Why get screened and vaccinated?
Sexually Transmitted Infections (STIs) are found more frequently in men who have sex with men (MSM) than in other groups.
For example, MSM seen in the DSC Clinic are 25 times more likely to get infectious syphilis, 4 times more likely to get gonorrhoea and 1.5 times more likely to get chlamydia than other groups.
HIV is also more frequently found among MSM than in heterosexuals. Other viral STIs, like hepatitis A, hepatitis B and herpes, also affect MSM more frequently.
How are HIV and STIs related?
“Having an STI increases
the risk of catching HIV”
The inflammation caused by an STI (whether or not you have symptoms) increases your risk of getting HIV. If an ulcer (open sore) is present (from herpes or syphilis), the risk of catching HIV is even greater.
“Having an STI increases
the risk of transmitting HIV”
STIs increase the viral load and make it easier to pass on HIV to your sexual partners.
Furthermore if you are HIV positive and you catch an STI, the STI may have more severe effects on you, or can worsen the HIV infection.
Note: Having regular check-ups to monitor your HIV infection does not mean that an STI screen is also being done.
How often should I get tested?
We recommend a full STI and HIV screen at least once a year even if you have 1 regular sex partner. You should have screens every 3 to 6 months, if you:
• Have unprotected anal sex
• Have multiple sex partners
• Attend venues, such as saunas, where you have anonymous sex
• Use recreational drugs during sex
• Have partner(s) who engage in the above activities
How can I protect myself against STIs/HIV?
Use condoms every time you have sex.
Remember, although oral sex puts you at a low risk of getting infected by HIV, the risk of getting other STIs is still high, so use a condom for oral sex as well. In addition, have regular STI and HIV screens, know your HIV status, and get vaccinated against hepatitis A and B.
What does an STI screen involve?
An STI screen for MSM involves:
• Hepatitis A
• Hepatitis B
• Hepatitis C (if you are HIV positive or have ever injected recreational drugs)
• Herpes (HSV-1 and HSV-2) (depending on your symptoms)
*Even if you do not have receptive anal sex, that is, being the “bottom” partner, you can still get an STI in the rectum through other activities like rimming (oral-anal contact) and fingering. An anal swab is recommended even if you do not have anal sex.
Get vaccinated against hepatitis A and B if you are not immune. Once vaccinated, you no longer need to include them in your STI screens, and are protected lifelong.
What vaccinations are available for MSM?
Hepatitis A and hepatitis B vaccinations are strongly recommended for MSM.
HPV (Human Papillomavirus) vaccination is available. It is considered in MSM aged 26 years or younger, who have had few sex partners to date or those who have not yet become sexually active. Discuss with your doctor whether this vaccine is suitable for you.
What is hepatitis A and how is it passed?
Hepatitis A is a virus that infects the liver causing liver inflammation. It usually causes a mild to moderate illness, but can occasionally be severe.
You can get hepatitis A by getting small amounts of faeces in your mouth. This can happen through sexual activities such as:
• Touching used condoms or anal sex toys, then putting your fingers in your mouth.
• Finger-rectal sexual contact (fingering, fisting) then putting your fingers in your mouth.
• Oral-anal contact (rimming).
It can also be passed on by eating contaminated food or using eating utensils handled by an infected person.
How to prevent hepatitis A infection?
Unlike other STIs, condom use does not provide protection against hepatitis A.
Vaccination provides over 95% protection against hepatitis A.
What is hepatitis B and how is it passed?
Hepatitis B is a virus that infects the blood and liver, causing liver inflammation and long term liver disease. Occasionally it can be fatal by causing liver scarring (cirrhosis) or liver cancer.
It can be passed through contact with blood and bodily fluids through:
• Sexual intercourse with an infected person.
• Sharing contaminated needles when injecting drugs.
• Mother to child during pregnancy and delivery.
• Receiving contaminated blood products.
How to prevent hepatitis B infection?
Consistent condom use protects you against hepatitis B.
Vaccination provides more than 95% protection against hepatitis B.
What is HPV and how is it passed?
HPV (Human Papillomavirus or wart virus) is a viral STI that affects skin and mucous membranes.
There are many types of HPV.
“High-risk” types of HPV (including types 16 and 18) can, over long periods of time, cause cervical, penile and anal cancer.
“Low-risk” types of HPV (including types 6 and 11) cause visible genital and anal warts but are rarely associated with cancer.
HPV is spread through genital skin-to-skin contact. Sexual penetration is not necessary for infection.
Using condoms during sexual intercourse does reduce the risk of getting HPV but it is not 100% effective, since uncovered skin may still carry the virus, even if it appears normal.
How to prevent HPV infection?
Vaccines are available against 2 or 4 types of the virus and they consist of 3 injections, given over 6 months. These vaccines are the most helpful if you have not had many sexual partners.
What should I do if I have an STI?
If you think you have been exposed to the above infections or have had any type of sex with another man, visit the DSC Clinic for a sexual health screen.
Abstain from sex until you have completed treatment for an STI and advise sex partners to get tested and treated as well.
If you were diagnosed with gonorrhoea or chlamydia, get a repeat test after 3 months. Re-infection is common.
A specialised Men’s Clinic is also available at the DSC Clinic every Wednesday (8am to 11am). It provides confidential screening, treatment and consultation for MSM.
We have attempted to provide full, accurate and up to date information in this patient information leaflet, based on current medical evidence and opinion. However, information and advice may vary from different sources, and over time. If you have any further questions, see your doctor or healthcare provider.