HIV-positive man, ask your provider about getting screened for HPV-related anal cancer as well.
Whether you’re going for a regular test or you’re worried that you may have gotten exposed to HIV, it’s best to know exactly which test you’re getting and what it can measure. Not all HIV tests are the same. Your HIV test experience will differ depending on if you choose to test at home or go to a clinic. The actual HIV tests themselves differ based on what they measure–some HIV tests detect pieces of the virus itself, while other tests measure something the body produces (antibodies) in response to an HIV infection. Knowing the type of HIV test you receive will help you better understand how accurate your results are.
Rapid antibody test
This test looks for HIV antibodies (which our body produces in response to an HIV infection). This test does not detect the HIV virus. Because our bodies can take up to 3 months to produce antibodies at levels that can be detected by this type of test, a rapid antibody HIV test may not give an accurate result for people who have been recently infected with HIV. In other words, people who have been recently infected may test negative for HIV even though they are HIV positive.
4-6 weeks (up to 3 months) after infection, most people will have enough antibodies to test positive.
12 weeks (3 months) after infection, about 98% of people will have enough antibodies to test positive.
Rapid antibody/antigen combination test
This type of test detects antibodies to HIV in addition to fragments of the virus called the p24 antigen. The p24 antigen can be detected in the body earlier than antibodies, which means that this test can detect earlier HIV infections than rapid antibody tests.
12-26 days after infection, the p24 antigen can be detected by this type of test
20-45 days after infection, HIV antibodies can be detected by this type of test
This type of test detects the presence of HIV virus material, which means that they are able to detect infections earlier than antibody tests. These tests are more expensive than antibody tests, so are not offered in as many places.
10-14 days after infection, there will be enough viral material for a positive result.
Home testing kits
There are currently two “home tests” which have been approved by the FDA for use in the U.S.
“OraQuick” is an antibody test that you take at home. It can test oral fluid (saliva) samples in addition to blood samples. Because it is an antibody test, it may not detect early HIV infection (in other words, people who have been infected in the previous three months). Up to 1 in 12 people may receive a false negative result (which means that even if the test says they’re negative, they’re actually HIV-positive) with this test. This means it’s very important to get confirmed by additional testing in a clinical setting.
“Home Access HIV-1” is not actually a test, but a kit you can use to take a blood sample. You can then mail the kit with your sample to a lab for processing, and the laboratory will do a follow-up test to confirm a positive result. This test can be done anonymously. The manufacturer also offers confidential counseling and referrals.
There’s a period of time after a person is infected during which they won’t test positive. In other words, there’s a period of time when a person is HIV-positive but won’t know it yet. This is called the HIV “window period.”
The window period can last between 10 days and three months, depending on the person’s body and on the HIV test that’s used. During that time, a person can test HIV-negative even though they’re HIV-positive. Someone in the “window period” of HIV infection can still transmit HIV to another person. In fact, people with very early HIV infection, who may still be in the window period of HIV infection, are actually much more infectious than later on in their infection. That’s one reason frequent testing is so important.
HIV/STD Testing Reminder Services
These are web and/or mobile-based notification services that remind users to get tested for one or more STDs at pre-determined monthly intervals. Most of these reminders have been created by local programs, though one is also from Gilead. Use the reminder that’s right for you even if you don’t live in the city that hosts it. If you want a do-it-yourself reminder, consider asking your smartphone to give you a reminder every three months! And to find a test site near you, go to gettested.cdc.gov.