HIV Positive Men and STIs

If you are HIV positive there are some extra things you need to know about STIs. Some STIs may adversely affect HIV while HIV can make the treatment of some STIs more difficult.

Some STIs can dramatically increase the HIV viral load (the amount of virus) in cum, pre-cum and anal mucus because the immune system is fighting both the HIV infection as well as the other STI. Your last test indicates what your viral load was at that time, not what it might be now and it only tests the amount of virus in your blood not your cum or other fluids. If you are HIV positive, an increased viral load means a greater risk to your health, and also makes passing on HIV more likely if you are having unprotected sex.

Having HIV and an STI can also make the STI more severe and more difficult to treat. It is also more likely that viral infections like herpes will recur more often than for an HIV-negative person.

Syphilis is more common in HIV-positive men. It can progress faster in people infected with HIV, is more difficult to treat, and is more likely to have neurological complications.

In the past, sexual activity was thought to be low risk for hepatitis C transmission. However, there is now an increasing number of cases occurring among gay men and other men who have sex with men (MSM), particularly among those men living with HIV.

Using condoms and water-based lube is the most effective way to prevent HIV transmission.

Condoms also offer some protection against a range of other STIs. They do this by preventing transfer of infected fluids or by covering infected sites. However, because STIs are transmitted in a variety of ways the protection condoms give is not complete.

Even if you show no symptoms, it is possible to have an STI and pass on the infection.

To reduce the impact of STIs on your health you can:

  • Get tested for syphilis every 3 months when you get your blood work done;
  • Have a full sexual health check regularly, at least every year and more frequently if you are having a lot of sex;
  • Get tested for hepatitis C once a year;
  • Get vaccinated for hepatitis A and B (hepatitis B antibody level should be tested yearly to check for the need for a booster), and speak to your doctor about the vaccination for HPV (see the Vaccinations section for more information); and
  • Use condoms to reduce the chances of picking up and passing on STIs.