HIV and STIs

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.

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.

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

Antiretrovirals and hormones

If you are 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 is important that your HIV healthcare team knows about any hormones you are 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 transmen 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 is important to have your testosterone levels monitored.

Body fat changes

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

Unprescribed hormones

If you are 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

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

Support

At the time of writing there are no specific support groups for transmen who are living with HIV. See our support and counselling page for transmen’s support.

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

Going to a sexual health clinic can be unnerving for anyone and it may be particularly difficult for trans people. But if you think you have a sexually transmitted infection (STI) it is important to get it diagnosed and treated.

You may feel awkward talking to staff about your sexual health, but you will need to let them know your history so that they can diagnose you correctly, especially if you need an examination. It may be helpful to let the doctors and nurses looking after you know how you would like to be addressed.

When you arrive at the clinic, you may find there is a male and female waiting room. It’s important that you feel comfortable sitting in the female area. When you arrive you will have to speak to the receptionist and fill in some details – you could mention your history on the form so that the doctor is able to treat you correctly. However, if you prefer, you can wait until you are in your consultation with the clinician to disclose.

You may feel awkward talking to staff about your sexual health, but you will need to let them know your history so that they can diagnose you correctly, especially if you need an examination. It may be helpful to let the doctors and nurses looking after you know how you would like to be addressed.

Examinations

It might be necessary for the nurse or doctor to examine your genital area to diagnose you, or they may need to take swabs. This may be a distressing prospect for you. If this is the case try to discuss your feelings with the person treating you.

It might be possible for you to take the swabs yourself, or the doctor might decide an examination isn’t necessary. It could be that they will need to examine you - this may be the only way to get the correct treatment for your symptoms.

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 is a sexual health clinic in which is just for trans people, their partners, friends, and family:

cliniQ
56 Dean Street Soho