Here at Ending HIV we get a lot of questions about sexual health. So, we’ve compiled the most frequently asked questions from the community.
If you can’t find what you’re looking for, you can ask us and one of our staff will get back to you.
Before reaching out to us, please read the below:
Ending HIV is a sexual health campaign for gay, bisexual and other guys who have sex with guys, based in NSW, Australia. As such, we prioritise questions received in relation to these communities. If you are living overseas or in another state, there may be limits to the support we can provide. While our peers are highly knowledgeable, they can’t give specific medical advice. Whatever your concern, always seek the advice of a doctor or trained medical professional you trust.
Contact the NSW Sexual Health InfoLink
The NSW Sexual Health InfoLink is an anonymous and nonjudgmental information service for the NSW general public. You can call on 1800 451 624 to speak with a sexual health nurse or visit their website here.
Contact the PEP Hotline
If you think you’ve been exposed to HIV in the past 72 hours, then should consider taking post-exposure prophylaxis (PEP); a 4-week course of HIV treatment that a person can take after they have been possibly exposed to HIV to prevent an infection.
Find out if you are eligible for PEP and where you can access it near you by calling the PEP hotline on 1800 737 669.
Contact ACON for general enquiries
Here at Ending HIV we get a lot of questions about sexual health. So, we’ve compiled the most frequently asked questions from the community.
I’m experiencing symptoms that I think might be HIV or an STI, what should I do?
If you have been sexually active and are experiencing symptoms such as discharge, pus, soreness or pain coming from the area of your genitals or rectum then you may have an STI. But the best way to be sure is to get tested.
You can visit a sexual health clinic or doctor/GP. Some sexual health services such as a[TEST] only offer asymptomatic screening, which means they will be unable to see you if you are experiencing symptoms, so be sure to check in advance that the service is right for you.
Is my HIV testing result accurate?
Modern HIV testing methods are highly accurate, and HIV tests conducted in healthcare settings should be considered reliable.
To make sure your testing result is conclusive, you will need to be aware of and test outside of the HIV window period. Most people who’ve had unprotected exposure to HIV will test positive within 1 month after exposure, but a small number of people may take up to 3 months. This time between HIV exposure and when HIV is detected by a test is known as the window period. If you have tested negative within this 3-month period, you will need to test again to confirm your result.
If you test negative at 3 months after your potential exposure to HIV, it will almost always mean you do not have HIV, given there has been no other risk of transmission in that time.
How much does it cost to get tested?
All public sexual health clinics across NSW are free of charge to attend and are usually also able to provide testing and treatment at no cost. Similarly, there are some self-testing services such as you[TEST] and Dried Blood Spot testing that are also free.
Seeing a doctor/GP in other settings for sexual health testing may incur a charge for the consult, pathology (performing the tests) and treatment, depending on if you have Medicare and if the service bulk bills.
We encourage you to check ahead of your consult to make sure you aren’t surprised with a bill.
Is testing for HIV and STIs confidential?
In NSW and Australia, the law requires all consultations with doctors and health professionals to be confidential, including sexual health testing. Though, there are rare situations where they may be required under law to report information if they have concerns around yours or someone else’s safety, for example if someone is at risk of harm. You can find information around confidentiality of sexual health testing on NSW Health’s website here.
If you live in other parts of the world, we recommend doing research into local laws around confidentiality and privacy.
What is the HIV window period?
The HIV window period is the time between infection and when the virus can be reliably detected from a test. It takes time for HIV to be detected in the body by a test, and while most people who’ve had unprotected exposure to HIV will test positive within 1 month after exposure, a small number of people may take up to 3 months.
Read more about HIV and the window period here.
What should I do if I test positive?
It can be a difficult time after a HIV diagnosis. We encourage reaching out and speaking to a counsellor who may be equipped to help you through this period and provide you with resources, support and information about what it means to be living with HIV today.
If you are living in NSW, you can access our specialist counselling service at ACON or consider connecting with a peer service like a[START]x that puts you in touch with other HIV positive people. This enables you to meet others who have the experience of living with HIV and who understand what you are going through.
If you are living outside of NSW, connect with a local service such as an AIDS council or HIV Positive organisation who may be able to provide support.
Can I get HIV from oral sex?
Oral sex is very low risk for HIV transmission. This risk can increase if there is ejaculation in the mouth and cuts and sores are present, though this risk is still considered low.
