HIV (Human Immunodeficiency Virus) attacks your body’s immune system by invading your CD4 or T-cells, destroying them and then replicating itself. Left untreated, HIV may lead to an AIDS (Acquired Immune Deficiency Syndrome) diagnosis. A diagnosis is indicated by a CD4 cell count less than 200.
Men who have sex with men (MSM) are at an increased risk for HIV and other STIs/STDs. The only way to know your HIV status for sure is to get tested. Often the virus has no symptoms and left untreated, can cause serious damage to your immune system and to your health.
The CDC recommends that all sexually active gay and bisexual men get tested for HIV at least once a year. Men who have more than one sexual partner or who engage in casual sex should get tested every 3 to 6 months.
Testing positive for HIV can be overwhelming. The first step is to remember that HIV can be a manageable disease if treated. HIV medicines can’t cure HIV, but most men with HIV and who are in treatment are able to live full lives and enjoy good health.
Early treatment is vital, so you’ll want to see a health care provider as soon as possible. It’s recommended that you start medication as early as possible, but it begins with talking with a healthcare professional to do an HIV baseline evaluation. They’ll help you navigate next steps and to prescribe which medicines to take.
HIV service organizations also provide free case management services to help you navigate the healthcare system and link you into appropriate services to help you stay healthy. Please see our resource section for more information.
If you think you may have been exposed to HIV, you may be able to stop the infection by taking PEP (post-exposure prophylaxis). PEP is medicine that you can take if you are HIV-negative and you believe you have been exposed to HIV. If you take PEP as directed, it can stop the HIV virus from infecting your body. However, you need to take PEP as soon as possible after an exposure, ideally within 2-3 hours and must started within 72 hours.
Hospital emergency rooms should be able to start the PEP process. King County recommends Madison Clinic at Harborview Medical Center, 325 9th Ave, Seattle, WA 98104. Phone: (206) 744-5100.
PEP cost ranges from $600 to over $1000, but places like Harborview will assure you can get on PEP regardless of your ability to pay. Additionally, if you don’t have insurance, ask about drug assistance programs to help cover the cost.
If you think you may have been exposed during a sexual assault, go to the emergency room as soon as possible. Hospital staff can examine you for exposure and begin the PEP process.
There are a lot of reasons why MSM are at a higher risk. For one, the prevalence of HIV among MSM is 40 times that of sexual partners of heaterosexual men. Additionally, anal sex is biologically a higher risk for HIV acquisition than vaginal sex (as much as 18 times more risky!).
The CDC estimates that if current rates continue, the lifetime risk of gay and bisexual men getting HIV is 1 in 6. However, there are many more tools to help prevent the spread of HIV.
HIV is transmitted through these following bodily fluids: blood, semen, pre-seminal fluid, rectal fluid and breast milk.
Pre-exposure prophylaxis (or PrEP) can lower the chances of getting infected. It’s a combination of two HIV medicines (tenofovir and emtricitabine), sold under the name Truvada® (pronounced tru vá duh), which is approved for daily use as PrEP to help prevent an HIV-negative person from getting HIV from a sexual or injection-drug-using partner who’s positive. Studies have shown that PrEP is highly effective for preventing HIV if it is used as prescribed. PrEP is much less effective when it is not taken consistently.
Talk to your health care provider for more information.
No, you should not stop using condoms because you are taking PrEP. PrEP doesn’t give you any protection against other STDs or STIs, like gonorrhea and chlamydia. Also, while PrEP can significantly reduce your risk of HIV infection if taken daily, it doesn’t completely reduce your risk. Combining additional strategies like condom use with PrEP can reduce your risk even further.
If used the right way every time you have sex, condoms are highly effective in preventing HIV and some STDs you can get through body fluids, like gonorrhea and chlamydia. However, they provide less protection against STDs spread through skin-to-skin contact, like human papillomavirus or HPV (genital warts), genital herpes, and syphilis.
PrEP can cause side effects like nausea in some people, but these generally subside over time. No serious side effects have been observed, and these side effects aren’t life threatening. If you are taking PrEP, tell your healthcare provider about any side effects that are severe or do not go away.
Resources may be available that can help pay for PrEP. For example, Gilead’s Advancing Access Program. To see if you are eligible for this program provided by PrEP’s manufacturer call (855) 330-5479. Eligibility is based on income.
Additionally, both Medicaid and Medicare should cover PrEP.
PrEP is meant for HIV-negative individuals. Taken daily, the medicine in your bloodstream can help block HIV from taking hold and spreading through your body.
When taken every day, PrEP can reduce your chances of getting HIV by more than 90%. PrEP works best when it is combined with condoms and other ways to protect yourself from HIV.
You should not start and stop the PrEP medication based on when you think you will be exposed to HIV. Only people with a strong commitment to taking PrEP regularly should take the medication.