getting tested – what happens at a sexual health clinic

by Harriet Yudkin

Anyone who is sexually active – having a sexual relationship – is at risk of catching a sexually transmitted infection (STI). STIs are infections that can be passed from one person to another through vaginal, anal or oral sex. Some STIs, like pubic lice and genital warts, can even be passed on through close contact of the genitals. STIs are very common and you don't need to have had lots of sexual partners to get one.

symptoms

© Getty

An important thing to remember is that lots of STIs often don't have any symptoms – so you may not know when you have one. That doesn't mean that if you just ignore it it might go away – if left untreated, many STIs can be painful and uncomfortable and some, like chlamydia, can lead to serious complications such as infertility (not being able to have a baby). So, if you think you may be at risk, it's worth getting a check-up. For more information on possible symptoms, see our feature on STIs.

getting there

where can I go for a check-up?

You can do this at any sexual health clinic. These are sometimes called 'GUM' clinics, which is nothing to do with gums or teeth – it stands for genito-urinary medicine. You don't need to be referred by a GP – you can just go to any clinic, even if you don't live in the area.

Sexual health/GUM clinics offer a free and confidential service for the screening (testing) and treatment of all sexually transmitted infections, including HIV. They also offer free condoms, advice on safer sex practices and support about any concerns you may have about STIs. Many clinics also offer counselling around sexual issues such as relationship problems, sexual difficulties, sexual abuse or assault. See help and info for information on finding your nearest clinic. Or have a look in your local phone directory under 'Health Centres' or 'Clinics'. If you get stuck, you could always phone the nearest large hospital and ask them where the sexual health clinic is, as many of the clinics will be part of a large hospital.

will anyone find out I've been?

Any information you give in the clinic is completely confidential, which means that staff in the clinic – receptionists, nurses, doctors, health advisers – cannot tell anyone outside the clinic that you have been. This is the same if you are under 16. The only time they may need to tell anyone is if they are concerned that you or somebody else may be at risk of harm if they don't tell – but they will always try to discuss this with you first. If you're really worried, you can always use a false name. All they ask is that you remember which name you used and make sure the clinic has some way of getting in touch with you.

can you just walk in?

Clinics either have fixed appointments that you have to book in advance, or drop-in sessions so you can just walk in and wait to be seen, or a mixture of both. Most clinics get very busy so if you call for an appointment it may take some time to get through or to get an appointment, but keep persevering! Likewise, if you just walk in, you may have to wait a while to be seen.

common worries and questions

can I choose if I see a man or a woman?

Usually, clinics will offer you a choice of seeing a man or a woman. When women are examined by a male doctor, there will always be a female nurse present.

what sort of questions will they ask?

The doctor, nurse or health adviser will ask you about your concerns and about any symptoms you may have, who you have had sexual contact with and what type of contact it involved. It's important to be honest, as this helps them to know which tests you may need. The staff at the clinics are all very used to hearing all sorts of details about people's sex lives and won't judge you or be embarrassed by things that you tell them.

'The doctor was really friendly, she was really nice. She really put me at ease because it was quite nerve-racking.' (Sharelle, 16)

You may have attended a clinic because your partner has an infection or because you have been given a contact slip. This is a piece of paper that explains that you may have been exposed to an STI and suggests that you have a check-up. If this is the case, you need to give the slip to the doctor or nurse.

will they do tests then and there?

If you are concerned that you may have an infection, you can have tests straight away. Alternatively, you may want to think about it and decide to come back another day.

'They gave me enough time to think about things, to talk over with my friends and parents, so I didn't feel rushed or anything.' (Teresa, 16)

Try to make sure you do not pee for at least two hours before you go, as this may affect the reliability of the tests.

can you be tested if you have your period?

If you have your period, and are keen to be seen as soon as possible, you can still go to the clinic. However, if you are just going for a general check-up, it may be better to time it when you do not have your period as it is easier to do the tests.

what if you have had sex the night or some time before you go?