Read more about the risk of HIV from oral sex here.
My partner says he’s ‘undetectable’, can he still give me HIV?
If someone living with HIV is “undetectable”, it means they have achieved an undetectable viral load (UVL) and suppressed the virus in their body. When a person living with HIV has an undetectable viral load, it is not possible for them to pass on the virus to their HIV negative sexual partners. This is because there is not enough of the virus in their system for it to be transmitted. Undetectable viral load is one of the most effective HIV prevention strategies, along with condoms and pre-exposure prophylaxis (PrEP).
Read about undetectable viral load and the studies that support its effectiveness here.
What is the risk of HIV from mutual masturbation?
The risk of HIV being transmitted through mutual masturbation or a hand job is zero. However, the transmission of other STIs can be different.
For HIV to be transmitted, it requires the bodily fluids (ie blood, semen, front hole or vaginal fluids, anal fluids or breast milk) from a HIV positive person who is not on treatment and does not have an undetectable viral load to enter the bloodstream of a HIV negative person. Often, this is through unprotected penetrative sex or sharing injecting equipment.
Read more about HIV and how it’s transmitted here.
Is spit OK to use as lube?
Spit and saliva are not a recommended as a substitute for lube. Compared to purpose-made lubricants, it dries out quickly during anal sex and can make it easier for friction to build up which can cause tears in the anal lining.
Find out more about the benefits of water-based, silicone-based and hybrid lubes here.
I think I’ve recently been exposed to HIV, what can I do?
If you think you’ve recently been exposed to HIV then you should consider accessing post-exposure prophylaxis (PEP). PEP is a 4-week course of HIV treatment that a person can take after they have been possibly exposed to HIV to prevent an infection. For PEP to be effective, it must be taken within 72 hours of the possible exposure. You can get PEP from sexual health clinics and hospital accident and emergency departments. If you are in NSW, you can find the nearest location to you by contacting the NSW PEP Hotline on 1800 737 669 (1800 PEP NOW) or visit the Get PEP website.
If more than 72 hours has passed, we’d encourage you to get tested with a sexual health service or doctor/GP to discuss your options
Where can I get PrEP?
There are a range of ways you can access PrEP in Australia.
For those with Medicare, PrEP is available at a subsidised rate through the Pharmaceutical Benefits Scheme (PBS). To get PrEP, you need to visit your doctor/GP or a sexual health clinic, where they will ask you some questions to determine your eligibility. If PrEP is right for you, they will give you a prescription and you will be able to collect PrEP from a pharmacy near you. There are also online pharmacies and community organisations such as PrEP Access Now that may offer other cost-effective options.
If you are not Medicare-eligible, you can legally import PrEP to Australia, often at a comparable price.
You will still need a prescription from your doctor/GP, then you can visit PrEP Access Now to find a range of different importation options.
What is the difference between PrEP and PEP?
PrEP (or pre-exposure prophylaxis) is a HIV prevention method where a HIV negative person takes HIV medication prior to potential HIV exposure to prevent infection. This can be taken daily, on-demand or on a periodic basis, depending how they identify, preferences and the type of sex they have. Learn more about PrEP here.
PEP (or post-exposure prophylaxis) is a month-long course of HIV medication that, if started within 72 hours after a potential exposure, can prevent a HIV infection. Read more about PEP here.
I forgot to take my PrEP dose, what do I do?
Depending on your circumstances, you may either be able to simply restart your PrEP schedule or you should seek medical advice.
For example, if you have been taking PrEP daily for the minimum period required to achieve optimal protection and have only missed one dose, then you should be afforded a good level of protection by the drug that is already in your system. In most cases, you can restart your daily dosing schedule to ensure continuous protection, however discussing the circumstances with your doctor/GP is advised.
If you were taking PrEP on-demand or if you’ve more recently started PrEP, then you might be at a higher risk, and should seek medical advice as soon as possible. If you can’t get in contact with your prescribing doctor, you can speak with a sexual health nurse on the NSW Sexual Health InfoLink on 1800 451 624 (Monday to Friday 9 AM to 5:30 PM), or outside of those hours you can contact the PEP Helpline on 1800 737 669 (24 hours) to determine your level of risk and whether starting a course of PEP will be necessary.
Read more about what to do if you’ve missed a dose of PrEP here.
If I take a break from PrEP, and then restart, how long do I have to wait until I’m protected?
