People living with HIV
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- Some people living with human immunodeficiency virus (HIV) may be at higher risk of other sexually transmitted infections (STIs)
- Undetectable equals untransmittable: people who take antiretroviral therapy for HIV daily as prescribed, and who achieve and maintain an undetectable viral load, cannot sexually transmit the virus to an HIV-negative partner. Treatment should be initiated as soon as possible after diagnosis
- Men who have sex with men should be tested for STIs every 3 months, and other people living with HIV annually, although patients who are not sexually active may be tested less frequently
- Hepatitis B, hepatitis C and herpes co-infection are common among people living with HIV
|
Testing | ||
|---|---|---|
|
Site/specimen |
Test |
Consideration |
|
First pass urine or self-collected vaginal swab |
NAAT/PCR gonorrhoea/chlamydia |
Self-collected vaginal swab or clinician-collected endocervical swab (during clinically indicated examination) are more sensitive |
|
Men who have sex with men: oropharyngeal swab and self-collected anorectal swab | ||
|
Blood |
At each clinical blood draw | |
|
Yearly in men who have sex with men and people who inject drugs | ||
|
Hepatitis A antibody |
Vaccinate if antibody negative Test if not vaccinated and to confirm antibody response | |
|
Hepatitis B |
Test if not vaccinated and for antibody response. Vaccinate if no history or no documentation of full vaccination course. | |
NAAT – nucleic acid amplification test
Anti-HBs – Hepatitis B surface antibody
Specimen collection guidance
Clinician collected | Self-collection
Clinical indicators for testing
Special considerations
- Local support, through a sexual health clinic, is available
- Women with HIV should be offered 3-yearly cervical screening test
- Contraception in women with HIV
Even if all test results are negative, use the opportunity to:
- Educate about condom use, contraception, HIV PrEP/PEP, safe injecting practices, consent, CST and vaccinations for HAV, HBV and HPV as indicated.
- Vaccinate for hepatitis A and B, if susceptible
- Discuss and activate reminders for regular testing according to risk
- 100% of people living with HIV should have evidence of baseline serology for hepatitis A, hepatitis B, hepatitis C and syphilis in records
- 100% sexually active people living with HIV are offered STI testing at least annually
