Yosef Azad asks the questions
In recent years a lot has changed in HIV testing. You no longer have to go to a sexual health clinic to get a test. You can also get tested in the community and by some GPs. You also no longer have to wait days for a result, in a couple of minutes you can know your status. Laboratory tests are better at diagnosing recent infection – you can get a reliable result from a blood sample from four weeks after possible risk, not three months as before. And ‘home sampling’ kits have been around for a few years now. These allow you to take a blood spot or saliva sample in the privacy of your own home (or wherever ..), you send it off – and are told the result over the phone or in person. They are proving popular with many gay men and there are a good number of HIV-positive results, showing this is an effective way to reach people who have undiagnosed HIV.
But for many years there have also been self-testing kits available online from overseas where you take the sample yourself and then see the result immediately – a bit like a pregnancy test. They have been illegal, unregulated, and as a result with no guarantee as to their accuracy. The Government has, will live on average ten years less than someone diagnosed in good time who starts treatment when recommended.
Gay men are advised to test at least once a year but only 15% do according to Public Health England. And for men with many partners or who are not always using condoms, the recommendation is to test every three months. Three months? Not so easy to t that in: self-testing could mean more people test and more people are diagnosed. This not only benefits the individual with HIV as you’ll get treatment as soon as it’s needed – crucially it can help ensure you don’t spread HIV to your sexual partners (and some guys have a lot of them!…) in the weeks and months immediately after you got it when you are extremely infectious.
How reliable are the results? As I’ve said, with the self-tests there is a ‘window period’ of three months immediately after infection when the test will not pick HIV up – but once this period is passed, the self-tests are extremely good at detecting HIV with no false negative results. So if the test says you don’t have HIV, then you don’t have it.
There will however be a small percentage of false positives – that is why we don’t talk about ‘positive’ results for these tests but rather ‘reactive’. If you have a reactive result you need a confirmatory test at a sexual health clinic. It’s possible the self-test is wrong.
Will gay men get a reactive result but then do nothing about it? Possibly – though that could happen with an anonymous test in a sexual health clinic. Hopefully, most gay men are aware of the very effective HIV treatments, which are easy to take and for most people very tolerable, which means you can live a normal active lifespan with HIV if you are diagnosed in good time.
A self-test will not be for everyone. Some may need more support when they find out their result. If you don’t want to get a result by yourself, don’t use the self-test, go to a sexual health clinic instead. However, we all like choice. Expanding the ways we can test and making it as easy as possible, can only be a good thing.
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Testing & Treatment is by far the best way of managing your sexual health, for sexually active adults the recommendation would be to get tested every 3 months, but as a minimum you should get tested once a year. Find out more:
Testing in London – https://shl.uk
Testing in England – https://www.nhs.uk/service-search/sexual-health/find-a-sexual-health-clinic
Testing in Wales – https://111.wales.nhs.uk/localservices/?pc=n&s=SexualHealth&sort=default
Testing in Scotland – https://www.sexualhealthscotland.co.uk/get-help/sexual-health-service-finder
Testing in Northern Ireland – https://www.sexualhealthni.info/genitourinary-medicine-gum-clinics
MonkeyPox in 2022 over 2000 cases of MonkeyPox was confirmed in gay man. The outbreak was cantered on London. It’s usually a mild illness that settles on its own, but it can sometimes become more serious.
Find out more – https://mpx.shl.uk/
Get Vaccinated – https://www.nhs.uk/conditions/mpox/find-a-mpox-vaccination-site/
PrEP stands for Pre-Exposure Prophylaxis, in simple terms, its a pill that when taken correctly; by somebody who does not have HIV; is effective in stopping HIV transmission.