At the Clinic

There is a useful clip of a tour of a local GUM clinic here on the respect yourself website 

People are often scared to death about being screened for sexually transmitted infections – some due to mythical horror stories that are still doing the rounds or more likely due to plain old embarrassment.

People imagine that the waiting room at a clinic resemble the green room of the Jeremy Kyle show, full of chavs and slappers. However, it looks like any other normal waiting room, full of ordinary people from all walks of life, ages, colours, both rich and poor – like we said we all make mistakes – and just because you may wear a suit doesn’t make you infallible. The fact that you’ve bothered to turn up shows you’re mature and sensible enough to take responsibility for yourself.

So how do they test for STIs?

First things first, at most GUM clinics you may need to make an appointment. If you have symptoms, you will usually be able to get an emergency appointment, however, if you just want to have a general check up you may have to wait for a week or so to get in. Things vary considerably across the country – what ever you do, though don’t be put off – peace of mind is worth the wait.

Some services work a slightly different system, whereby you can drop in and be seen by a triage nurse who will have a chat with you and give you a quick check over. They will then make you an appointment to come back obviously the more urgent cases will be seen straight away – but for a general MOT you will most likely have to come back another day.

Anyway back to the testing. If you want a full screening to check for all types of STIs then there are usually four types of investigations that will be done to you.

  1. A urine sample
  2. Swab test
  3. Blood test
  4. Visual examination

However, before they even think about testing you they will ask you to have a chat with one of the nurses. Now this is the part that can sometime upset people if they aren’t sure what to expect. During the interview the nurse will ask you very personal questions – that may sound judgemental – but they aren’t. They ask everyone the same questions regardless. They do this not because they are nosy or being judgemental – they are trying to work out the likelihood of you having an infection, where it might be and the probability of you having passed it on to someone else.

Questions may include things like:

  • when was the last time you had sex?
  • What type of sex did you have?
  • Did you use any contraception?
  • How many partner’s have you had recently?
  • When was the last time you had unprotected sex?
  • How many partner have you had since?
  • Have you ever paid for sex?
  • Have you ever been paid for sex?
  • Have you ever had sex with other men?

This is a point I always highlight with students – young people tend to have the attitude that everyone is judging them – it is one of the main reasons why some young people don’t access services. It can really put them off if they aren’t expecting it – but if they are forewarned – they know it is nothing personal and simply all part of the process.

 

Testing…

1. The first thing they will ask you to do is a simple urine sample – you have to pee in a pot – not very scary at all – it can get a bit messy but it depends on your aim! So if you are booked in, try not to go to the loo for an hour before. The majority of STIs can be traced this way through a simple urine sample.

2.Next, will probably be a swab test – for girls this is simply a cotton wool bud on the end of a longer stick, which can collect a few cells or a sample of any unusual discharge. Now, for lads they rarely bother these days – usually only if they know you have an infection, but are unsure what it is… but anyway this is where the horror stories come from.

When I was at school I, like many I was regaled with shockingly, eye wincing tales of the umbrella test – I still know of science teachers who peddle this crap. The infamous umbrella test goes like this – a nurse would insert what looks like a metal cocktail umbrella into the tiny opening at the head of your penis – it would then be opened up and pulled out, scraping the walls of the tube as it came – ouch!

It is another one of those urban myths – Actually I don’t really get the point of this one – its not like it’s going to encourage you to getting checked out – and no matter what the horror story, there aren’t that many things that will put you of sex in the heat of the moment!

Anyway, a swab test for boys is much more of an eyebrow raiser rather than something to scream about. A male swab is a very small cottonwool bud – which doesn’t open up into an umbrella, it doesn’t scrape anything; it doesn’t get jammed down inside like a dipstick; it doesn’t twist, open up, vibrate, flash or come with a ringtone. It simply slips inside a few mm, without pain or much bother. It takes about half a second and wont have you screaming the cubical down – in all honesty it might make you go “..uhm?!” as it does feel a little weird, but only because most of us aren’t accustomed to sticking things down there.

3. what is more likely to make you scream is actually the third test, a blood sample, as many of us are scared of needles! A blood test checks for infections such as HIV, Hepatitis and syphilis.

When checking for HIV there are several different tests currently in use. Some places it can be done with a saliva swab, other it is still done with a blood test – however, depending on when you were exposed and which test is used will depend on how soon the test will give an accurate reading. Some tests still have a three month incubation window from initial exposure – some are as short as three weeks. As a result, if you are suspected of being exposed to HIV, you may be asked to return in 12 weeks time for a second blood test as it takes this long for the antibodies your body makes in response to the virus to appear and this is what we often test for.

