GetMEScreened

The Maine CDC Infectious Disease Prevention Program is here to help you understand your risks and decide on an STD screening schedule that is right for you. That could mean getting screened once, twice, or even four times a year.

HIV testing is free in Maine!

Why should you get screened for STDs?

Because all Sexually Transmitted Diseases (STDs), even HIV, are treatable, and most are curable.

STDs impact young people the hardest. In the U.S., almost half of all new infections in 2018 were among people aged 15-24. But that doesn't mean you should skip your screening later in life. Many people who get very sick with HIV or other STDs are older and have lived with asymptomatic or dormant viruses in their bodies for years.

The sooner you get tested, the sooner you can take action. Some STDs can lead to serious health problems if they're not treated; and an untreated STD can also increase the chances of transmitting or getting HIV. So get screened regularly to protect your health (and your partners', too!).

If you test positive for chlamydia or gonorrhea, you can get treatment for both yourself and your partner without your partner needing to get tested (learn more about Expedited Partner Therapy).

The Maine STD Control and Prevention Program works to reduce transmission, keep track of cases, and improve treatment of all reportable STDs (Chlamydia, Gonorrhea, Syphilis, and HIV).

About HIV

HIV stands for human immunodeficiency virus. It weakens a person's immune system by destroying important cells that fight disease and infection. There is currently no effective cure for HIV. But with proper medical care, HIV can be controlled - even to the extent that it is untransmittable through sexual contact. Some groups of people in the United States are more likely to get HIV than others because of many factors, including their sex partners and risk behaviors.

How common is HIV in Maine?

The Maine CDC Infectious Disease Prevention Program publishes the number of new HIV cases every year, including cases per 100,000 people in each county, percentage with risk factors, and percentage of male to female. You can view the most recent HIV surveillance reports at the links below:

Maine HIV Surveillance Reports: 2018 (PDF) | 2019 (PDF) | 2020

The Maine CDC Infectious Disease Prevention Program works with partners and other stakeholders to keep these numbers as low as possible.

Who should get an HIV test?

The Maine CDC recommends that EVERYONE between the ages of 13 and 64 get screened for HIV at least once in their lifetime. Based on your risk, you should screen either once, twice, or four times every year. It's easy to do, and Maine's changing seasons can serve as your built-in reminder.

All women, and all men who have sex with women, ages 13-64	Test at least once in their lifetime
Women, and men who have sex with women, seeking evaluation and treatment for STDs	Test at the time of evaluation/treatment on an opt-out basis.
All pregnant women	Test at the first prenatal visit on an opt-out basis
Pregnant women who: inject drugs, have a new sex partner during pregnancy, or have multiple sex partners	Retest in the third trimester. If not screened during pregnancy, rapid test at delivery.
Men who have sex with men (MSM)	Test at least annually. Those who don't know their status, have multiple partners, or inject drugs should consider screening every 3-6 months.
Transgender and gender diverse persons	Discuss and offer screening, at a frequency based on individual risk level

The real danger with HIV is in not knowing.

If you don't get screened on a schedule, you may not know you have the virus until it has made you very sick.

HIV testing is free in Maine!

Prefer to test at home? You can order a free test kit from TakeMEHome or the Frannie Peabody Center. HIV testing kits are also available over the counter at many retailers for ~$40. This document (PDF) answers some frequently asked questions about the take-home test.

Living and Loving with HIV: How to stay healthy and prevent transmission

If you are HIV-positive, you can still live a healthy and normal life on every level (including your sex life).

You can go on viral suppression medications, which will keep you healthy and symptom-free, and can take your viral load down to an undetectable level. Once that happens, as long as you keep up your treatment regimen, you will no longer be able to transmit the virus sexually. This concept is called U=U.

Keeping up with treatment has its challenges, but there is plenty of support and help out there. Maine's Ryan White Part B Program provides medical case management services to Maine people living with HIV and AIDS, including help connecting with health care, psychosocial, and other services that can keep you on track and in adherence with your treatment plan.

And if you are having trouble affording your treatment, the AIDS Drug Assistance Program may be able to help.

Meanwhile, your partner(s) can go on PrEP, which stands for pre-exposure prophylaxis and provides 99% protection against sexual transmission of HIV.

