STIs (sexually transmissible infections) are viruses, bacteria and parasites that are passed on between people during sex. Some infections, like syphilis, can cause serious damage to your health if left untreated. From the mid-1980s, when most gay men started using condoms, the rate of other STIs such as syphilis and gonorrhoea fell dramatically. As a result, many gay men stopped getting regular sexual health checks apart from HIV tests. However, since the late-1990s the rate of STIs has been increasing. Getting a sexual health check is easy and painless, and most STIs are easily treated. Not all STIs show symptoms, or symptoms may be so mild that you don’t notice them; this means you could have an STI (and be passing it on to your sex partners) without knowing it.

STIs and HIV

For HIV-negative men, having an STI increases the risk of getting HIV because the cells of the immune system are attracted to the site of STIs, and it is these cells that HIV targets.

For HIV-positive men, STIs can increase levels of HIV in cum, pre-cum and rectal fluids. This makes passing on HIV more likely if you are fucking without a condom.

Also, an inflammatory STI (chlamydia or gonorrhoea) or an ulcerative STI (herpes or syphilis) increases the risk of passing on HIV because the virus is more concentrated at the site of infections.

HIV-positive men need to be particularly careful about STIs. This is because some STIs act differently in people with HIV, HIV makes some STIs more difficult to treat, and some STIs can accelerate the progress of HIV.

Getting tested

The more sex partners you have, the more often you should get a sexual health check. All gay men should get a sexual health check at least once a year, even if you only have one regular partner. You should get tested for HIV and STIs up to four times a year if you have sex without condoms, or if you have more than 10 sex partners in six months, or if you take part in group sex, or if you use recreational drugs during sex.

An STI test can be done regardless of whether you have symptoms. A rectal or throat swab will be taken to test for chlamydia and gonorrhoea. A swab looks like a long cotton bud. You will need to provide a urine sample to test for chlamydia and gonorrhoea in the urethra (your cock). A blood sample is taken to test for viruses including HIV, hepatitis A, B and C, and for syphilis, which is a bacterial infection. Your doctor should tell you what you are being tested for. Test results will usually take a few days to come back. You may need to make another appointment to receive these results in person, but many clinics now offer the option of receiving results by phone, SMS or email.

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