On a daily basis I get maybe thirty or forty emails from people reading this column or people visiting my website. Some are asking for support, others asking questions about HIV, a few are even hate-mail (the crazies are everywhere) – and an alarming number telling me that they’ve never had a HIV and/or STI (Sexually Transmitted Infection) screening.
Of course I always handle these messages sensitively. I suggest that they should go and book themselves in for a full STI screening and even provide a link to the Terrence Higgins Trust website where they can pop in their
postcode and find a clinic near them. But the whole exchange often leaves me baffled and concerned. Many of these people are in their mid-to-late twenties – how they have got this far in life (presumably having sex along the way) and never having had a check up?
Is it simply a case of sticking their heads in the sand or is there something more going on here? Having spoken to some of them in more depth there’s definitely some ostrich like behaviour for sure, for some ignorance really is bliss, if you don’t know something is wrong then you don’t need to worry about it – but for others it’s a fear of the testing process itself, and this can only be due to lack of education around the topic.
Going for a STI screening really is not that big a deal. Honestly. I went for one only the other month (I go every six months – and so should you if you’re sexually active). Here’s what happened:
I arrived at the clinic at about 10am. I sat around watching Jeremy Kyle in the waiting room until I was called through by a doctor. They ask you a few simple questions:
Why’ve you come in today? “routine testing”,
Do you have any symptoms? “none”,
Any pre-existing conditions? “HIV-positive”.
After that I head back to the waiting room for a couple of minutes for a spot more Jezza (turns out he wasn’t the father). Then a nurse calls me through to one of the other rooms. She takes a couple of throat swabs (say “ahhhh”), a tiny swab from the end of my penis (it does pinch a little, but it doesn’t hurt), and a swab from my ass. Another nurse comes into to take a couple of vials of blood and then I’m given a little bottle to go put a urine sample in. I’m good to go. That’s it! takes about 45 minutes, one hour tops. They’ll text me any results in two weeks time.
(If I didn’t already know that I was HIV-Positive they would have also offered a HIV Rapid Test, which gives you a result in 15 minutes)
It’s incredibly important that each of us get regular STI screenings. Most sexual health charities recommend twice a year or more frequent if you’re more sexually active. Whilst you may not have any symptoms you may still carry any number of infections without even knowing it. I myself had absolutely none of the ‘flu-like’ symptoms often associated with HIV and only found out at one of my regular screenings.
Getting checked out doesn’t just mean that you’re looking after yourself, it means you’re showing respect and looking out for those who you sleep with – after all you’d hope anyone you slept with to have been checked recently, wouldn’t you?
So if you’ve never been checked out, or maybe it’s been far too long since your last test perhaps today’s good deed could be calling up your clinic and booking yourself in for a little MOT. Don’t know where your nearest one is – sorry, that’s no excuse. Head over to THT.org.uk and click ‘Sexual health’ to use their ‘Service Finder’ tool.
Well hello there,
This week I’m lucky enough to have a guest post from our favourite TV doctor and fellow Attitude columnist, the handsome Doctor Christian Jessen. In this post we won’t be discussing embarrassing bodies or healthy eating, but rather condoms – the simple tool for safer sex…
We all know that condoms offer us the best protection (98% effective when used properly) from both STIs (Sexually Transmitted Infections) and unwanted pregnancy, but are you sure that you’re using them correctly?
Don’t be so sure: a study of 1,400 teens by Southampton University found that 6% had put the condom on too late and another 6% took the condom off too soon.
Here are some simple DOs and DON’Ts to make sure you’re using your condoms properly:
- Only use approved latex or polyurethane condoms that bear the BS Kite mark.
- Make sure you have the right condom for YOU – just like penises they come in many sizes.
They can be measured for at home by you and ordered online to save any embarrassment.
- Check the date before you use it, out of date condoms become brittle and break.
- Make sure you have the condom the right way round BEFORE you apply it to the head of your penis.
- With one thumb and finger grip the tip of the condom to squeeze out any air, then use your other hand to roll the condom as far down as you can.
