If you’re sexually active, it’s generally a good idea to get a full STI screen (including a HIV test) at least once a year. However some people may be more at risk of contracting HIV or other STIs, and therefore be advised to get tested more frequently.

For instance, gay men who are sexually active with casual partners are advised to get tested every three months if they’re having unprotected sex.

If you think you may have come into contact with HIV, you should visit a GUM clinic or speak to a doctor as soon as possible. They will arrange for you to be tested for the virus, but may also be able to issue post-exposure prophylaxis to help lower the chances of a possible infection developing.

In this post, we’ll discuss:

Why is testing for HIV so important?

HIV is a progressive illness, which can cause the immune system to become severely damaged and incapable of fighting off infections. The virus doesn’t really cause any characteristically distinct symptoms during the earlier stages of infection, so in previous years many people who have contracted the virus haven’t realised until it has become quite advanced.

Rash and flu-like symptoms are the most commonly experienced signs during the incubation period; but these symptoms can so often be caused by numerous other conditions that they do not always serve as a sign of a HIV infection.

It’s much easier to treat HIV and get the virus under control when it is diagnosed early; antiretroviral treatments can help to suppress the virus and stop it from progressing further. This is why detecting HIV early is so crucial, and the only way to know if you have it is to get tested.

What does HIV testing involve?

HIV testing is performed through serology, which is blood testing. This can be done through a needle and syringe in a GUM clinic, but there are also finger prick sample kits which enable people to get tested from home.

Saliva testing can also detect HIV, but this is thought to be less accurate than a blood test.

Why do certain groups need to get tested more often?

Some people are more at risk of getting HIV due to the type of sex they have, or who they’re having sex with. And it’s these groups of people for whom more regular testing is recommended (every 3 months).

Sexual intercourse is the most common route of HIV transmission. The virus can be passed on through semen, vaginal fluid or the blood. Oral sex is considered a low risk route, whereas unprotected vaginal sex carries a much higher risk, and unprotected anal sex is thought to be even higher.

This is partly because the lining and mucosa in the anus is more susceptible to the infection; but also because the likelihood of ruptured tissue, and in turn bleeding, is also higher during anal sex.

This is why men who have unprotected sex with men on a casual basis are advised to get tested more often.

Other people also at increased risk may be advised to get tested more often too. This includes:

  • people who practise ‘chemsex’ (having sex with one or more people while under the influence of drugs)
  • women who have unprotected sex with men who have unprotected sex with men
  • people who use injectable recreational drugs and share needles

Historically, HIV has been much more prevalent in developing African countries than it has been elsewhere. For this reason, African men and women, or people who have unprotected sex with people who have lived or spent time travelling in Africa (due to the disease being more prevalent in African countries) are also advised to get tested more regularly.

Your doctor or sexual health nurse will normally tell you if they think you should get tested for HIV more often.

Are HIV diagnoses rising or declining?

In the UK, new diagnoses among straight men and women have been in gradual decline since 2008. The number of new diagnoses among gay and bisexual men rose between 2008 and 2015, but then fell in 2016.

Between 2015 and 2016, the total number of diagnoses dropped by 18%, according to figures from Public Health England.  

Statistics showed that men who have sex with men and black African men and women were disproportionately affected. 54% of new diagnoses in 2016 were MSM, while 19% were in heterosexual men and 22% in heterosexual women; and only a quarter of heterosexual men and women diagnosed were white.

Charity Avert have suggested that awareness of how the virus is passed on could be decreasing (less than half of people when asked in a survey by the National AIDS Trust could correctly list all of the transmission and non-transmission routes).

Are there times outside these when someone should get tested?

Yes, if you think you may be (or have been) at risk. In addition to getting tested regularly, it’s a good idea to have an STI screen whenever you have had unprotected sex with someone whose sexual health status you don’t know. Further to this, if a sexual partner has told you they have been diagnosed with an STI, then you should get tested as soon as you can.