It doesn't matter if you have had sex some time before you go to the clinic. Some infections take between a few days and three months to show up on tests so, if you are worried about a recent sexual encounter, you may need to go back for repeat tests after a period of time.

tests

what will they do to me?

So that the doctor or nurse who sees you can check if you have an infection or not, he or she will have to examine you and take some samples for testing. This usually involves taking a urine sample and swabs taken from the genitals, as well as a blood test for some STIs such as HIV and syphilis. All tests are optional and should only be done with your permission. Talk to the doctor or nurse if there is anything you are not sure about.

'They explained what was going to happen and if you were unsure they made you feel comfortable. It made me feel easy because if I had any queries or anything they were all right about it, they made you feel like it was normal to have queries and should ask questions.' (Daniel, 17)

Women will usually have an 'internal' examination – this is when the doctor or nurse feels inside your vagina to check that your reproductive organs (womb, fallopian tubes and ovaries) are all right. They will also usually take some swabs from your cervix (the entrance to your womb) and from your urethra (where you wee from). To do this, they will use a speculum, which is put inside your vagina to open it up a little bit so the doctor or nurse can see inside. Then they will take the swabs, which are done with something a bit like a little cotton bud. It's easier if you relax your muscles, which may be difficult if you are nervous, but they will try to put you at your ease. The swabs may feel uncomfortable, particularly if it is the first time and you are not used to it, but it shouldn't hurt, and only takes a few seconds.

Men will usually have a swab taken from the end of their penis. There are lots of myths about umbrella-type implements being put down men's willies – but these are just myths! The swab is just like a thin cotton bud that goes just inside the urethra (where you wee from). It may feel uncomfortable, but it shouldn't hurt and only takes a few seconds.

Both men and women may have swabs taken from their throat and from their rectum (bottom), depending on what sexual activity you have had. A blood test will be necessary if you want to be tested for HIV and syphilis. You may also be asked to talk to a health adviser about having the test, so they can talk to you about your feelings and about what you would do if you found out that you were HIV positive (had HIV).

'It was useful to talk to the health adviser because it helped me think about things and answered a lot of questions.' (Mark, 19)

results

when do I get the results? Will I have to go back?

Some of the results will be available on the day. After your examination, you will usually be asked to return to the waiting room while the nurse looks at the swabs under a microscope. Then you will return to see the doctor who will tell you if any infection has been found in the preliminary tests and the findings of the clinical examination.

The rest will usually take between one to two weeks, as the samples will have to be sent to a laboratory to get the results. You will have to go back in person to get results of HIV tests (and some clinics offer a same-day testing service, so you could get the results the same day). This is so that if you were found to have HIV, you could talk to somebody about it in confidence. The rest of the test results should be available by telephone. Some clinics ask you to make an appointment to telephone in. If you have been given treatment for an infection, you may have to go back to check the infection has gone.

treatment

The good news is that many STIs can be treated. Some, like chlamydia and gonorrhoea, can be cured altogether – usually with antibiotics. The doctor may recommend starting treatment before your test results come back if there is a high chance of you having the infection. Some treatments just involve taking one tablet but if you are given a course of tablets, it's really important to finish the course – even if the symptoms have gone away – otherwise the infection won't get cured.

Make sure you tell the doctor or nurse if:

• you are on the pill,
• if you are, or think you might be, pregnant,
• if you're breastfeeding.

Other STIs, such as genital warts, can be frozen, treated with chemicals, or given laser treatment to get rid of them. Genital warts can be difficult to get rid of – they often come back and need more than one course of treatment.

what about sex?

You will be asked to keep off sex during the treatment. This is really important as, otherwise, you will just keep passing the infection back and forth with your partner(s) and won't be able to get rid of it.

what about partners?

It's also important that your sexual partner(s) are treated too. This may be difficult, especially if you are no longer in touch with them, but the clinic staff will help you manage this if it is difficult. You may just feel like ignoring the situation, but it's important for any previous partners to get treated too, as they may get long-term complications if left untreated.

