Updated Guidelines: Australian STI & HIV Testing Guidelines 2019 for Asymptomatic MSM

Sexually Transmissible Infections in Gay Men Action Group (STIGMA), September 2019

Most sexually transmitted infections (STIs) are asymptomatic. Testing and treatment of asymptomatic men who have sex with men (MSM) is the most effective method to interrupt transmission and reduce the burden of illness. In particular, syphilis is increasingly common, is often asymptomatic, and can cause significant morbidity.

The main barriers to STI control are insufficient frequency of testing in MSM, and incomplete testing. For example, chlamydia and gonorrhoea tests should be performed at all three sites (swab of oropharynx and anorectum, and first
pass urine), and syphilis serology should be performed every time a HIV test or HIV treatment monitoring is performed.

HIV is now a medically preventable infection. All men who are eligible under the Australian HIV Pre-Exposure guidelines should be actively offered PrEP: www.ashm.org.au/HIV/PrEP All people with HIV should be advised to commence treatment and, where possible, have an undetectable viral load.
These guidelines are intended for all MSM, including trans men who have sex with other men .

This current version is endorsed by the Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine, Australasian Sexual Health Alliance, Australasian Chapter of Sexual Health Medicine of the Royal Australasian College of Physicians and is approved as an accepted clinical resource by the Royal Australian College of General Practitioners.

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