4. The final investigation which takes place for a full STI check up is a visual examination. They will ask you to pull your pants down so they can check out your bits and pieces to make sure there aren’t any lumps bumps, or visual sores, warts or unusual discharge and that everything looks nice and healthy. If it would make you more comfortable you can ask to be examined by either a female or male nurse or doctor if you would prefer – it’s up to you.

One final point – everyone who works at a GUM clinic spends their days looking inside people’s pants – there is nothing that they haven’t seen before, and trust me no one will be passing judgement on your flaps and foreskins. Remember, the doctors and nurses are here to help you, so don’t be afraid or embarrassed – this is what they do and usually they’re pretty good at it.

So that is how they test for STIs and that’s basically it – now that wasn’t so terrible, was it?

Most of your tests will be back pretty quickly, however some may take a few days, it varies form different health authorities around the country.

But again it may be worth remembering that most tests have a three week window period. So if you had unprotected sex on Friday night and got tested first thing Monday – you would be advised to come back again in a few weeks time – as you may get a false negative as the infection is not yet detectable.

Positive? Not sure what to do?

Now if any of your tests come back positive – first things first – DON’T PANIC! This was the whole point of getting checked out in the first place. Now you know you can do something about it.

Contrary to popular belief most sexually transmitted infections are perfectly treatable and are embarrassing rather than life threatening. The majority are fairly simple to treat and leave no lasting damage when treated early – it’s the ones that are left untreated that usually cause the problems – for example if you have Chlamydia it does very little to you and can be removed with a simple dose of antibiotics – one tablet in most cases and you’re all sorted; although if left untreated it can go on to cause a whole host of problems including infertility.

Of the 26 generally recognised STIs there are only four that can’t be fully cured with antibiotics. The other four are all viruses – they can be treated and contained but not cured.

However, if you are one of the unlucky ones who contract one of the more serious infections, such as HIV or Hepatitis, then it is still far better to be aware of what you have as there is loads of support out there. In fact, HIV although still very serious is not the life sentence it once was (and still is in other countries around the world). Although there is still no cure, it can be managed with healthy lifestyle choices and later with a strict regime of medicines called HAART.

By knowing that you do have a serious infection, whilst worrying, at least you can learn how best to live with it and also protect those you care about around you. There is a huge amount of support and advice for those living with things like HIV and their families.

Partner notification:

Obviously, if you have an infection – you must have caught it from somewhere – or rather someone. Another function of the GUM clinic is to try and prevent further transmission; this is why you will probably be asked about your previous sexual partners – especially any recently that you may have had unprotected sex with, as they will more than likely need to be tested and treated too. Again, the staff are not here to judge you – they are merely trying to prevent further transmission and treat those who are at risk of infection – so be honest – they aren’t really concerned if the person you slept with wasn’t your regular partner – they are not a moral jury, they are doctors and nurses.

They will encourage you to talk to any partners for yourself and ask them to come and be tested too. This isn’t a pleasant conversation for most people – “You alright love? How was your day?… Great… me? Oh I’ve got Chlamydia and I think you should get tested too – I’ve made you an appointment for next Tuesday.. so what’s for dinner?” It can get a little bit awkward, mainly because we still have a huge amount of stigma associated with catching sexually transmitted infections – whereas when you give your partner the flu there doesn’t seem to be there same issues!

Indeed, that is probably because we are still all wound up in the idea that only dirty people who sleep around catch STIs – or that you must of cheated with some dirty slapper to of caught one. Unfortunately, many STIs don’t have any symptoms and can lie dormant for years without any trace.

Anyway, back to partner notification – sometimes it may not be best for you to notify some of your previous partners for yourself. Most sexual health services will offer to contact your ex-partners for you if it is more appropriate. It is not always easy to tell an ex they have Chlamydia when you’re already not really on speaking terms.

Now, finding out you have an STI or even only suspecting you may have one throws up lots of ethical dilemmas, such as whether or not you tell your partner(s) – especially if the risk may have come from cheating on them.

Indeed, one thing you need to be aware of in the mean time is that you use protection until you are given a clean bill of health otherwise you run the risk of passing on the infection to them. Obviously, this may pose a problem if you and your partner, don’t use condoms as a regular form of contraception, as it may raise a few questions. Whether or not you are honest about why you think you may have caught an infection is not up to me and is none of my business – however whatever you do, don’t take the easy option and risk exposing them too; make sure you either abstain from sex or use a condom in the meantime. Be creative, a little white lie may save you lots of trouble and keep you both safe.

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