What Happens When You Go for an STI Test

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.

Several medical sample tubes, for a post on STI testing

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!

Five Meaningful Things To Do for World AIDS Day

December 1st is World AIDS Day. The AIDS epidemic, at its height in the 1980s and early 1990s, is still in many ways ongoing and has claimed over 35 million lives in the last ~40 years. Check out this fact sheet to learn more.

A red ribbon for a post on World AIDS Day

From the World AIDS Day website:

[World AIDS Day is] an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first ever global health day.

Many of us, especially LGBTQ+ people, feel helpless in the face of something this huge. It scares the shit out of lots of us – and it should. AIDS was and is one of the most destructive pandemics in human history. But there is hope, too. UNAIDS have a hugely ambitious treatment plan which, if it works, will see 90% of HIV-positive people knowing their status, 90% of these on antiretroviral therapy, and 90% of these with a viral load declared “undetectable” – all by 2020.

So today I wanted to share some small but meaningful things you can do to make a difference this World AIDS Day.

1. Donate if you can

Donate to a charity that’s doing important work in the areas of HIV and AIDS. I suggest amfAR who are pioneering research into a cure, Terrence Higgins Trust who campaign and provide services connected to HIV and sexual health, or the National AIDs Trust who fight for change and champion the rights of people living with HIV/AIDS.

2. Get a test and know your status

When was your last full sexual health screening? Go book one in now! If you’re sexually active, you really should be getting a test every six months at a minimum – and more often if you have multiple partners, practice unprotected sex, or regularly have anal sex. I’m fairly slutty and I have a full screening every 3 months. Knowing your status is the best way to protect yourself and your partners.

3. Smash the stigma and share factual information

See people talking shit about people with HIV, AIDS or STIs? Tired of false information? Engage in some stigma-smashing by challenging them to rethink their views and sharing some facts. People living with HIV are not dirty, sluts, immoral or stupid. HIV cannot be transmitted except via infected blood or sexual fluids (or to infants via breast milk). It cannot be passed on through kissing, skin-to-skin contact, sharing food or drinks, water fountains, toilet seats, mosquitoes, saliva, sweat, or modern blood transfusions. This handy guide is useful to share.

4. Stock up on sexual health supplies

As many people as possible practicing safer sex is one of our greatest weapons against HIV/AIDS. Make sure you’re well-stocked with condoms, dams and gloves, as appropriate to the types of sex you have. If you can’t afford to buy supplies, ask your doctor or sexual health provider where you can access them for free. Remember to check your condoms and dams before using to make sure they’re still in date!

Pro tip: Gay bars/clubs and sexuality-focused events often give out safer sex supplies as freebies. If you go to any of these, don’t be scared to claim some for yourself! I used to go out to gay bars so often I don’t think I paid for condoms until I was 24.

5. Wear your red ribbon

The red ribbon is the internationally-recognised symbol of HIV/AIDS awareness and advocacy. Here’s a useful list of where to get them in the UK. If you can afford to, you can also buy a brooch version and support NAT’s work.

What are you doing to support World AIDS Day and show solidarity with people affected by HIV all over the world?

Image from Pixabay. Contains an affiliate link.

[Guest Blog] The Thirst of “Femmes d’un Certain Age” by Evelyn Archer

When I started out on this quest to publish a select few guest bloggers on my site (and pay them for it, of course!) part of my mission was to share the stories I cannot tell. The experiences I have not had. That’s one of the reasons I was so excited by this piece by Evelyn Archer. Here, we’re talking Sex After 40! I’m in my late 20s. The myths about sex stopping is one of the things I’m very afraid of about growing older. But here, Evelyn tells us that not only can sex after 40 be amazing – it might just be the best ever. She’s also sharing some wisdom she’s learned along the way. Over to her…

Amy x

A 40th birthday cake, for a guest post on sex after 40 by Evelyn ArcherThe Thirst of “Femmes d’un Certain Age” by Evelyn Archer

Some doctors call it “The Surge”. I call it “The Going Out of Business Sale”.

Here’s the truth: in my late 30s through mid-40s, I’d done without sex for a long time. In a long, otherwise happy marriage – between medication side effects, interpersonal issues and plain old fear – we’d been Not Having Sex for longer than I like to admit. I told myself that everyone gets to define these things for themselves (still true), but there was also another message that I was getting and internalizing without really realizing it. A woman over 40 with a sex drive is a joke. A grotesque joke. Either played for laughs or an object of scorn and pity – we’re Stifler’s Mom from American Pie, Mrs. Roper from Three’s Company (Google it, my sweet babies).

