Yesterday I went for my quarterly sexual health check-up. This is an important part of my life as a non-monogamous person and it’s now a really normal, routine, “no-big-deal” thing. But that wasn’t always the case! When I went for my first STI check-up at age 19, I was shaking like the proverbial leaf and had no idea what to expect.
So let’s answer some common questions, shall we? Please bear in mind that my experiences are entirely based in the UK, so if you live in a different country your experience may vary somewhat.
Where do I even go for a test?
There are sexual health clinics or “GUM” (genito-urinary medicine) clinics at most major hospitals and at some smaller practices too. Just Google “sexual health test + [your town]”.
Some clinics have “walk in” times where you just turn up and wait to be seen. Bear in mind these tend to be VERY busy – I arrived 15 minutes before the clinic time officially started for my test, and still waited about an hour. Get there early, bring a book, and don’t expect to be seen in five minutes. Alternatively, some clinics have bookable appointments, where you ring up and book like any other medical appointment. Again, these services are very busy and in-demand so you might need to wait a couple of weeks to be seen. If you have symptoms, explain this at the clinic or on the phone and you may be seen sooner.
Do I have to pay?
Nope! In the UK, all sexual health services including testing and contraception are free of charge. Praise the NHS.
If I’m under 16, will they tell my parents?
No! As long as you’re over 13, you’re entitled to the same medical confidentiality as anyone. If your provider feels that there is a serious risk to your safety going on, such as sexual abuse, they may need to tell someone in order to keep you safe, but according to NHS guidelines “the risk would need to be serious and this would usually be discussed with you first”.
Also, if you’re under 18, get off my blog. This is not the space for you. Get yourself to Scarleteen.
Do I have to answer questions about my sex life?
Your provider will ask questions about your sexual practices so they can make sure they’re giving you all the tests and advice you need. You don’t HAVE to answer anything you don’t want to, of course, but it’s important to be as honest and thorough as you possibly can to make sure you get the best care. Everything you say is in strict confidence. Questions may include:
- When was your most recent sexual encounter?
- What is the sex of that partner? (They may assume opposite binary sex unless you tell them otherwise. It’s bad practice but heteronormativity is strong).
- Is that partner your regular/only partner?
- Have you ever injected drugs or knowingly had sex with someone who injects drugs?
- Do you have reason to believe you might have come into contact with HIV?
- Have you been raped or sexually assaulted? (If you indicate yes, they’ll ask if you need any support or resources).
- Have you ever paid for, or been paid for, sex?
- Have you had sex with someone born outside of the UK?
- When was your last sexual health screening?
- Are you pregnant or do you think you might be pregnant?
Once you’ve gone through these preliminary questions, it’s time for your test.
How is a test carried out?
There are slight variations depending on the clinic but here’s how it normally goes:
For folks with a vulva, you’ll swab the inside of your vagina and possibly provide a urine sample.
For folks with a penis, you’ll provide a urine sample and may also swab just inside your urethra.
If you engage in receptive anal sex, you will swab just inside your anus.
If you engage in oral sex, the health care provider will swab the back of your throat.
Unfortunately, anal and oral swabs are not always offered as a matter of course. You may need to prompt your provider for these. I strongly advise you do so, as infections can grow in these areas of the body without being present in the genitals.
The provider will then do a blood test to check for blood-borne STIs such as HIV, Syphilis and Hepatitis. (You can get a vaccination against Hepatitis B and if you haven’t had the vaccine, I recommend you ask your provider for it. This is most commonly offered to men who have sex with men, or women who have sex with bisexual men, but I really believe everyone should get it if possible).
You do the vaginal and rectal swabs yourself in private, either behind a curtain in the consulting room or in the bathroom. Your provider will give clear instructions on correct insertion of the swabs. There is not usually a need for a genital examination unless you have any symptoms such as genital warts, a rash or pain.
Does the test hurt?
