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HIV and STIs

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What does a trans man need to know?

  1. Trans risks
  2. Trans and positive
  3. Clinics

Trans risks

Whether or not you’ve had lower surgery, the basic information about safer sex is pretty much the same: use a barrier such as a condom or a Femidom along with water-based lube.

More about lowering your risk.

More about sex for trans men.

Some sexually transmitted infections (STIs) such as genital warts and herpes are passed on through close skin contact, so a condom won’t necessarily protect you against these infections.

More information about STIs.


Trans men and HIV

It's easier to acquire or pass on HIV if you have another sexually transmitted infection.

If you've recently had lower surgery and have unhealed skin, this could also make it easier for you to acquire or pass on HIV, as bleeding can provide a route into or out of your body.


Risks of unprescribed hormones

If you inject yourself with unprescribed hormones , do not share needles as HIV and hepatitis C can be passed on through blood. 

More information about HIV.

Trans and positive

Here are some things you need to know if you're an HIV positive trans man.


Antiretrovirals and hormones

If you're living with HIV, the antiretroviral treatment you receive will be tailored so that it can be taken safely alongside your hormone treatment.

Antiretrovirals may alter the hormone levels in your body, so it's important that your HIV healthcare team knows about any hormones you're taking (including any that are unprescribed) as well as the quantities.

Existing research on drug interactions in women taking both the contraceptive pill and antiretrovirals has helped medics advise trans women on the likely interactions between oestrogen therapy and antiretrovirals. There has not, however, been equivalent research carried out to look at drug interactions in trans men who are taking testosterone and antiretrovirals.

Currently it seems that most antiretrovirals appear not to be affected by hormones.


Stopping HIV treatment

If you stop taking your antiretrovirals or change the amount of testosterone you take you must tell your healthcare team. Remember, it's very important to have your testosterone levels monitored.


Body fat changes

If you're taking antiretrovirals, you may be concerned about body fat changes. Although this is linked to older antiretrovirals, it still happens sometimes - it's important to go to your HIV doctor if you notice any signs of this or any other side effects.


Taking unprescribed hormones

If you're taking any hormones which have not been prescribed by a doctor, be sure to tell your HIV doctor. It’s very important that they know about this as it may affect the antiretroviral treatment you take.


Monitoring your hormone levels

Make sure you go to have your hormones levels monitored. This is important for all transmen but if you're taking antiretrovirals it's especially important.


Support for HIV positive trans men:

At the time of writing there are no specific support groups for trans men who are living with HIV. See the Help tab of our wellbeing page for trans men’s support.

i-Base also have a useful Q and A page for trans people who are living with HIV.

You can access support, counselling, community forums and all manner of other services if you're HIV positive in myHIV.

Clinics

If you're sexually active, it's advisable to go to a sexual health clinic for regular check-ups because some infections don’t have symptoms. The clinics provide a free, confidential service including:

  • Testing for different infections.
  • Providing treatment - usually having the medication on site so you don't have to take a prescription elsewhere.
  • Free condoms and lube.
  • Advice and information, including details of other services if you need them.

When going to a clinic you'll be given a registration form to complete. You may be asked if you have any symptoms. You don’t have to tell the receptionist that you're trans - you can wait to tell the clinician this in private.


Examinations

Some clinics have gender-specific waiting and treatment rooms and they might not have the equipment needed to do all the necessary tests in a ‘male’ treatment room. If concerned, call the clinic beforehand to discuss their facilities and your requirements. You can also have someone come with you, and ask to see a male or female clinician.

When you see the clinician treating you, it's a good idea to discuss any genital surgeries and the sex you've been having, as this will affect what samples are taken. It’s best to be completely honest so that they can give you the best care.

During your examination, the clinician may want to take some swabs from your throat, rectum and genitals, including the inside of the vagina if you still have one. Vaginal swabs are usually done using a speculum. Some clinics now allow you to take some swabs yourself. You may be offered blood tests to check for infections such as HIV, hepatitis or syphilis. You'll be told how to get all the results and how long it will take to receive them (which can vary from straight away to a few weeks).


Being treated with respect

It’s important that all the staff in the clinic treat you with dignity and respect. If you feel at any time that this hasn’t happened, it may be worth making a complaint or talking to the Patient Advice and Liaison Service (PALS) at the hospital.

Some areas have sexual health clinics for trans people. Contact THT Direct to find out what’s available where you live.

If you live in London there's a sexual health clinic which is just for trans people, their partners, friends, and family:

cliniQ
56 Dean Street Soho

There's also a clinic for trans people in Brighton - it's called Clinic T.

 

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The Information Standard: Certified member

This article was last reviewed on 24/3/2015 by Anna Peters

Date due for the next review: 24/3/2018

Content Author: Aedan Walton

Current Owner: Michelle Ross

More information:

Nam, Aidsmap.How the immune system works. 2012

Nam, Aidsmap. Overview of HIV and the immune system. 2012

Nam, Aidsmap. The basics. HIV and the immune system. 2012 

Nam, Aidsmap. How transmission occurs. 2012

Nam, Aidsmap. Body fluids. 2012

Nam, Aidsmap. Many patients diagnosed with HIV today will have normal life expectancies, European studies find. 22/2/10

Nam, Aidsmap. HIV treatment. 17/2/12

Nam, Aidsmap. Safer drug use. 2012 

NHS Choices. Death shows risk of illegal sillicone jabs. 10/2/11 

Nam, Aidsmap. HIV and sex booklet

Transgender people, hormonal therapy, and HIV treatment interaction. Darby Hickey. Published in GMHC Treatment Issues, December 2008. 

The Body. Transgender Health and HIV. Kimberly Keller, M.Sc. From San Francisco AIDS Foundation. Summer/Fall 2009

The Body. Transgender Therapy and HIV. Two complicated conditions rolled into one. Enid Vazquez
From Test Positively Aware Network 
July/August 2008

The Body. An Interview With Walter Bockting, Ph.D. A Leading Expert on HIV in the Transgender Community Explains Why There's More Work to Be Done. By Jeff Berry from Test Positive Aware Network. July/August 2008.

Nam, Aidsmap. HIV and sex booklet. 2011  

Can't pass it on

People on effective treatment can't pass on HIV

If everyone knew this, we could bring an end to stigma and stop HIV transmissions.

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Condoms

The easiest and most effective precaution to take against most STIs is using a condom.