I had no model for what my sex life after 40 was “supposed” to look like. It was “supposed” to Go Away. In fact, cursory Googling revealed a stark, depressing story of “sexless marriages”, of couples living with resentment and disappointment, or at best as friendly roommates, co-owners in the Business of Our Life. A sexual life was something I used to have, someone I used to be, and it looked like I would have to find a way to live without it.

But through hard work in therapy and a bunch of other stuff we came together again.

And now we can’t stop boning each other. But as an essentially cishet (I mean, het-ish, but that’s another post) monogamous couple, in order to truly get back on track, we had to take our cues from outside the cishet community (which is unsurprisingly UNHELPFUL in terms of sex positive information). Instead we turned to queer folks and trans folks and polyamorous folks.

If my partner and I were struggling, for whatever reason, with penetrative P-in-V sex, why was this the “end of sex” for us? Would we say that what our queer friends, our trans pals did in bed wasn’t “really sex”? Of course not! That doesn’t even make sense! So why did it have to be that way for us? Once we stopped putting P-in-V sex at the center of our sex lives, once we stopped seeing “everything else” (oral and manual and toys and everything) as a “lead up to the main event” our entire sex lives transformed. All of a sudden, “fucking” was whatever we decided it was.

So we started fucking all the time.

We can’t seem to stop. He comes home early from work just for banging. We send dirty gifs to each other. We keep a Sex Toy Wish List on Lovehoney. And we haven’t seen our friends on a Saturday night in months because we’re so tired from banging all afternoon, all we can do is eat spaghetti and watch cartoons.
And it was from polyamorous folks writing about relationships and intimacy that we learned that we have to TALK ABOUT EVERYTHING ALL THE TIME. We have to find ways to talk about stuff we don’t want to talk about. How to sit in uncomfortable feelings like disappointment and jealousy, and still hold space for each other.

It never occurred to us to actually have a conversation about what we WANTED to do
specifically, only what we DIDN’T want to do. From the BDSM community that we learned that we can just talk out whatever is “on the table” for fucky stuff and instead of all that talking “ruining the moment” (or whatever) it leads to a more fun and satisfying play-time.

The power of just listening

But let me be clear: all these terrific queer, trans, poly sex positive folks (bloggers, Twitterers, Instagram folks) are not giving this information to US. Their work is not necessarily FOR us, it’s for themselves and for each other. But by shutting up, and by watching and listening closely, I learned a new way to look at and talk about sex. As these folks process and manage their own sex positive liberation, it shows me a different way of inhabiting my own sexuality, shows me ways to question and ways to talk. It’s not one person in particular, but this chorus of voices, and quietly immersing myself in what they have to say has utterly changed my marriage, my relationship to sex, and the way I see myself.

But still, my high levels of desire seemed to be out of sync with public opinion and popular culture. There’s still the Google-able stuff about The End of Sex, but dig a little deeper and there’s something called “The Surge”. The way I understand it (and I am a writer not a doctor, so do your own research!) is that here at the End of my Childbearing Years my body knows that each egg it releases could be its last. So it releases a surge of hormones telling me “YOU BETTER BANG EVERYTHING BECAUSE THIS COULD BE YOUR LAST CHANCE”. But there’s SO little information on this (and most of it anecdotal) it reminds me of how monstrous our culture sees Femmes d’un Certain Age whose sex drives are still strong. We’re still a joke, still grotesque. Still Mrs. Roper, still Stifler’s mom.

Dawn Sera and Tristan Taoromino have talked about it on their podcasts a couple of times, but there’s little in popular culture for me to look to. Even looking for women over forty in romance novels came up thin, even thinner if you want something a little hotter than “sweet” and “tender”.

So…where ARE we?

WHY is no one talking about this? Why is the only talk of women and
middle age and desire about our thinning hair, our drying and atrophying vaginas, our hormone therapy, our inevitable march to a dry and sexless grave?

Well, I’m not having it. I’ve decided to embrace my monstrousness (if indeed that’s what it is). And I’m leaving you with some resources that really helped me. (These may Old News to you Sex Positive Veterans, but they were news to me).