If you are in a relationship, this can raise lots of questions and suspicions about where the infection came from, but try not to jump to any conclusions. It's possible to have an infection without having any obvious symptoms and it's never possible to determine exactly when someone got infected – so they could have been infected from a previous partner. Try to talk to the staff at the clinic about your feelings, doubts and concerns.

'The doctors were really helpful. They talked to you right and didn't talk to you like they were above you or anything. They explain it all and make you feel at ease – cos they tell you that it's not only you that has this problem, that really helps.' (Steven, 18)

help and info

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organisations

Brook
421 Highgate Studios
53-79 Highgate Road
London NW5 1TL
Helpline: 0800 0185 023 (Mon-Fri 9am-5pm)
E-mail: admin@brookcentres.org.uk
Website: www.brook.org.uk
Provides free and confidential sexual health advice and contraception for anyone under 25. The website has tons of useful information including a secure on-line enquiry service and a text messaging service.

Caledonia Youth (CY)
Tel: 0131 229 3596
E-mail: information@caledoniayouth.org
Website: www.caledoniayouth.org
At various locations throughout Scotland, Caledonia Youth provides free, confidential support to enable young people in Scotland to make informed, responsible choices about their personal and sexual relationships. Contraception is provided and advice offered on various issues such as safe sex, parental consent, sexual wellbeing and negotiation skills.

FPA
2-12 Pentonville Road
London N1 9FP
Helpline: 0845 310 1334 (Mon-Fri 9am-6pm)
fpa Scotland: 0141 576 5088 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
fpa Northern Ireland: 028 90 325 488 (Mon-Thurs 9am-5pm; Fri 9am-4.30pm)
Website: www.fpa.org.uk
The fpa can advise on all sexual health matters, including contraception, abortion and sexual health. A range of factsheets are available to download free from the website. You can also get details of family planning clinics, sexual health clinics and other sexual health services anywhere in the UK.

Marie Stopes International
153-157 Cleveland Street
London W1T 6QW
One Call: 0845 300 8090
Website: www.mariestopes.org.uk
Runs a range of reproductive health services including contraception, abortion counselling, well women screening, gynaecological consultations, vasectomy, and psychosexual and relationship counselling.

NHS Direct
Helpline: 0845 4647 (24 hours)
Website: www.nhsdirect.nhs.uk
The NHS 24-hour service provides expert health advice from trained nurses. An extensive database of medical information is available on their website. They can also advise you if you wish to make a complaint about the NHS.

Sexual Health Line
Tel: 0800 567 123 (24 hours)
Textphone: 0800 521 361
Gives confidential advice and information about STIs or any other aspect of sexual health. Can also tell you where to find local sexual health services.

Sexwise
Helpline: 0800 28 29 30 (7am-midnight, every day)
Website: www.ruthinking.co.uk
Offers information, advice and guidance to young people aged 12-18 about sex, relationships and contraception. The website also allows you to search for services anywhere in the UK.

websites

AVERT
www.avert.org
Information for young people about HIV infection and AIDS, sex, puberty, sexuality, contraception and condoms. Includes personal stories, articles and resources such as quizzes, statistics, FAQs and printable booklets.

British Association for Sexual Health and HIV (BASHH)
www.bashh.org/directory.htm
Downloadable directory providing details of GUM clinics across the UK and Republic of Ireland.

Condom Essential Wear
www.condomessentialwear.co.uk
For more information on condoms, sexual health, how to protect yourself from STIs and how to find your nearest GUM Clinic.

Like It Is
www.likeitis.org/indexuk.html
Website for 11-15 year olds, providing advice on issues such as contraception, periods, teenage pregnancy, sex and sexuality.

Sexually Transmitted Infections (STIs)
www.nhsdirect.nhs.uk/en.asp?TopicID=617&AreaID=4065&LinkID=3140
Straightforward but brief outline of sexually transmitted infections (STIs) and their treatments. Part of the NHS Direct website.

Society of Sexual Health Advisors
www.ssha.info/public/index.asp
Information on sexually transmitted infections and related conditions and sources of help and support.

(December 2002, resources updated February 2005)