For your information, let’s talk STIs. We’ll start with general info, then take a closer look at HIV, viral hepatitis (Hep A, B, and C), and HPV.
Anyone who’s having sex can come into contact with an STI. Some STIs (like the herpes virus) can also be passed on simply through skin-to-skin contact. Luckily, most STIs are easily treated with pills, injections, or creams.
Although some STIs cause symptoms like itching, burning, or discharge, many STIs don’t show any symptoms. This makes it especially important to get tested.
Get tested regularly
In general, it’s worth getting tested for STIs once a year. However, if you’re having multiple or anonymous partners, consider getting tested every 3 to 6 months.
Some STIs, like HIV and Hep C, can be transmitted when infected blood from one person gets into the bloodstream of another person, including through broken skin. Some of us may be more predisposed to small tears and bleeding from the front hole. This is because of decreased estrogen due to aging and/or taking T.
Some doctors may not always know what our bodies are like or the kinds of sexual health needs that we have. This can make it hard for us to get tested properly for STIs.
The type of STI testing you’ll need depends on the sex you’ve been having.
So, when asking for testing, it’s worth ensuring that it covers all the kinds of sex you’ve had since any previous STI test. Did someone suck your flesh cock without a barrier last year? Do a urine test! Did a cis guy cum in your ass without a condom recently? Get a rectal swab! And so on.
If you test positive for an STI, it’s best to notify any past and current sexual partners so they can get tested and treated early. If you’re unable to notify others safely, you can anonymously tell partners using free online platforms like tellyourpartner.org. Alternatively, a healthcare worker/public health officer can tell partners on your behalf while maintaining your confidentiality. Ask your healthcare provider about your options.
In some situations, Canadian law requires you to disclose that you’re HIV positive. Some people in Canada have been charged for not disclosing their HIV status. These laws are rapidly evolving, so to stay up to date, visit aidslaw.ca.
HIV (Human Immunodeficiency Virus) is a virus that can weaken your immune system, the body’s built-in defence against disease and illness. It’s possible to have HIV without knowing it, so it’s a good idea to get tested regularly.
There’s no cure for HIV yet, but there are very effective treatment options. With proper care, people with HIV can live long and healthy lives.
- Know your status: If you’re unsure of your HIV status, get tested.
- Get tested regularly: Every 3 to 6 months, if you’re having sex often.
- If you think you’ve been exposed, find out your status: Get tested, preferably within three weeks of the possible exposure activity.
HIV can be passed on through:
- blood, including menstrual blood
- semen (cum) and pre-cum
- front-hole fluid
- vaginal fluid
- anal fluid
- chest milk.
HIV is transmitted when the virus in one of these fluids gets into the bloodstream of another person—through broken skin, the urethra at the opening of a flesh cock, or the wet linings of the body (like the front hole, vagina, or ass).
The two main ways that HIV can be transmitted are:
- through sex (when there’s enough of the virus to expose a sexual partner to HIV—see “If you’re undetectable, you’re untransmittable” below)
- sharing needles or other equipment to inject drugs (including hormones).
HIV can also be transmitted to a fetus or baby during pregnancy, birth, or chestfeeding.
HIV can’t be transmitted through sweat, saliva, or urine.
If you’re undetectable, you’re untransmittable
Good news: If you’re on HIV treatment that’s keeping the amount of HIV in your blood at undetectable levels, you can’t transmit HIV through sex. This is called U=U (undetectable equals untransmittable).
“Undetectable” means that the amount of HIV virus in your blood (your viral load) is so low that tests can’t find HIV in your blood for at least six consecutive months.
You’ll need to stay on HIV treatment, as prescribed by your doctor, to maintain an undetectable viral load.
Note: Serosorting involves sex between people who choose sexual partners with the same HIV status as their own (e.g., if you’re HIV negative, pairing up with someone who’s also HIV negative). However, serosorting isn’t the most reliable strategy because a person’s HIV status can change. For example, someone might have become HIV positive since their last HIV test or they might think they’re HIV negative because they have no symptoms. For more information, visit TheSexYouWant.ca.
Getting tested for HIV
It takes around three months for HIV antibodies to become detectable in your blood, so it’s important to get tested regularly for HIV.
There are different ways to test for HIV. Some include:
- Standard blood testing: A sample of your blood is taken from a vein in your arm and sent to a lab for testing. Your results will be available up to two weeks later.