About U=U (Undetectable = Untransmittable)

What is undetectable?

The goal of all HIV treatment is to get the person to a level where their viral load is undetectable. The definition of undetectable is ever-changing; but for the purposes of U=U, it means less than 200 copies of HIV per milliliter of blood. Getting and keeping your viral load at or below that level (also called viral suppression) is the best thing someone with HIV can do to stay healthy and feel good.

How do you become undetectable?

Most people who are HIV positive can get their viral load down to a suppressed level within six months by taking HIV medication (also referred to as antiretroviral therapy, or ART).

How good is the evidence for this?

While it may be surprising, the scientific evidence is solid: between 2016 and 2018, three large-scale studies followed tens of thousands of couples with mixed HIV status where the HIV-positive partner was undetectable. The studies tracked nearly 130,000 acts of condomless penetrative sex, and there was not a single instance of a partner with an undetectable viral load passing the virus on to their HIV-negative partner.

What is untransmittable?

Once a person has achieved viral suppression and maintained it for six months, a side benefit is that their HIV becomes untransmittable; or more specifically, they are unable to transmit HIV to others through sex. To be untransmittable, you have to both achieve and then maintain an undetectable viral load.

What does this mean for me?

If you are HIV negative and your partner is positive but undetectable, they will not pass HIV on to you – even if you don’t use condoms. That said, unprotected sex still has its risks, especially if one or both of you has other partners; so prevention methods such as condoms (for other STIs) and PrEP (for HIV prevention from other partners) may still be important for your health.

The science around U=U can be especially reassuring for people in mixed-status relationships who hope to have a child. Couples in which one person has undetectable HIV and the other is HIV negative can have unprotected sex to conceive; and viral suppression allows pregnant people who are HIV positive to give birth to babies who are HIV-free.

About PrEP (Pre-Exposure Prophylaxis)

What is PrEP?

PrEP is a preventative medication that can reduce your risk of getting HIV from sex by 99%! The word PrEP stands for Pre-Exposure Prophylaxis, with “prophylaxis” meaning the prevention or control of an infection or disease. There are currently three FDA-approved PrEP medications. The first two options, Truvada and Descovy, are both taken as a daily pill. The newest PrEP medication, cabotegravir (Apretude), is an injection that you get once every two months.

Who is PrEP for?

PrEP is for anyone at risk of contracting HIV who wants to take every step to keep that from happening. This includes people who are straight, gay, and bisexual, and who are male, female, transgender, or gender non-conforming. While some people are statistically at higher risk than others (including people who have anal sex, inject drugs, have multiple partners, or have an HIV-positive partner), your personal risk level is highly individual and something you will want to talk to your health care provider about.

How does it work?

If you are exposed to HIV, PrEP stops the virus from taking hold and spreading throughout your body. It is highly effective if used as prescribed, but much less effective when not taken consistently. And it only protects against HIV - not pregnancy or any other STDs. You have to be HIV negative (not living with HIV) to take PrEP, so your provider will check your status at the time of prescription and every three months while you’re on it.

Why is PrEP a big deal?

With PrEP, someone who is HIV negative can have unprotected sex with someone who is HIV positive or who doesn’t know their status and feel confident that they won’t contract the infection. The second layer of protection for sexual partners with mixed HIV status is the concept of U=U, which stands for Undetectable = Untransmittable. Thanks to advances in HIV medications, a person who is HIV positive can suppress their viral load to a level where the virus is unable to be sexually transmitted to a partner. Over the past decade, the wide scientific acceptance of U=U plus the availability of PrEP have combined to break down a lot of the stigma around HIV status. As long as you and your partner both know your status, you can live a healthy life together on every level.

Where in Maine can I get a prescription for PrEP?

Your primary care doctor can prescribe PrEP, and most insurance plans will cover it. If you don’t have a primary care provider, your insurance doesn’t cover it, or you don’t have insurance, there are many medication assistance programs that can help.

For help navigating PrEP in Maine, PrEP 207 is a great resource.

About Syphilis

What is syphilis?