Depending on how you identify, restarting PrEP and achieving optimal protection will vary.
If you are a cisgender man, you will need to take 2 pills (a double dose) between 2 and 24 hours before sex and then continue taking a pill every 24 hours after that double dose. If you are a trans man who only has receptive anal sex, you can follow this same method, however it is advised to discuss this with your doctor/GP.
For trans men who have all other types of sex (such as frontal sex), you will need to take 1 pill every day for 7 days before you have sex to achieve optimal protection, and then continue taking a pill every 24 hours after that.
Any time you decide to change your PrEP regime, it’s good to keep your prescribing doctor/GP involved so they can ensure any necessary testing is administered and provide you with any additional advice on starting and stopping.
Read our guide on restarting PrEP and what to do beyond your first dose here.
My pharmacy doesn’t have my usual brand of PrEP in stock, is a different brand just as effective?
There are several brands of the drug PrEP (Tenofovir Emtracitabine) available, and while you may be more familiar with brand names such as ‘Truvada’, they are all just as effective at preventing HIV.
All PrEP purchased through a pharmacy in Australia will be compliant with the strict guidelines for medicines as regulated by Therapeutic Goods Administration (TGA). PrEP purchased from recommended websites through the personal importation scheme will also go through similar checks.
You can find more information on what to look out for on PrEP Access Now’s ‘Buy PrEP Online’ page.
What are the side-effects of PrEP?
Some people who start PrEP may experience some side effects, though most won’t. Side effects can include:
- Dizziness and headaches
- Stomach cramps
Usually, these stop after a few weeks. But if you are on PrEP and these side effects last longer, talk to your doctor. Longer-term side effects are very rare but possible, so it is important to adhere to regular check-ups with your doctor. Read more about possible side effects here.
Can I drink alcohol while on treatment?
Some HIV medications can affect your tolerance to alcohol. However, their effectiveness is not generally affected by consuming alcohol. Consuming alcohol may affect your adherence to treatment where you might forget to take your medication consistently. If you have concerns around the interaction alcohol has with your medication or its impacts on your adherence to your treatment regimen, we recommend discussing options with your doctor.
What is the cost of HIV treatment in NSW?
The good news, for people living with HIV in NSW, is regardless of your Medicare status, you can now access HIV treatment without cost.
People with Medicare will be able to access the medication for free, through the s100 co-payment waiver, which will be completed with their doctor at the time they have their medication prescribed. With the signed waiver and their prescription, they’ll then be able to attend any local pharmacy to have their medication dispensed.
People without Medicare will need to access treatment through a public hospital-based pharmacy to avoid incurring any costs.
What is "U=U"?
U=U stands for “Undetectable equals Untransmittable” and refers to science behind people who are living with HIV who take antiretroviral medication and achieve an undetectable viral load. Someone with an undetectable viral load cannot transmit the virus to an HIV negative partner. Read more about undetectable viral load here.
Do HIV treatments have bad side effects?
In the very early days of the HIV epidemic, treatments often caused severe and debilitating side effects. Today, with a wide range of new and improved medicines, treatment is far less toxic, has a much lower risk of side effects and is better at controlling HIV. If you are on HIV treatment and find it is causing side effects, talk to your doctor to discuss alternatives you could try.
What is HIV?
HIV stands for Human Immunodeficiency Virus. HIV weakens the immune system, which is our defence system against disease and infection. When the immune system becomes severely weakened by HIV, it can lead to AIDS (Acquired Immune Deficiency Syndrome), making the body more susceptible to other infections and cancers.
HIV predominantly exists in bodily fluids such as blood, semen, anal fluids, front hole fluids and breast milk and can be transmitted if one of these fluids from someone living with HIV enters another person’s bloodstream.
Read more about HIV here.
What are the common symptoms of HIV?
Symptoms of HIV vary from one person to another, and if you experience symptoms, you’ll usually experience them in the first 1-2 months after transmission. Many people, though not all, will experience severe flu-like symptoms including:
– Fatigue and headache
– Swollen lymph nodes, achy muscles, and joint pain
– Skin rash
– Nausea, vomiting and diarrhoea
– Sore throat and dry cough
– Night sweats
Considering many of these symptoms can be confused with other forms of illness, or you may not even experience symptoms at all, the only reliable way to know your HIV status is to get tested.
Read more about the symptoms of HIV here.