- Rapid testing: A couple of drops of blood are taken by pricking your finger. You’ll get a result within a few minutes. If the result is reactive (that is, probably HIV positive), you’ll need to get a standard blood test so that a lab can confirm the result. If the second result is negative, you don’t need to be retested.
- Self-testing: You are able to give yourself the rapid test by collecting a sample of your own blood from your finger, testing it, and interpreting the results.
In Canada, you can get anonymous HIV testing (both standard blood testing and the rapid test) at some clinics and community health centers. You can call ahead of time to confirm.
Living with HIV
You can’t cure HIV, but you can keep it under control and lead a long and healthy life by taking medications as prescribed by your doctor.
If you’ve become HIV positive:
- Get treatment as early as possible: Early treatment reduces the chance of any HIV-related health problems. Visit catie.ca or talk to your doctor about your best options.
- Speak with your doctor or pharmacist about any other meds you’re taking: Some HIV medications increase or decrease the level of testosterone in your body, and affect certain other meds (e.g., recreational or party drugs, medications for hair regrowth therapy).
- Consider proceeding with your surgery plans: Testing positive for HIV doesn’t prevent you from getting surgery, including gender-affirming surgery.
- Get connected to other care: HIV organizations and community health centers can support you. These services are also a good way to connect with peers and to other services and resources. To find your local HIV organization, visit HIV411.ca or contact email@example.com.
Viral hepatitis (also called Hep) is a type of liver infection. Sometimes, if you have viral hepatitis, you might not show any symptoms.
There are five types of Hep. Below, we’ll focus on the three main types: A, B, and C. For more details on Hep, see catie.ca.
Hep A and B
Hep A gets transmitted when the feces (shit, stool) of a person with Hep A comes into contact with the mouth of someone else (e.g., by ingesting small amounts of contaminated feces during the course of sex, by eating food or drinking water that’s contaminated with infected feces, etc.).
Hep B gets transmitted through contact with semen, front-hole fluids, vaginal fluids, and blood.
Protect yourself against Hep A and Hep B by getting vaccinated.
In some provinces, these vaccines are free for some people, like men who have sex with men, so check if you’re eligible.
Hep C gets transmitted when the blood of someone with Hep C gets into someone else’s bloodstream—for example, by:
- Sharing personal items with wet or dry blood on them, like toothbrushes, and needles for injecting, tattooing, and piercing.
- Having barrier-free sex that involves blood.
Hep C has no vaccine but can be treated and cured with Hep C treatments. Speak to your healthcare provider. After you are cured, you can get Hep C again. Cure does not provide immunity to Hep C.
Human Papilloma Virus (HPV) is the most commonly transmitted STI. Most sexually active people have one or more HPV infections in their life.
HPV is transmitted mainly through physical sexual contact—including skin-to-skin contact, regardless of whether any penetration or body fluids are involved.
There are different types of HPV. Although most types of HPV go away on their own without causing any problems, some can cause genital warts and others can lead to cancer.
Find out if you need a pap test
Pap tests detect types of HPV that can cause cervical cancer. If you have a cervix and are sexually active, it’s worth getting a pap test every three years. If you’ve had a full hysterectomy with complete removal of the cervix, ask your doctor if you need a pap test (especially if you have a history of cervical cancer).
Find out if you need an anal pap test
Anal pap tests exist too. If you’re having anal sex or have a history of cervical cancer that’s related to HPV, it’s a good idea to ask your doctor if you need anal pap tests to reduce your risk of getting anal cancer.
If you haven’t been vaccinated, see your doctor
In most of Canada, the HPV vaccine Gardasil-9 is given in schools (usually between Grade 4 and Grade 7). If you haven’t been vaccinated against HPV, speak with your doctor. In certain provinces, some people can get free HPV vaccination (like MSM under 26 years old in Ontario), so check if you’re eligible. Visit our Resources page for details.
The mpox virus (formerly called monkeypox) has started circulating in the sexual networks of gay and bisexual men.
It’s a virus that can cause a rash, lesions, or blisters, along with fever, muscle aches, and extreme tiredness. Both animals and humans can contract the virus, and it’s spread by close and prolonged contact. It’s in the same family of viruses as smallpox, but mpox is less contagious and has milder symptoms.
Mpox may be something queer and trans men who have sex with men need to consider when making choices about their sexual health. Getting vaccinated against mpox is a good way to prevent symptoms and stop its spread. Learn more about mpox here.