Syphilis is a sexually transmitted disease (STD) that spreads through vaginal, anal, or oral sex without a condom (specifically, exposure to a syphilis sore), and can also spread to a baby during pregnancy.

How common is it in Maine?

The Maine CDC Infectious Disease Prevention Program publishes the number of new syphilis cases every year, including cases per 100,000 people in each county, percentage with risk factors, and percentage of male to female. You can view the most recent syphilis surveillance reports at the links below:

2017 (PDF) | 2018 (PDF) | 2019 (PDF)

What are the signs and symptoms of syphilis?

Syphilis develops in stages (primary, secondary, latent, and tertiary), each of which can have different signs and symptoms.

During the primary stage of syphilis, you may notice a single sore or multiple sores at the site of infection (typically penis, vagina, anus, rectum, lips, or mouth). It is usually firm, round, and painless and heals after three to six weeks. Even after the sore goes away, you will still need treatment to stop the infection from moving on to the secondary stage.

In the secondary stage, you may develop sores in your mouth, vagina, anus and/or a rough red or reddish-brown rash on the palms of your hands or the bottoms of your feet. The rash usually won’t itch, and it is sometimes so faint that you won’t notice it. Other secondary symptoms include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and/or fatigue. Like the primary stage, these symptoms will go away on their own; but without treatment, the infection will progress to the latent and/or tertiary stages.

The latent stage, during which syphilis hides in your blood with no visible signs or symptoms, can last for years.

The tertiary stage is very serious and occurs 10 to 30 years after infection. Most people do not progress to this stage. Tertiary syphilis damages internal organs including the heart, blood vessels, brain, nervous system, and can result in death.

During any of the stages above, syphilis can progress to neurosyphilis, ocular syphilis, or otosyphilis (syphilis of the brain, ear, or eye). Neurosyphilis (brain) symptoms include severe headache, muscle weakness or movement problems, and mental state changes (trouble focusing, confusion, personality change, or problems with memory, thinking, and/or decision making). Ocular (eye) syphilis symptoms include eye pain or redness, vision changes, and blindness. Otosyphilis (ear) symptoms include hearing loss, tinnitus, dizziness, or vertigo.

How can you prevent and treat syphilis?

The only way to be completely sure you won't get syphilis (or other STDs) is to not have sex. If you are sexually active, your chances of getting it will be lower if you are in a long-term monogamous relationship with a person who has been tested and does not have syphilis. That said, if a person has a syphilis sore in an area not covered by a condom, the infection can still spread.

Antibiotics can cure a syphilis infection, but they might not undo damage that the infection has caused; and having/treating syphilis once will not prevent you from getting it again if you are re-exposed.

Who should get tested for syphilis, and when?

You should get tested regularly for syphilis if you are sexually active and are a man who has sex with men, have HIV, are taking PrEP, or have partner(s) who have tested positive for syphilis. If you are pregnant, you should get tested at your first prenatal visit and may need follow-up testing at 28 weeks and/or at delivery. Most providers will use a blood test, but testing the fluid from a syphilis sore is also an option.

If you test positive during pregnancy, you will want to start treatment right away. Syphilis can lead to a low birthweight, premature baby, or stillborn. Babies born with syphilis may not show any symptoms; but if they do not get treatment right away, they may develop serious problems within a few weeks, leading to cataracts, deafness, seizures, and/or death.

About Gonorrhea

What is gonorrhea?

Gonorrhea is an STD that can cause infection in the genitals, rectum, and throat. It is very common, especially among young people ages 15-24 years. It is spread through sex without a condom (vaginal, anal, or oral), and it can also spread to a baby during childbirth, causing serious health problems for the baby.

How common is it in Maine?

The Maine CDC Infectious Disease Prevention Program publishes the number of new gonorrhea cases every year, including cases per 100,000 people in each county, percentage with risk factors, and percentage of male to female. You can view the most recent gonorrhea surveillance reports at the links below:

2017 (PDF) | 2018 (PDF) | 2019 (PDF)

What are the signs and symptoms of gonorrhea?

Short-term symptoms in women may not appear at all; but if they do, they can include painful or burning urination, increased or bad-smelling vaginal discharge, and bleeding between periods. Men may have burning urination, a white, yellow, or green discharge from the penis, and/or painful or swollen testicles (less common). Men and women can both have rectal symptoms including discharge, itching, soreness, bleeding, and/or painful bowel movements.

