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Pozitively Healthy: A Gay Man's Guide to Sex and Health in Canada


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STI Information for HIV Positive Guys

Sexually transmitted infections (STIs) can affect your health. But there are things you can do to protect your health. Some people use the term "sexually transmitted disease" rather than "sexually transmitted infection" -- each term means the same thing.

The Bare Essentials About STIs

Be practical but not paranoid about STIs and your health. Speak with your doctor about making STI testing a regular part of your health care. Information on STIs is available from many sources -- some sources are listed at the end of this guide.

The most common STIs include:

  • Chlamydia
  • Gonorrhea
  • Syphilis
  • Parasites in the gut or stomach
  • Genital herpes
  • Warts on the ass hole, inside the ass or on the cock (caused by the human papilloma virus, known as HPV)
  • Hepatitis A, B and C.

Most STIs can be treated and cured with common antibiotic medications.

Genital herpes is different. Herpes sores and blisters can be treated with medication. But the viruses that cause herpes stay in your body. These viruses can cause flare-ups of herpes blisters and sores from time-to-time.

Hepatitis C and warts caused by HPV are also different.

Special Information for HIV Positive Guys

HIV positive guys don't get chlamydia or gonorrhea any easier than HIV negative guys. And the treatment for chlamydia and gonorrhea -- antibiotic pills -- is the same whether you have HIV or not. But HIV positive guys (compared to guys without HIV) may:

  • Have to take three times the normal dose of antibiotics to cure early stage syphilis.
  • Have more frequent or severe outbreaks of genital herpes.
  • Suffer more significant damage to the liver when they are infected with the virus that causes hepatitis C disease. And it can be harder to treat hepatitis C disease in people who have HIV.
  • Be more likely to get anal cancer from HPV.

If you have an STI that has not been cured it is easier for you to pass HIV to your partner during unprotected sex. This is true even if all your symptoms are gone. Just because your symptoms are gone it doesn't mean the STI is cured.

HPV, Anal Warts and Anal Cancer

HPV means human papilloma virus. HPV is spread through skin-to-skin contact and can cause warts. These warts appear most often on the ass hole, inside the ass or on the cock. They usually look like tiny cauliflowers. These warts can be treated. But HPV can stay in your body. So even after the warts are treated they can re-appear in the same place, or appear in another place.

Certain types of HPV infections inside the ass can eventually lead to anal cancer. Compared to other people, HIV positive gay men have a higher risk of developing anal cancer. However, even if you have anal warts you will not necessarily get anal cancer.

Your doctor can give you an anal exam to check for abnormal lumps or bumps inside your ass (and check your prostate for cancer at the same time).

Hepatitis C

HCV means the hepatitis C virus. It is the virus that causes hepatitis C disease. HCV can be transmitted sexually. Guys with HIV are more likely than HIV negative guys to be infected with HCV.

You can't count on any symptoms to let you know you've got HCV. The only way to know for sure is to get a blood test. You should get tested for HCV regularly (probably at least once a year), especially if you are fucking without condoms, having rough sex, sharing sex toys or sharing needles if you inject drugs.

For More Information

For More Information About Gay Sex, Cruising, Dating and Relationships

For Information About HIV, STIs and the Law

For Information About HIV, Hepatitis C, Other STIs and Your Sexual Health

  • CATIE (Canadian AIDS Treatment Information Exchange) or call toll free 1-800-263-1638 [if you're in Canada]
  • CATIE Hepatitis C Prevention & Harm Reduction Toolkit or call toll free 1-800-263-1638 [if you're in Canada]

For Information About Safer Drug Use and HIV

  • Drugs, alcohol, and gay men -- information and some things to think about from Action Séro Zéro
  • from the Toronto party scene, but useful no matter where you party

*Available through the CATIE Ordering Centre, available online at or by calling 1-800-263-1638 [if you're in Canada]


This guide, originally developed by Toronto People With AIDS Foundation through a partnership with Ontario's Gay Men's Sexual Health Alliance (GMSH), has been adapted and reprinted in partnership with CATIE (Canadian AIDS Treatment Information Exchange). Thanks to members of the Poz Prevention Working Group of the GMSH for their contribution. Thanks also to the medical / scientific reviewers.

Funding provided by the AIDS Bureau, Ontario Ministry of Health and Long-Term Care, Government of Ontario, and the Public Health Agency of Canada. The views expressed in this resource do not necessarily reflect the views of the Government of Ontario or the Public Health Agency of Canada.

A companion guide, HIV disclosure: a legal guide for gay men in Canada, is also available. Both guides are accompanied by a manual for service providers, Poz Prevention: knowledge and practice guidance for providing sexual health services to gay men living with HIV in Canada. Copies of these publications can be ordered through the CATIE Ordering Centre, available online at or by calling 1-800-263-1638 [if you're in Canada].

Decisions about particular medical treatments should always be made in consultation with a qualified medical practitioner knowledgeable about HIV-related illness and the treatments in question.

Toronto People With AIDS Foundation and CATIE, in good faith, provide information resources to help people living with HIV/AIDS who wish to manage their own health care in partnership with their care providers. Information accessed through or published or provided by the Toronto People With AIDS Foundation or CATIE, however, is not to be considered medical advice. We do not guarantee the accuracy or completeness of any information published by the Toronto People With AIDS Foundation or CATIE. Users relying on this information do so entirely at their own risk.

Glenn Betteridge, Managing Editor
Derek Thaczuk, Writer
Top Drawer Creative, Design

© 2009 Toronto People With AIDS Foundation and Canadian AIDS Treatment Information Exchange

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This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
See Also
More Resources Related to Gay Men and HIV/AIDS

Reader Comments:

Comment by: Walker (Australia) Wed., Dec. 21, 2011 at 2:35 am UTC
Hi look i came across to your page as a suprise to me that HIV can affect your sex performance for everywhere i go to my GP or calling the HIV hotline they are telling me the oppisite, i am a 27 year old female and have been with my husband for 5 years and only found out he had HIV which he knew about but did not tell me. I have noticed that my husbands sexual performance was changing, he was getting erections but as soon as he will insert his penis it would go down, before we use to have sex for hours but now he only last's 10 minutes, his medication is Atripla and his viral load is low but i have noticed that he sleeps alot and he eats less but when he does eat he never puts on weight (his really skinny), his got red blood shot eyes and his sexual performance has changed where he does get a erection but does not last long, would you know what this is caused from?
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Comment by: Trevor (RSA) Fri., Jan. 15, 2010 at 1:25 am UTC
This guide is excellent in my view! It is informative,frank,clear and to the point. Many of these issues are the same everyone in this position has to work through. Had I known of the resources provided on this site and in particular this guide, it may have saved me so much time, mental anguish and pain. I am however still a proponent that if you can persuade yourself to use condoms at all times it is really worthwhile for you and anyone you have sex with.
HIV replicates astronomically quickly if even slightly out of control and so mutations that are ARV resistant are very likely.

According to Prof Racaniello, “because over 1016 HIV genomes are produced daily, thousands of potentially resistant viral mutants arise for any combination of ARVs. The HIV-1 genome can exist as (10 with 6020 zeros) different sequences. In perspective: there are (10 with only 11 zeros) stars in the Milky Way."
So in order to ensure effective control of viral activity and future effectiveness of ARV’s for persons that may still be infected it is essential to keep one’s own virus strains quarantined as far as possible and not to allow even remote re- or co- infection to be possible. For this reason I believe condoms and other safe sex practices are also not negotiable.
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