Resources

  • Tristan Taoromino’s podcast “Sex Out Loud” (available wherever fine podcasts are uploaded). She has more talk of kink and gender and queer politics so this was right up my alley.
  • Dawn Serra’s “Sex Gets Real” (available wherever fine podcasts are uploaded). She has a softer, more relationshippy slant. There’s also lots of good stuff about the intersection of fat positivity and sex positivity. (Be prepared to hear the word “yummy” a lot.
  • Oh Joy, Sex Toy is a web comic by husband and wife team Erika Moen and Matt Nolan. I went there just for sex toy reviews and what I got was SO much more. The illustrations are really sweet, with lots and lots of body diversity (which I don’t see everywhere).
  • Come As You Are: the Surprising New Science that will Transform your Sex Life, by Emily Nagoski. The research here on how desire can work for some folks was a revelation to me. (Also Erika Moen does the illustrations!) Not so science-y that it’s dry, yet doesn’t read like a self-help manual. She is a scientist and a sex educator and this book is great.

Author photo of Evelyn ArcherEvelyn Archer is an author living in New England. You can find her books here and you can sign up for her super fun newsletter, “The Strange Files” here. She also writes erotic shorts as “Madeline Moon”. You can find them here, or here.

 

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I Had My First Smear Test and…. It Was a Complete Non-Event

I am in my late twenties. In my country, people with cervixes are offered cervical smear tests (often called “Pap Tests” in the USA) every three years from the time they turn 25. These tests detect abnormal cells on the cervix and act as an early screening for cervical cancer or warning signs thereof. Until this week, I’d never had one, despite being several years overdue.

Two medical swabs face down on a surface. For a post on cervical smear tests.

The reasons for this are varied, but there are two main ones. The first is practical: I moved house a lot prior to moving in with Mr CK (11 times in 9 years by my count) and as such had to register with a lot of different doctors in different cities. I’m not sure one of the letters inviting me to book in for a smear even found its way to me until I was at least 27. The second reason is that I was scared. I had a horrible experience when I got my IUD put in about 3 years ago – pain that rendered me entirely unable to function for three days and very much struggling for over two weeks. Therefore, understandably, the idea of anything going near my cervix elicited a strong and visceral NOPE reaction from me. So I just kept putting it off.

What eventually pushed me into going for one was a person in my extended poly/swing network having something flag up on their screening. I realised that by not knowing my status, I am not only putting myself at risk (and there is some history of cancer striking young in my family) but also putting my lovers at risk. And I couldn’t do that. I made the appointment.

On the morning of, I asked Twitter how much pain I should expect. Answers ranged from “none” to “maybe a bit but it’s over quickly” to “you probably wanna book the day off work”. (It was a little late for that, of course). I popped a couple of ibuprofen, just to be sure. Had I not been driving, I might have gone straight for the codeine, which my doctor gave me for the severe pain when my IUD acts up.

So what happened?

I went in and the lovely nurse introduced herself and asked if I was happy to have a student nurse present for the test. I said I’d rather not as it was my first time, and they were both fine about that. She asked about my STI testing history. I said we test every three months and had in fact been the week before. She asked if I knew about HPV, and I said yes.

I went behind the curtain, took my knickers and jeans off, and got comfortable on the bed thing. (I’ve never understood the point of a privacy curtain when they’re literally about to look at your insides, but there you go). The nurse explained that she would open my vagina with a speculum and do a quick swab of my cervix. She said I might feel some pressure, but it shouldn’t hurt.

Having one’s vagina opened with a plastic speculum is never comfortable. (Unless you’re into that sort of thing. Which I actually am when it’s with a sexual partner in a roleplay scenario. But dear god, fun medical play is a MILLION MILES from an actual medical exam). I winced a bit but remembered to breathe. I braced myself for severe pain.

“There you go, we’re done”. And the nurse was removing the speculum from my vagina and taking off her gloves.

“What, that’s it?” I could hardly believe it.

“Yep!”

Wow, I thought. That really was nothing.

The whole thing took less than five minutes. I felt no pain and only the mildest discomfort. A tiny price to pay indeed for knowing my status, protecting myself and my sexual partners, and possibly avoiding cervical cancer in the future.

So why am I telling you this non-story?

Honestly, I was fully expecting to have to tell you a horror story involving immense pain, shitty judgemental clinic staff, an unplanned day off work or all three. But none of this happened.

So instead I thought I’d share this story in the hopes that, if you’re afraid of getting your cervical smear, this will put you at ease. The staff should be kind and understanding. You shouldn’t feel any pain – even if your cervix is extremely sensitive and grumpy, as mine is.

Please – if you have a cervix, get your test. It takes five minutes, it doesn’t hurt, and it’s a tiny thing that could potentially save your life. Just go. I’m now kicking myself that I didn’t go three years ago!

If this post was helpful to you, please consider buying me a coffee to say thanks!

Image from Pixabay.