In the long term, untreated gonorrhea can cause serious and permanent health problems, including pelvic inflammatory disease (PID) in women and a painful testicle condition in men that can cause infertility. Rarely, it can also spread to your bones or joints and become life-threatening. And it can also increase your chances of getting HIV.

How can you prevent and treat gonorrhea?

The only way to be completely sure you won't get gonorrhea (or other STDs) is to not have sex. If you are sexually active, your chances of getting it will be lower if you use condoms the right way every time or you are in a long-term monogamous relationship with a person who has been tested and does not have gonorrhea.

Who should get tested for gonorrhea, and when?

Men who have sex with men should get tested for gonorrhea every year, as should all sexually active women under 25 and women over 25 who have new or multiple sex partners, or a sex partner who has a sexually transmitted infection. Gonorrhea can usually be detected through a urine sample, though urine only testing misses more than 70% of infections that are in the rectum or throat. If you have had receptive anal or oral sex, ask your healthcare provider about conducting a swab test at those sites (rectum and/or throat). The infection can be cleared with medication, though some drug-resistant strands are emerging, so it’s important to follow up with your healthcare provider if symptoms continue for more than a few days after treatment. Your provider will also schedule a follow-up test roughly three months later.

About Chlamydia

What is chlamydia?

Chlamydia is a common STD that can infect both men and women, and can permanently damage a woman’s reproductive system, making it difficult or impossible to get pregnant and raising the risk of ectopic (outside the womb) pregnancy. It is spread through vaginal, anal, or oral sex, and can also be passed to a baby during childbirth. This can cause an eye infection or pneumonia in the baby. Chlamydia infection may also cause an early delivery. What are the signs and symptoms of chlamydia?

What are the signs and symptoms of chlamydia?

Chlamydia often has no symptoms, but can still cause reproductive damage. The onset of symptoms can also be delayed for several weeks.

Short-term symptoms in women include an abnormal vaginal discharge and burning urination. Symptoms in men include a discharge from the penis, burning urination, and testicular pain or swelling (less common). Men and women may also have rectal symptoms including pain, discharge, or bleeding.

If the infection isn't treated, it can lead to serious health problems including pelvic inflammatory disease in women and infertility in men. It also may increase your chances of contracting or spreading HIV.

How can you prevent and treat chlamydia?

The only way to be completely sure you won't get chlamydia (or other STDs) is to not have sex. If you are sexually active, your chances of getting it will be lower if you use condoms the right way every time or you are in a long-term monogamous relationship with a person who has been tested and does not have chlamydia.

The infection can be cleared with medication, though treatment will not undo any permanent damage that the infection has already caused. Repeat infection is common, so your provider will also schedule a follow-up test roughly three months later.

Who should get tested for chlamydia, and when?

People under age 25, men who have sex with men, and people with new or multiple sex partners or a sex partner with an STD should get tested for chlamydia every year, and pregnant people should be tested at their first prenatal visit. This is usually a simple urine test, though it can also be done with vaginal, rectal, or throat swab. Urine only testing misses more than 70% of infections that are in the rectum or throat. If you have had receptive anal or oral sex, you should be tested at those sites (rectum and/or throat).

About Hepatitis C

What is hepatitis C?: Hepatitis C is a liver infection that is spread through contact with an infected person’s blood, often by sharing needles or other equipment used to prepare and inject drugs.
What are the signs and symptoms of hepatitis C?: For some people, hepatitis C is a short-term illness; but for more than half of people, it becomes a long-term, chronic infection. Chronic hepatitis C can result in serious, even life-threatening health problems like cirrhosis and liver cancer. People with chronic hepatitis C often don’t feel sick until they begin experiencing symptoms of advanced liver disease.
How can you prevent or treat hepatitis C?: The Maine CDC Infectious Disease Prevention Program is dedicated to preventing and controlling all viral hepatitises, including hepatitis C. The CDC recommends that ALL adults get tested for hepatitis C - learn more about why here; and learn some of the special conditions for people who inject drugs here (PDF).