Year: 2019

Heads-up: this post specifically discusses the STI testing process at a sexual health clinic in the UK based on my experience. Increasingly, different NHS authorities do things slightly differently, so this won’t necessarily be entirely representative. The process may also differ significantly in other countries. Despite its inherent limitations, I hope the information is still useful. Needless to say, none of this is a substitute for qualified medical advice.

This week I went to my local sexual health clinic for my quarterly screening, otherwise known as an STI (sexually transmitted infection) test. This is a routine part of my life as a non-monogamous person and something I barely think about other than remembering to schedule it. However, this wasn’t always the case. The first time I went, shortly after opening my previously-monogamous relationship at the age of 18, I was nervous because I didn’t know what to expect.

Let’s answer some common questions about the process of visiting a sexual health clinic in the UK.

How Often Should I Get Tested for STIs?

It depends on your risk profile.

People who have more partners and people who have unprotected sex (including oral sex) should test more regularly. Experts recommend everyone gets tested at least once per year. Yes, committed monogamists, that includes you! Monogamous people can contract STIs if someone cheats, but also through unknown pre-existing infections (some STIs can lie dormant for months or years), treatment failure for a past infection, and incomplete or false-negative screenings. Getting tested doesn’t imply that you don’t trust your partner, or that you are not to be trusted.

If you have a single, long-term partner and/or always use barriers for every type of sex, an annual test is likely enough. If you have a lot of partners, practice unprotected sex, or do sex work, you’ll need to test much more regularly. As a polyamorous person, I personally test every three months.

Whatever your relationship style, testing before every new partner is advisible. And, of course, you should get a test if you believe you may have been exposed to an STI or a sexual partner discloses an infection. Remember to observe the testing windows after a possible infection for the most accurate results.

Where Do I Go for STI Testing in the UK?

You have two main options for STI testing in the UK: home testing or visiting a sexual health clinic. This post focuses on clinic-based testing, but do-it-yourself tests are a convenient option if you don’t have a local clinic, can’t get there, or simply prefer to test in the privact of your own home.

Some sexual health clinics offer walk-in times during which you can simply turn up and wait to be seen. These clinics tend to be very busy. Get there early, bring a book, and expect to be waiting for a while.

Some clinics also have appointments slots which you can book online or on the phone the same as any other medical appointment. Again, these services are very busy and in high demand, so you may need to schedule your test well in advance. If you have symptoms, believe you may have been exposed, or a sexual partner has been diagnosed with an STI, tell the clinic and you may be seen sooner.

Do I Have to Pay for STI Testing?

Nope! In the UK, all sexual health services including testing and contraception are available free of charge on the NHS. Free home testing kits are also available in most areas through various

I’m Under 16, Will the Clinic Tell My Parents?

No.

In the UK, as long as you’re over 13, you’re entitled to the same medical confidentiality as anyone and this includes when you visit a sexual health clinic. If your provider feels that there is a serious risk to your safety, such as suspecting that you might be experiencing sexual abuse, they may need to tell someone in order to keep you safe. However, according to NHS guidelines, “the risk would need to be serious and this would usually be discussed with you first.”

If you’re under 18, please stop reading my blog and check out Scarleteen or Bish for accurate information about sex, sexual health, relationships and your body.

Will I Have to Answer Questions About My Sex Life?

Your provider will ask you questions about your sexual practices. You don’t have to answer any questions or disclose anything you don’t want to, but it’s important to be as honest and thorough as possible. This is the best way to make sure you get the tests, advice, and other care you need.

Questions may differ slightly at each clinic, but here are some I’ve been asked or have heard about others being asked at STI testing clinics in the UK:

• When was your most recent sexual encounter?
• What is the sex of that partner? (They may assume the opposite binary sex unless you tell them otherwise. It’s bad practice but heteronormativity is strong.)
• Is that partner your regular/only partner?
• Do you use condoms or other barriers when you have sex?
• 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?

How is an STI Test Performed?

If you have a vulva, a swab will be taken from inside your vagina and you’ll need to provide a urine sample. If you have a penis, you’ll need to provide a urine sample. Some clinics also do swabs from just inside the urethra. If you have anal sex, you’ll need to do a rectal swab, and if you have oral sex you’ll need to do a throat swab.

