Sex with Drew

Your sexual health questions answered.

Sexual Health Questions & Answers

Drew is a Certified HIV Pharmacist and has been working in sexual health for several years. Below are some of the most common questions he has received and their answers.

If you are having symptoms or would like to get tested, book a free online appointment with a Nurse Practitioner on our team or visit one of our in-person sexual health clinics.

You can also call, text or email us 7 days week!

Some people don’t experience symptoms but may still have an STI and be able to pass on an infection. The only way to be sure is to get tested. One of the reasons for HIV transmission is that 14% of Canadians living with HIV do not know, aren’t treated, and can pass it on. HIV can affect anyone – all ages, gender identities, and sexual orientation. In fact, 1 in 4 new HIV infections in Canada are in women. People who do not get throat or rectal swabs may also unknowingly have an STI.

It is important to know your status and get regular testing. Some guidelines suggest testing every 3 months for people who are regularly sexually active outside of a monogamous relationship, at minimum once a year. If you start PrEP you will get regular testing.

Looking to get tested? We provide free online appointments for anyone in Ontario and can order tests to be done locally. We also have in-person sexual health clinics in Toronto and Ottawa. Learn more here!

Undetectable is when a person living with HIV is consistently on effective medication and regular blood tests are not able to detect the HIV virus. This means the condition is in excellent control and they can not transmit HIV to a partner through sexual intercourse. This is what U=U represents, that Undetectable = Untransmittable.

The individual will need to continue to take their medication and get regular bloodwork to ensure they remain undetectable. Not everyone on HIV medication is undetectable – their doctor will advise them of their bloodwork to know. Most people living with HIV in Canada on treatment are undetectable. Check out our section on U=U to learn more.

Receiving oral sex will not transmit HIV. Most references suggest giving oral sex to someone is low risk. What does low risk mean though? There are some case reports of transmission occurring, but it is generally unusual. If there is a decrease in oral hygiene or mouth sores/open sores the risk would increase.

It would also be dependent on the amount of virus and sexual fluid (ie. Did ejaculation occur?). For more info ask your local public health unit or contact us. 

A urine test will not show if there is an infection in the throat or rectum (there are swabs for this). It’s always best to advise whoever is testing you about your sexual activity. Otherwise important tests might not be ordered. It also may impact the choice of antibiotics given as there are some types of infections that are harder to treat in certain groups of people. You can learn more about this and sexual health swabbing here!

Asking if someone is “clean” implies someone with an STI or living with HIV is unclean. This untrue, hurtful, and perpetuates stigma. This also sets up for shaming yourself if you acquire an STI later on. #LanguageMatters

If you want to know someone’s status the best thing is to offer yours first. Or you can ask questions around when a person was last tested. The other person can then decide if/what they would like to share back. 

Sometimes when we’re behind a keyboard we forget there’s another person on the other side. Be nice. Be kind. Be Human.

PrEP is a medication people who are HIV-negative can take regularly to prevent acquiring HIV before a risk exposure. It is a proactive medication regimen because we take it before being sexually active.

This differs from PEP which is a reactive medication regimen. This means that someone takes PEP after they have had a risk exposure. So – say you are with someone and forgot to use a condom or later found out they may not be on effective medication and living with HIV. A person can take PEP (which is a 28-day medication regimen) within 72 hours to reduce their risk of acquiring HIV. The earlier the better!

PEP works well but the precise effectiveness is not well documented. What we do know is that the earlier a person begins PEP after their risk exposure the greater the effectiveness. If you or anyone you know ever needs PEP they should go to the emergency room for medication as soon as possible.

Emergency rooms often will provide a PEP starter pack for a day or two and provide a prescription. We can ship out the remaining medication in your PEP regimen across Ontario or you can access it directly from our Toronto site at Bloor & Spadina. We can also support follow-up lab monitoring after starting. 

If interested in starting PrEP right after PEP our team can assist with this as well. The medication for PrEP is not sufficient for PEP use by itself. You can learn more about Ontario’s original province-wide PrEP service here.

Pharmacist Drew says...

"Go Swab Yourself!"

If you’re not completing swabs during sexual health testing (or PrEP monitoring), you’re missing out on two super important tests: Gonorrhea and Chlamydia.