Gay men have a variety of ways to determine when to test for HIV. For some, it’s a routine event that’s happened since they became sexually active; others test more sporadically, perhaps before starting a new relationship.
The BC Centre for Disease Control, working in collaboration with HIM, Vancouver Coastal Health and other partners have created four testing guidelines for sexually active gay men in Vancouver.
More at risk? Test every three months.
High-risk sex includes anal sex without a condom with a partner who are of unknown status or haven’t reached an undetectable viral load.
To reduce your risk of picking up HIV, use condoms during anal sex, and reduce the number of partners you’re having anal sex with, or opt for lower-risk activities (like oral sex or mutual masturbation). HIV test “window periods” are shorter now: you can now get tested more often, and get your results sooner.
Less at risk? Test every 12 months.
Low-risk sex includes oral sex, anal sex where condoms are used and sex with a regular partner whose status you know (like a boyfriend or husband). There is no risk of HIV transmission if having sex with a guy who is undetectable, or a guy who is on PrEP. That said, any condomless sex may result in transmission of other STIs.
Low-risk doesn’t necessarily mean no-risk. Even guys who may consider themselves no-risk should test for HIV every 12 months. Sometimes, a risk event may happen (by accident, mistake, or even planned). If so, you may want to change your testing pattern to every 3 months, or follow the Test After a High-Risk Event guidelines (below).
Test after a high-risk event.
Sometimes, high-risk events happen. If you’ve had a condom break, or had unprotected anal sex with someone whose status you weren’t completely sure of, get tested.
Guys who have recently picked up HIV may be in the “acute” stage. Guys in this stage do not usually know they are infected but HIV is replicating quickly insider their bodies, making them much more likely to pass on the virus. In BC, you can now get an accurate HIV test ten days after a risk event. Don’t wait to get tested.
If you are concerned you might have been exposed to HIV, take PEP within 72 hours to dramatically decrease the likelihood of transmission.
Test before giving up condoms.
If you and your partner (boyfriend, friend with benefits, husband) want to give up condoms, you should both get tested, but only after three months of using condoms consistently. Assuming you are not exposed to HIV outside your relationship, you can both feel certain of your results after three months.
Some guys have a hard time being monogamous. Some guys think they are in a monogamous relationship when they are not. Discussing sex outside the relationship may be a way of reducing future risk. For instance, you may decide that if sex outside the relationship occurs (intentionally, or in the heat of the moment) it should be as low risk as possible. If you or your partner has a high-risk event, talk about it, and get tested right away.