What does testing entail?
You’ve never had an HIV test? You’re starting a new relationship? You’ve had sex without using a condom? You’re pregnant or you want to become pregnant? The screening test for HIV and other blood-borne and sexually-transmitted infections (BBSTIs commonly known as STIs) is the only way of detecting the presence of an infection and accessing the necessary medical follow-up and support.
It’s confidential and free! Because these infections often produce no symptoms, the screening test gives you peace of mind and lets you preserve your health and that of your partners.
C’est confidentiel et gratuit! Comme ces infections ne présentent souvent pas de symptômes, le test de dépistage vous permet d’avoir l’esprit tranquille et de préserver votre santé et celle de vos partenaires.
There are several places where you can have a screening test done for HIV and other sexually transmitted and blood-borne infections (BBSTIs):
- a family medicine clinic
- a CLSC
- a specialized sexual health clinic
- a family planning clinic
- youth clinic ( for people aged 25 and under)
Testing is confidential and free (note that some clinics charge administration fees) for anyone who has a valid health insurance card issued by the RAMQ or an eligibility document for the Interim Federal Health Program (IFHP).
The screening test involves taking a blood sample and, if necessary, other samples, such as urine. It takes only a few minutes.
You can undergo testing starting at the age of 14 without needing parental consent.
In general, a health insurance card is required to have a screening test for HIV and other BBSTIs.
- In Montréal, contact Doctors of the World Canada, an organization that provides medical services to people who are waiting to receive official immigration status: 514 281 8998 extension 246.
- Elsewhere in Québec, contact your local community HIV organization.
Anonymous HIV testing
Anonymous HIV testing is an exceptional measure for people who have a higher risk of contracting an STBBI compared to the general population. It’s only provided by SIDEPs (Services intégré de dépistage et de prévention des ITSS, or integrated STBBI testing and prevention services), which are located within at least one CLSC in every region of Québec. In these places, you don’t need to show a health insurance card or any other ID, and the service is free. The service will not be offered to you right away; you need to ask for it when you make your appointment.
HIV can be transmitted through the following body fluids:
- Sperm (including pre-seminal fluid)
- Vaginal and rectal secretions
- Breast milk
It is transmitted only when one of these fluids from a person living with HIV, who doesn’t know their status or who is not undergoing treatment, comes into contact with the bloodstream of another person. For example:
- During vaginal or anal sex that involves penetration with a penis, with or without ejaculation.
- When sharing sex toys.
- Through blood when sharing material used for injecting or inhaling drugs.
- Through blood, during body piercing or tattooing with contaminated equipment.
- During pregnancy, while giving birth or while breastfeeding, in the absence of effective HIV treatment
On the other hand, HIV is NOT transmitted in everyday situations such as the following:
- Use of private or public toilets.
- Sharing glasses, dishes or utensils.
- Physical contact, such as shaking hands or kissing.
- Sneezing, spitting (saliva) or tears.
- Bites from a mosquito or any other insect.
- Eating, working or playing sports with an HIV-positive person.
Other BBSTIs (blood-borne or sexually-transmitted infections commonly known as STIs) can be transmitted more easily than HIV, for example, during oral sex. Considering that lesions can be found in areas not covered by the condom, in this specific case, the condom may not offer complete protection. Very often, you’ll have no symptoms or the symptoms will not be visible. Having an BBSTI increases the risk of contracting or transmitting HIV.
Vaginal and anal sex
To reduce risks:
Correctly use a latex, polyurethane or polyisoprene condom for vaginal and anal sex.
Use water-based or silicone lubricants. Don’t hesitate to re-apply such products, as they minimize the risk of tearing. Oil-based lubricants are not compatible with condoms. This information is indicated on the lubricant container.
When performing anal sex and vaginal penetration, remember to change the condom when moving from the anus to the vagina in order to avoid transmitting bacteria from one place to the other.
Don’t forget that condoms also protect against unplanned pregnancies.
It is also recommended to wear a condom when sex toys are shared.
For cultural or personal hygiene reasons, some women use vaginal douches or other substances to clean their vagina, before or after sexual relations. These substances can irritate the vaginal mucosa and potentially increase the risks of BBSTIs. It is recommended to wash the vulva daily with water only.
You may have heard about PrEP (pre-exposure prophylaxis), which means taking anti-HIV treatment in order to prevent infection. In Québec, PrEP is provided to people who are at high risk of being infected with HIV. For instance, it’s offered to couples in which one person is living with HIV and the other is not. In this context, PrEP can be a way to prevent infection.
To have access to PrEP, you need a prescription from your doctor.
To protect yourself and reduce risks:
Maintain good oral hygiene and avoid oral sex if you have wounds, cuts, ulcers, gingivitis (inflammation of the gums) or other infections.
Avoid having oral sex the day you visit the dentist.
Avoid brushing your teeth, or using dental floss or mouthwash an hour BEFORE and an hour AFTER oral sex. This minimizes the possibility of getting cuts, irritations or blood in your mouth.
Avoid getting semen or vaginal secretions in your mouth.
When being tested for blood-borne or sexually transmitted infections (BBSTIs commonly known as STIs), ask the doctor to take a specimen from your throat.
Using a condom or dental dam (latex square) during oral sex is another way of minimizing risks. They can be bought flavored or non-lubricated.
Emergency contraception (morning-after pill)
In situations where a condom wasn’t used or if it broke during sex, the emergency oral contraceptive pill (or morning-after pill) allows a woman to avoid an unplanned pregnancy if taken quickly. Even if this pill can be taken up to 5 days (120 hours) after sex, it is advisable to avoid delay in order to ensure maximum effectiveness.
This pill is available without prescription and it is available to women, including minors, at pharmacies and emergency rooms (ER), and in most clinics and women’s centers.
The pill is free for young women under the age of 18 and for full-time students under the age of 25. The emergency oral contraception has no or few significant side effects and will not prevent future pregnancies. Since, its use should be reserved for emergency situations, other options could be considered afterward: oral contraception, condom.
For more complete information, contact:
Post-Exposure Prophylaxis (PEP)
PEP, or post-exposure prophylaxis, is a treatment that you can take after having anal or vaginal sex without a condom with a partner who is living with HIV and not being treated for it, or with a partner whose status is unknown.
For this treatment to be effective, it must be started as quickly as possible, within a maximum of 72 hours after risk exposure. Some health professionals who do not specialize in HIV may be unaware of this treatment. Therefore, it is highly recommended to consult clinics that specialize in HIV and blood-borne and sexually-transmitted infections.
You can go to the emergency room at your closest hospital, or make an appointment at a specialized clinic. Remember that it’s important to be seen as quickly as possible, within 72 hours of the risky sexual activity.