Sex with Drew
Your sexual health questions answered.
Sexual Health Questions & Answers
Pharmacist 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.
For general questions please call, text or email us. If you are having symptoms or would like to get tested, book a free online appointment with a Nurse Practitioner on our team.
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. People who do not get throat or rectal swabs may 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.
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. 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 poor oral hygiene/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 more resistant in certain groups of people.
There is a fair bit of stigma when it comes to STIs. Asking someone if they are “clean” can imply a person living with HIV or any other STI is unclean or dirty – which isn’t the case at all. It’s best to simply share your status and ask when someone was last tested & their status. (They may or may not choose to share.) Stopping stigma starts with you! Words matter!
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.
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 for free 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.
We provide FREE internal and external condoms at our Toronto pharmacy site as well!
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.