MSM stands for men who have sex with men. For this group, HIV, syphilis, chlamydia and gonorrhoea belong in a complete STI check. If you have had oral or anal sex, a urine test alone is often not enough: throat and anus count too. How often you test depends on your sex life and whether you use PrEP.
That last point about throat and anus is often forgotten. Research suggests a share of missed infections sits exactly there.
Which STI tests matter for MSM?
For MSM it usually involves HIV, syphilis, chlamydia and gonorrhoea, with hepatitis added depending on your situation. HIV and syphilis are tested via blood, chlamydia and gonorrhoea via urine and, if needed, a swab. The RIVM and Soa Aids Nederland advise MSM to keep up that broad check.
| STI | Where or how it is tested |
|---|---|
| HIV | Blood |
| Syphilis | Blood |
| Chlamydia and gonorrhoea | Urine, and with oral or anal sex also throat and anus |
| Hepatitis | Blood, depending on vaccination and situation |
This table is a guide, not a prescription. Which check fits you is something you discuss with the GGD, the Centre for Sexual Health or your doctor. Not sure where to start? Read which STI test do you need, and when?.
Why test the anus and throat too?
Chlamydia and gonorrhoea can also sit in the throat or the anus, without symptoms. A urine-only test then misses those sites. So with oral or anal sex it makes sense to test there separately.
This is well studied. In a US study among MSM (Patton et al., Clinical Infectious Diseases, 2014), a share of infections sat in the throat or anus and would be missed if testing was via urine alone. That is why site-specific testing belongs in a complete check.
How often should MSM get tested?
There is no single number, but with changing partners testing often happens more than once a year. For MSM at higher risk, the RIVM and Soa Aids Nederland mention shorter intervals. What fits you is something you set with the GGD or your doctor.
My honest view: make it a rhythm rather than a panic move. Testing regularly and calmly works better than only checking when you are worried.
What is the connection with PrEP?
If you use PrEP, regular STI testing is a standard part of it. PrEP protects against HIV, but not against chlamydia, gonorrhoea or syphilis. That is why PrEP users are usually checked every three months.
Want to know whether PrEP suits you, read what is PrEP and who is it for?. If you have just been at risk, speed matters: see PEP: HIV risk within 72 hours after unprotected sex.
With us you can do an anonymous HIV test or a syphilis test in between, separate from where you arrange your PrEP.
Frequently asked questions about STI testing for MSM
Can I test for free at the GGD as an MSM? MSM often fall under the risk groups who can go to the GGD or the Centre for Sexual Health. The conditions differ per region, so check that beforehand.
Do I really have to test the throat and anus? If you have had oral or anal sex, that is often wise, because an infection can sit there without symptoms. Discuss with the testing provider which sites make sense for you.
How often is enough? That depends on your number of partners and your use of PrEP. For some MSM a few times a year fits, for others more often.
Does an HIV test still count if I use PrEP? Yes, the HIV test belongs with PrEP, because the protection only works well without untreated HIV. So that check is a fixed part of it.
Can I test anonymously without my GP knowing? Yes. With us you test anonymously and without insurance, so you keep it fully in your own hands.
Every STI result we provide is assessed by a BIG-registered doctor. If you have symptoms or questions about your situation, discuss it with the GGD, the Centre for Sexual Health or your GP; this article is explanation, not medical advice.
Sources
- RIVM, STI
- Soa Aids Nederland, Getting an STI test
- Thuisarts.nl, STI
- Patton ME et al. Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men. Clin Infect Dis. 2014 (PMID 24647015).
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