Unfortunately, anal and oral swabs are not always offered as a matter of course. You may need to prompt your provider for these or advocate for yourself to get them. I strongly advise you do so, as infections can grow in these areas of the body without being present in the genitals.

Most STI testing clinics in the UK allow you to take the swabs yourself in private by going into the bathroom or stepping behind a curtain in the consulting room. If you don’t feel confident or comfortable doing this, your provider may be able to do it for you.

They’ll also take a blood sample to check for blood-borne STIs such as HIV, Syphilis and Hepatitis.

There’s usually no need for a physical examination unless you have symptoms or specific concerns.

Does STI Testing Hurt?

Not really. The swabs aren’t exactly comfortable but they also shouldn’t be painful. Some people with penises find urethral swabs (if performed) slightly painful, but most say it is manageable and over quickly.

Most people don’t find blood tests painful beyond a quick, sharp scratch, but some people can have a more intense physical reaction to them than others. Tell your provider if you’re needle-phobic or tend to feel sick or lightheaded when you get blood drawn.

Will the Staff Judge Me?

No.

Your provider’s job is to help ensure your health and safety, not to judge you. People don’t generally go into sexual medicine if they are going to judge others for being sexual.

At the time of updating this post, I’ve been getting STI tests regularly for over 16 years and have very rarely encountered anythng I could even remotely describe as judgemental. Even on the incredibly rare occasions I felt judged, it was more of the “excessive misplaced concern due to ignorance” variety than the moral variety.

How and When Will I Get My Results?

This varies between clinics and your provider will tell you what to expect.

Increasingly, many UK STI testing clinics operate a “no news is good news” policy, meaning that if you don’t hear from them within a set period of time then you can assume everything is fine. They may give you a card with a phone number or online portal to check your results if you want to be sure.

I always recommend you do check, as it is possible (but rare) for a clinic to lose your samples. This happened to one of my partners once.

Some clinics may text or email you (usually something simple like “your tests are all negative”) or, less commonly, ring you to let you know you’re in the clear.

What If I Test Positive?

If you test positive for an STI, a typical UK sexual health testing clinic will phone you to let you know and advise you on your treatment options.

For many of the most common STIs, such as gonorrhea and chlamydia, treatment is a simple course of medication. Some STIs cannot be cured, but can be managed. If you have HIV, for example, you’ll need to take medication for the rest of your life, but that life can still be completely normal and fulfilling.

STIs are not a source of shame. They’re not a death sentence and they don’t signal the end of your sex life. Contracting an STI is no more shameful than contracting the common cold, a sickness bug, or the flu. They’re things that humans sometimes contract in the course of doing normal human activities like having sex. If you do have an infection, it’s much better to know about it so that you can get the most effective treatment quickly.

Bear in mind that HSV (herpes) and HPV (human papillomavirus) are extremely common—a majority of adults carry one or both and may never even know it—and are not picked up on most standard screenings unless you have symptoms such as warts. HPV can also be picked up on cervical screenings, so make sure you’re attending these if you have a cervix.

What Other Services Can I Get at an STI Clinic?

Sexual health clinics in the UK offer a range of services along with STI testing and treatment. Each clinic is slightly different but the services commonly available can include:

• Contraception including long-acting reversible contraceptives (such as IUDs and implants), advice and referrals for vasectomies and sterilisation, and emergency contraception.
• Free sexual health supplies such as condoms, dams, and lube.
• Pregnancy testing.
• Advice, guidance and support if you’re seeking an abortion.
• Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) to help prevent HIV.
• Ongoing care, support and monitoring for people who have HIV.
• Vaccinations to protect against various sexually transmitted infections such as HPV and hepatitis.
• Cervical smears.
• Support with sexual difficulties such as erectile issues, vaginismus, and pain during sex.
• Referrals for specialist services such as psychosexual therapy.
• Help, support and guidance after sexual assault.
• General advice on reducing your risk profile and having safer sex.

When did you last go for an STI test? If it’s been a while, go and book your next test now.

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