- Use a water or silicon based lube – this reduces friction and reduces risk of breaking the condom.
- If you’re having a long session consider taking a break and switching to a new condom.
- If you’re playing with more than one partner (lucky you) – use a different condom for each person. The same applies to sex toys, put on condom on them and change with every partner.
- Pull out whilst you’re still hard – making sure to hold the base of the condom.
- Throw it in the bin, don’t flush it.
- Don’t use an out of date condom – they can break more easily, and we don’t want that.
- Don’t bite condom wrappers open – you may damage the condom inside.
Remember that long nails can also cause damage to condoms.
- Don’t unroll the condom until you’re ready to roll it down and over your penis.
- Don’t use an oil based lube (this includes Vaseline and baby oil) – the oil weakens the condom and can lead to it failing.
- Don’t re-use a condom, this shouldn’t need saying but we’ll throw it in anyway.
- Don’t use two condoms at once – the friction between them can tear both condoms.
- Don’t use a condom and a female condom (or femidom) together for the same reason.
You can buy condoms at supermarkets, pharmacies and most convenience stores, if you’re too shy to do it in person why not order yourself some online from NHS Freedoms, and don’t forget that you can always pick some up for free from your local Sexual Health Clinic.
Doctor Christian Jessen
Currently 100,000 people are estimated to be living with HIV in the UK, but an estimated 25% of those are undiagnosed.
That’s 25,000 people who have HIV and don’t know about it! As we come to the end of HIV Testing Week in the UK and approach World AIDS Day 2012 I put some of your questions about getting tested and HIV to Dr Sebastian Winckler from DrEd.
1. Why is it so important to get tested for HIV?
Early testing is vital both for you, and for the people you’re sleeping with.
If you’ve got HIV and you’re getting treatment you can expect to live 40 years longer than someone who isn’t receiving treatment.
If you’re taking antiretroviral medication, you become less infectious to other people. Being aware of your status means you can start putting certain measure in place (such as safe sex)
to prevent transmission, as well as looking after your own health.
2. What stops some people from getting tested?
There are a lots of reasons why people avoid HIV tests, but usually it’s down to:
- The stigma surrounding HIV and AIDs: Despite advancements in treatment, in some communities there is still stigma about being HIV+, so many people feel embarrassed about getting tested. Remember, there is no shame in being HIV+.
- The inconvenience of testing: If you work during the day, it can be hard work finding the time to go.
- Fear: Some people are simply scared off getting a result they don’t want to hear. Remember though, it’s better to get tested and treated rather than making yourself, or others, ill.
3. Where can I get tested?
HIV tests are available free and confidentially from:
- Sexual health (GUM) clinics
- HIV testing centres (Terrence Higgins Trust Fastest centres, for example)
- LGBT Centres
- GP’s and family doctors
- HIV tests are available to buy from:
- Private clinics
- Online doctors services
4. I haven’t had any symptoms, so I probably don’t have HIV, right?
Wrong. Most people will experience a short, flu-like illness about 2- 6 weeks after being infected. This is your immune system putting up an initial fight against the virus and can last for up to a month. But, this can be easily mistaken for the flu and 20% of people don’t experience any symptoms at all.
After this has gone away, you are unlikely to notice any other symptoms for a long period of time. So the only way of knowing for sure is getting yourself tested.
5. Can a test pick up any HIV infection, regardless of when I’ve caught it?
No. A certain amount of genetic material needs to build up in your system before it can be accurately detected by a test. The time taken for this to happen is called the ‘window period’ and this is different for every test.
- The standard antibody (Ab) test will pick up HIV if you caught it more than 3 months ago.
- The combined antibody/ antigen test (4th Generation test) will pick up HIV if you caught it more than 6 weeks ago.
- The HIV PCR test will pick up HIV if you caught it more than 7-10 days ago.
In most cases, you will be given either the standard antibody or combined test. If you test negative for these, it doesn’t necessarily mean that you are HIV negative, because you might have been infected within the last 3 months (or 6 weeks). You are therefore advised to take a second test 3 months later for the all clear.
