Resilience, Equity, Acceptance, Leadership
Look, we get that you have sex, use drugs, and are making choices on the daily about what feels good for you.
It’s important that every young person feels empowered and informed about the decisions they’re making that affect their health and overall well-being. How do you know if a decision you’re making is right for you? Self-discovery is a journey, and we’re here to support you in making more informed, healthier, and safer decisions about your sexual health and wellness.
You can use the information here to remind yourself of the range of options that exist out there to keep you safer, healthier, and happier! Ultimately, the information from this section can help inform your daily decisions around your sexual health and/or drug use.
Through BOOM (for young guys who like guys) and What the Health?! (for street-involved youth), you’ll find information on HIV prevention, HIV testing, and HIV treatment, as well as substance use, harm reduction, healthier relationships, and challenging HIV stigma.
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People living with HIV cannot pass on the virus through sex if they are taking their HIV meds regularly and have an undetectable viral load. People with an undetectable viral load have so little of the virus in their bodies that our current HIV testing technologies cannot detect the virus when they take a test. U=U is backed up by scientific proof that when HIV is undetectable, it’s untransmittable! So spread the message of U=U and go on and get frisky!
Get PrEPped for sex! PrEP stands for Pre-Exposure Prophylaxis. PrEP is a combination of two anti-HIV meds that people who are HIV-negative can take to prevent getting HIV when having sex with someone living with HIV.
In Canada, this combination is called Truvada and has the anti-HIV meds: emtricitabine and tenofovir. PrEP is highly effective when taken daily.
For receptive anal sex, PrEP takes about 7 days to reach maximal protection. This means that if you’re interested in receiving anal sex, you should take PrEP at least 7 days before the day you have sex, the day you have sex, and continue taking PrEP daily after the encounter.
For receptive vaginal sex, PrEP takes about 20 days to reach maximal protection. This means that if you’re interested in receiving vaginal sex, you should take PrEP at least 20 days before the day you have sex, the day you have sex, and continue taking PrEP daily after the encounter.
PEP stands for Post-Exposure Prophylaxis. If you are HIV-negative and you were exposed to HIV, you can take PEP within 72 hours (3 days) to prevent getting HIV. PEP is a combination of three anti-HIV meds that people who are HIV-negative can take daily for four weeks (28 days) to prevent getting HIV. PEP is highly effective when taken daily after being exposed to HIV.
PEP is meant for a single exposure to HIV. If you have an ongoing risk for HIV, for example, if you are having sex on an ongoing basis with someone living with HIV, consider taking PrEP.
Using condoms correctly and consistently each time you have sex greatly reduces the risk of passing or getting HIV. Did you know there are two kinds of condoms?
In order to be effective at preventing HIV, use external condoms to cover the penis during sex and use condoms that are made from polyurethane, latex or polyisoprene.
Internal condoms look like pouches. In order to be effective at preventing HIV, insert internal condoms inside the vagina or anus during sex and use condoms that are made from polyurethane, or nitrile. Make sure you use a new condom each time you have sex.
Lately, condoms haven’t been getting much love from young people, and this is causing a huge outbreak in STIs across Canada, including syphillis, which is making a comeback at rates we haven’t seen since 1948! 😲
Did you know: STIs can increase the risk of HIV transmission! Learn more here.
Remember: condoms are our friend – they offer us a cheap and fun way to have safer, care-free sex!
Sex can be tricky to navigate! It’s not always easy to know what you want or how you feel about someone.
Here are some questions you can ask yourself as you figure out what you want from having sex:
Everyone thinks about sex differently and everyone has different things they like. It’s not always easy to know what you and your partner(s) want or how to communicate that with one another. Here are some questions you can bring up with a partner as you figure out what you want! Sexual health is everyone’s responsibility.
It’s important to check in and know that everyone involved is happy and content. No one owes anybody sex!
E.g. “Hey, is this ok?” “Are you ok with this?”
It’s important to know what you are comfortable with and conveying that to your partner(s); you deserve to be with people who respect your boundaries.
E.g. “This would feel even better for me” or “Lemme show you how I like it” or “I need condoms to have sex”
It’s hard to talk about sexual health and prevention strategies. There’s still a lot of stigma and people have a hard time asking each other about getting tested and using condoms. When someone opens up to you about their experience with STIs or HIV, it’s important to listen and stay kind, present, and knowledgeable. Make room for honesty, kindness, and vulnerability when you’re sharing hard-to-talk about experiences with one another.
Remember: safer sex is always possible, and there is no need to stigmatize anyone for their experiences or health conditions.
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HIV Testing is the only way to know for sure if you have HIV.
The HIV test is a blood test. There’s two ways this test can be done.
Rapid tests, also known as “point-of-care” tests, offer results within minutes after blood is taken, usually from a fingerprick.
Standard tests usually involve blood being taken from a vein in the arm. The blood is then sent to a lab for testing. Results take two weeks.
No matter what kind of HIV test you’re getting, your consent matters!
Consent in this case means that it is your choice to have an HIV test, and no one can force you to have one if you do not want to.
If you volunteer to have an HIV test, you are giving consent to a provider to do the test for you.
Sometimes, service providers may offer you an HIV test. This can happen in a couple of different ways: HIV testing may be offered to people through opt-in testing, or opt-out testing. In opt-in testing, a service provider would ask you if you’re interested in the test, and you have the choice to agree or not. In some cases, opt-out testing is offered. In this case, a provider would tell you that HIV testing is a part of routine testing for everyone, but that you have the option of saying no. (If you don’t say no in this case, providers are legally allowed to do the test.)
