Alice,

My boyfriend and I have been sexually active for nine months... He's the first guy I've ever been with this way. He's been with a couple other girls and was tested for HIV about two years ago. After he'd been tested, he had been with one other girl. He thinks it's a good idea if he gets tested, but because he knows I've never been with anyone else, he doesn't think I need to be tested... What do you think? I think I should be tested, just to be safe.

Dear Reader,

How great that you’re being proactive about HIV testing, a critical part of a responsible sexually active lifestyle! Since you’ve never been with someone else, the likelihood that you have contracted HIV is low, especially if your boyfriend and his partners utilized safer sex practices during their past sexual experiences. It is key to note, however, that symptoms might not be visible or obvious and people can be exposed to HIV in other ways than through sexual contact (more on that later). So it's definitely justifiable that you'd like more peace of mind and want to get tested yourself. Additionally, you and your boyfriend might also want to consider being tested for other sexually transmitted infections (STIs), such as chlamydia and gonorrhea since some STIs are more easily transmitted than others.

First things first, Reader, you indicate that you’ve never “been with anyone else.” It’s unclear whether you’re talking about vaginal and anal intercourse or other forms of sexual contact as well. Sex can have different definitions for different people and the risk for HIV varies depending on the type of sexual contact — vaginal and anal penetrative sex have the highest risk of transmission among the types. And, though the risk is much lower, oral sex can also pose a risk for HIV transmission. Furthermore, transmission can also occur through other types of exposure, such as sharing needles, breast feeding from a mother who is HIV-positive, a blood transfusion (which is rare), or specific kinds of contact with blood or bodily secretions from an infected person. For more information on ways it’s possible to contract HIV, check out Routes of HIV transmission in the Go Ask Alice! archives. In addition to your risk for HIV, you might also consider your risk for other STIs. Some STIs can be transmitted more easily than HIV through other ways, including via skin-to-skin contact. So, it could provide even more peace of mind to get tested for those as well. Speaking with a health care provider about what sorts of sexual contact you’ve had will help determine what STIs you might be at risk for and what additional tests would be appropriate for you.

Something else to consider is whether your boyfriend was using protection (e.g., internal/female condoms, external/male condoms, or other barrier methods) with his previous partners and when he was tested previously. It’s advisable that people get tested for HIV three months after unprotected sex and again at six months. It can take up to six months after an encounter for HIV to show up on a test, creating a lag time when an infected person may have a viral load that cannot be detected in a test. Since he wasn’t tested after his most recent partner and you’ve been sexually active for nine months, you could be at risk for contracting STIs if he hasn’t been using protection with you or his other partners.

It’s not all risk and no reward, though! There are plenty of ways that you can still get busy while reducing anxiety regarding STIs. Condoms and other barrier methods, when used correctly and consistently, can lower the risk of STI and HIV transmission. You and your boyfriend can also search through the Sexual & Reproductive Health archive for safer sex, HIV/AIDS, and other STI information, or you can check out these organizations and tools to get more answers to your questions:

Although your risk for having HIV is likely low, getting tested for it and other STIs might familiarize you with the testing facilities and process, which could be helpful if you feel the need to get tested again in the future. It can also resolve uncertainties you may have about your status; peace of mind can be a beautiful thing!

Alice!

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