Not really. Throat, anal and vaginal swabs aren’t exactly comfortable but shouldn’t be painful either, and they only take a couple of seconds. Some men do find the urethral swab slightly painful but, again, you only need to go very slightly inside and it only takes a few seconds.
Some people (hi, I’m one of them) find blood tests make them feel a bit sick and lightheaded. If this is you, tell your provider and they’ll let you lie down and should check on you at every stage. The actual test feels like a brief quick scratch, nothing more.
Will my provider judge me for the things I tell them?
They really shouldn’t. I’ve been getting STI tests regularly for 10 years and only a couple of times encountered a judgemental provider. And yes, I always tell them I’m a polyamorous swinger and exactly how many partners I’ve had since my last test.
Your provider’s job is to help ensure your health and safety, not to judge you. If you feel that they are overly judgemental or they make inappropriate comments about the things you tell them, you should report this to the hospital or practice.
Again: this is really rare. Most sexual health professionals are absolutely lovely. Comments I’ve had on explaining my lifestyle range from “sounds like you have lots of fun!” to “it’s great to see you’re being responsible and taking care of everyone’s sexual health”.
Even the judgy comments were hardly “you’re a filthy slut and you’re going to hell”. They were more along the lines of, “you need to be aware that you’re at high risk for STIs and unwanted pregnancy” (“no I’m not, because I take precautions and know the facts”, I did not say but wanted to).
How and when will I get my results?
Many clinics operate a “no news is good news” policy, meaning that if you don’t hear from them within two weeks you can assume everything is fine. But they should also give you a card or phone number with details on how to check your results if you want to be sure. I always recommend you phone, as it is rare but possible for a clinic to lose your samples. This happened to my partner once, and they didn’t call to let him know he needed to be re-screened until after the two week window had passed.
Other clinics may text or email you (usually something simple like “your tests or all fine”) or, less commonly, ring you to let you know you’re in the clear.
What if I do have something?
If you do have an infection, they will ring you to let you know. Then you’ll make an appointment to go back to the clinic and make a plan for treatment. For most of the common STIs, such as gonorrhea and chlamydia, treatment is a simple course of antibiotics.
For more serious STIs it’s more complicated (if you have HIV, for example, you’ll be on medication for the rest of your life – but you can still live a totally normal, long and fulfilling life). STIs are not a death sentence. They are not a source of shame. They’re things that humans sometimes contract in the course of doing normal human activities like having sex – and it’s much better to know so that you can get the most effective treatment quickly.
Bear in mind that HSV (herpes) and HPV (human papillomavirus) are EXTREMELY common – most of us are carrying one, the other or both and may never even know it! – and are not picked up on standard screenings unless you have symptoms such as warts. HPV can also be picked up on cervical screenings, so if you have a vagina make sure you go for your smear tests.
But STI testing is just for sluts!
Nope! Everyone, and I mean everyone, should be getting tests. Stigma like this, that people who go for tests are inherently slutty (and that being slutty is bad) contribute to the misinformation and fear-mongering that are already far too ubiquitous in our culture.
How often should I get a screening?
That really depends.
My partner and I go every three months because we are non-monogamous and quite promiscuous. Three months is also about the longest incubation period for any of the known STIs, so this schedule means that if we do contract something we are unlikely to have it for long without finding out.
If you’re a swinger, polyamorous or have a lot of casual sex, I really recommend the three-monthly schedule. At an absolute, absolute minimum, please try to go every six months.
Even if you’re in a monogamous relationship, it’s wise to test every now and then if there’s ANY possibility that either of you has had sex outside of your relationship at any point. Unfortunately, cheating is rife and many people have caught STIs this way and not known they had them for months or years.
Whatever your relationship style, I recommend a test before every new sexual partner where possible.
Anything else I need to know?
Many clinics offer free condoms and, less commonly, dams (for oral sex on vulvas). Don’t be afraid to ask for supplies or take them if they’re offered to you. Using barriers is the best way to protect yourself and your partners from STIs.
When did you last get tested? If it’s been a while, go and book one in!