If you want a faster result you can pay for a PCR test. But these are only offered at some clinics and may cost up to £250.
6. I think I’ve caught HIV within the last few days, what do I do?
If you’re worried that you’ve contracted HIV very recently, as in, within the past 72 hours (3 days) then you should go to your local GUM clinic or A&E department and request emergency PEP treatment.
7. I’m afraid to get tested because I don’t like needles
HIV tests don’t have to be done via needle or syringe, some clinics use ‘Fastest’ Rapid Testing which simply takes a prick on the end of your finger. Other clinics may take oral swabs instead, this method is considered less effective than a blood test however, so some clinics won’t offer it.
8. How long do I have to wait for my results?
That depends on the clinic you go to. Most will contact you with your result (or ask you to come back in for it) within 3-5 days. If you take a rapid test your result will be ready within the hour. Some clinics can take up to 2 weeks however, don’t be afraid to ask when you should expect the results.
9. What happens if I test positive?
First off, a positive result doesn’t always mean you’re HIV+. There is a small margin of error, so all positive results must be followed up by a confirmation test.
If you do test positive for that, then the doctor or nurse who informs you of your result will set up a meeting with a specialist who can assess the stage of your infection and talk to you about relevant treatment options. You’ll be put in touch with local HIV support groups who can help you cope emotionally, and make you realise that a positive result is not the end.
Thirty years on and HIV is still a problem in the UK, but it is no longer a death sentence. There is help out there and the earlier you get tested, the better your prospects. Whatever you do, make sure you get tested this HIV Testing Week.
Some charities that can help:
A few days ago I had the pleasure to meet a lovely guy with whom I was lucky enough to spend the night. Before anything even started to happen he told me that he’d recently contracted HPV. I was incredibly impressed that a) he’d been so upfront/honest with me, and b) he’d managed to tell me before I’d told him my HIV status.
So we had a chat about our various issues, both starting and ending with H and ending in V but all in all quite different conditions. Although I thought I was quite clued up on Sexually Transmitted Infections (STIs) I really didn’t know all that much about HPV. He explained a little, as did I about HIV.
Yesterday, being the curious soul that I am, I decided to do a little research into HPV. I’ve heard it mentioned here and there, especially into vaccinating school girls but that’s about it. I did some googling, I spoke to a sexual health nurse and my HIV consultant and below are some of my findings.
- HPV (Human papillomavirus) is the virus responsible for warts.
- There are currently 120 known strains of the virus.
- HPV is the most commonly transmitted STI in the entire world, (second in the UK behind Chlamydia)
- Approximately 80% of the population will contract a genital strain of HPV in their lifetime, with the 20-24 year old age being the most prevalent, although most will not show symptoms.
- Condoms provide some protection, but not complete protection as they do not cover the entire genital area.
- The human body will clear most HPV infections within 2 years naturally.
- Worldwide 5.2% of all cancers can be traced back to the HPV virus (largely anal and cervical cancers)
I asked my consultant whether I should get vaccinated against HPV and he told me that I’d have to pay to have it done privately as I don’t fall under the current NHS vaccination remit – and that it’d likely be wasted money as he’d bet I’ve already been exposed to at least one strain in the past.
It’s amazing such a common virus, one that will reach approximately 80% of us at some point is so unknown isn’t it?
Just another reason to go get checked eh? For more information check out the NHS page on HPV
All the best,
When it comes to HIV there are a lot of medical terms bandied about, things like viral load, CD4, HART, ARV, advanced infection and resistance to name just a few, and if you (like me), are not a doctor these can initially be somewhat confusing. What I’m talking about today however is ‘Early Diagnosis’.
Early Diagnosis is just that, making a diagnosis of HIV in the early stages of the disease. Whilst there is no defined time scale for Early Diagnosis it’s widely taken to mean within a year of the initial infection.
What are the benefits to Early Detection?
- You can start receiving specialist care. Some people may not need treatment for years, others like myself, might start in a matter of months. But once you’re under the care of a HIV clinic their regular monitoring will make sure you stay in tip top condition and recommend treatment to you - when it’s appropriate.