How soon you should get tested for an accurate result depends on what kind of HIV test you get.
The rapid HIV test looks for HIV antibodies. HIV antibodies are produced to fight against HIV within the first few weeks and months of getting HIV. Once produced, antibodies will remain detectable for life. When antibodies are detected on a rapid test, we say the test is reactive. When antibodies are not detected on a rapid test, we say the test is non-reactive. It takes some time for the body to produce enough antibodies to be detectable on rapid tests. The rapid HIV tests in Canada can detect antibodies in 99% of people at three months. This period of three months is known as the window period for rapid HIV tests. Being tested at 3 months after exposure gives accurate results. When a rapid HIV test is reactive, blood is sent to a lab for confirmatory testing.
The standard HIV test looks for HIV antibodies and another marker of HIV known as the p24 antigen. Unlike antibodies, the p24 antigen levels peak within the initial weeks of infection. By five to six weeks after infection, levels of p24 antigen are no longer detectable. At one and a half months after infection, the standard HIV test detects HIV in 99% of the population. This period of one and a half months is known as the window period for standard HIV tests.
You can get either nominal testing, non-nominal testing, or anonymous testing. Different regions in Canada have different rules around what HIV reporting looks like.
Before getting a rapid HIV test, the provider will offer you pre-test counseling. During pre-test counseling, the provider will ask you about your sexual history, explain the testing process, and review modes of transmission of HIV and other STIs. During pre-test counseling, you can ask about confidentiality, anonymity, and the kind of test you would want.
After getting the HIV test, the provider will offer post-test counseling. During post-test counseling, the provider will explain the results.
In the case of a negative test result, the provider would explain safer sex practices, provide education on harm reduction, and offer resources or referrals.
In the case of a positive result, post-test counseling may take a while to support the person in dealing with their feelings.
Post-test counseling is intended to link people to care and allow people to ask questions and find information for next steps. The counselor will also explain that blood needs to be sent to a lab for confirmatory testing, and that the results would be available within two weeks.
Before getting a standard HIV test, the provider should offer you pre-test counseling. During pre-test counseling, the provider may ask you about your sexual history, explain the testing process, and review modes of transmission of HIV and other STIs. During pre-test counseling, you can ask about confidentiality, anonymity, and the kind of test you would want.
In the case of a negative test result, you will likely not hear back from the provider.
In the case of a positive result, you will get a call to schedule an appointment to discuss your results. The provider will offer post-test counseling. During post-test counseling, the provider will explain the results. Post-test counseling may take a while to support the person in dealing with their feelings. Post-test counseling is intended to link people to care, and to allow people to ask questions and find information for next steps.
In most provinces and territories of Canada, (aside from Quebec), HIV is a reportable illness. This means that providers who come across a positive test result have a duty to report that result to public health representatives. You might have heard about the partner-notification system. This system exists to ensure that people know they are at risk of getting HIV, and to encourage people to get tested as quickly as possible. In Canada, when you test positive for HIV, you would be asked by a healthcare provider or a public health official to get in touch with people who may have been exposed to HIV since your last test. This would include anyone you are sexually active with, as well as anyone you share drugs with. If you don’t want to let people know directly, you can also share these people’s contact information with Public Health, and they will contact your partners for you letting them know that they may want to get tested for HIV. They will not reveal your HIV status to anyone, however in cases of monogamous relationships, people may guess about where they were exposed to HIV.
HIV411.ca has locations of HIV services near you.
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Viral Load: the amount of virus measured in copies per mL of blood.
CD4 Cells: a type of white blood cells of the immune system that HIV infects.
HIV treatment is called Anti-Retroviral Therapy, or ART. When HIV replicates in the body, it takes over a type of white blood cells in our immune system called CD4 cells, which makes it hard to fight off infections.
Today, thanks to advances made in research, ART is extremely effective in keeping the body’s immune system strong and healthy.
Treatment prevents HIV from creating more copies of itself within the body. Taking HIV treatment regularly suppresses the viral load in most people. When the viral load is undetectable by viral load tests, it is impossible to pass on HIV through sex.
It’s important for people living with HIV to take treatment regularly in order to prevent the virus from developing resistance. When side effects happen, it’s important to share them with your healthcare provider so that you can work with them to develop a drug combination and treatment plan that works for you. You deserve the care that’s right for you!
No matter who you are or where you are in you life, you deserve support, care, respect, information, and access to treatment. There may be services near your area; use HIV411.ca to connect with people for support.
Joining groups for people who have HIV or connecting with others who have been diagnosed can also be helpful. Know that there is a community for you. Reach out to your local HIV/AIDS Service Organization or other HIV/AIDS community supports.
Telling someone you have HIV is your decision. You don’t have to disclose your status to family, friends, or healthcare providers outside of your HIV healthcare provider. You don’t have to tell your co-workers, employers, people at school, or landlords. There is some legal stuff to think about when telling sexual partners about your HIV status. Visit the Canadian HIV/AIDS Legal Network for more info.
Disclosure involves a lot of other things to consider too. Here are some questions you can ask yourself or discuss within your circle of support:
There are also resources on HIV transmission, which may be helpful in discussions around disclosure. You can find more tips here.