- You’ll live longer. Studies have shown that the earlier you’re diagnosed the longer you’ll live. Things have come on in leaps and bounds in the last 30 years and someone diagnosed in their twenties will now live until their mid-seventies, and that’s without any advances in care that happen in the meantime.
- You can protect others. Knowledge is power. By knowing that you’re HIV+ you can inform past sexual partners that may have been at risk, and make more informed and responsible decisions with any future partners. Modern treatment can also reduce the risk of passing on the infection by upto 96%.
What are the challenges to Early Detection initiatives?
- Ignorance. Many people believe that they’ll know if/when they have HIV through symptoms such as a flu, or a rash. However, many people who contract HIV, myself included, show no symptoms at all, and even if they do experience flu like symptoms they may think it’s just the flu and nothing more serious.
- Fear. The idea that you may have HIV isn’t a nice one, in fact for most people it’s down right terrifying. This leads to people burying their heads in the sand and putting off testing. Other people are put off because they’re afraid of the tests themselves, when in fact most HIV testing is done in minutes with a simple prick test.
- Denial. I didn’t think I’d ever get HIV. I’m in my twenties, I was look after myself, HIV doesn’t happen to people like me does it? Wrong. HIV can happen to anyone, and at any time.
So, what next?
- Inform the masses. HIV awareness campaigns tend to be limited to niche publications, such as the gay press. I think there’s a pressing need for a national campaign, both in print and on TV, but unlike the adverts of the 80′s we need to inform, teach and encourage to test rather than shock and scare.
- Fight the stigma. There is still a lot of stigma surrounding people living with HIV, again this is firmly rooted in the 80′s where HIV and AIDS was portrayed as a dirty disease that affected dirty deviant people. We need to show that HIV affects people from all walks of life, and can be contracted in any manner of ways.
- Encourage testing. Through these new campagins, both nationally and targetted at specific communities, we need to encourage regular testing. Let people know that it takes only a few minutes, doesn’t involve needles and is free of charge.
Please, if you can, donate to one of the HIV charities and help them raise awareness and provide services. Consider reblogging/retweeting/facebooking/sharing this blog post to your followers and friends to do your part to raise awareness about the benefits of Early Detection. It only takes one click and could positively impact on any number of lives.
Love and respect,
Since I started this blog and my Twitter account a couple of months ago I have been inundated with messages, comments and tweets from people asking me questions about HIV, and whilst I’m by no means an expert I always endeavour to answer them to the best of my ability – and where I can’t I’ll refer them to one of the authoritative websites (like NAM, or THT). Some of the questions are from genuinely curious people, asking how it affects my day to day life, what treatment programme I’m on or how I’m coping with it – to name just a few.
Other questions I get asked, however, are far more worrying. Today, for example, I was asked in an email:
“How do I know if I have HIV? What are the symptoms?”.
The only way to tell whether you’re HIV+ (that means you have contracted the HIV virus) is to GET TESTED.
Yes it can be nerve-wracking going to get tested, we’ve all been there “Oh I’ll do it next week, next month, oh I’m busy then, I’ll do it next month” – putting it off and off, but all you’re doing is making it more difficult to eventually go and find out. Using modern ‘FasTEST’ testing kits you can have your results in as little as 15 minutes and no needles. Just a tiny prick on the finger and that’s it.
With early diagnosis and proper treatment you can live just as long and just as well as anyone else. I’ve received amazing care and support, both from the NHS and the THT, and I’m looking forward to living into my old age with some handsome man.
I urge everyone who reads this, who isn’t HIV+ or hasn’t been tested recently, GO AND GET TESTED THIS WEEK. Maybe you’re looking for an easy to do New Year’s Resolution? This one will take just 15 minutes of your time and could save your life, and save the lives of those you love and/or play with.
There are centres up and down the country, in big cities, little towns, gay centres, NHS centres, charity centres – you could even do it on your lunch break or on the way home from work. Use the THT Clinic Finder to find your nearest clinic and carry through on your new resolution.
Love and best wishes,