The number of people visiting sexual health clinics has fallen by 24% in the past decade, according to new figures released by NHS Digital.
Since 2015 alone, the number of people attending the services has dropped by 7% - from 2.03 million to 1.89 million. Meanwhile women are far more likely to visit services than men, with 7% of females aged 13-54 visiting a clinic at least once during 2016-17 compared to just 1% of males of the same age.
Natika Halil, chief executive of sexual health charity FPA, highlighted the importance of getting tested: “People often assume that they’ll know if they have a sexually transmitted infection (STI) because they’ll see the symptoms. Or they assume that they would need to have lots of different sexual partners in order to get an STI.
“In reality, it’s very common for STIs not to have any obvious signs, and anyone who’s had unprotected sex with a new partner should get themselves checked out – it only takes one time.”
Off the back of this, we spoke to sexual health experts about exactly what to expect when you visit a sexual health clinic - from the questions you’ll be asked, to the treatment you might need. Now, go forth and get tested.
What happens when you get there?
Clinics usually offer a variety of walk-in and appointment services, so it’s important to check the opening times beforehand and possibly book in advance to save waiting around. In cases where a person is disabled or English isn’t their first language, it’s worth contacting the clinic before the appointment to ensure it can meet specific needs.
Reception teams operate discretely and will try to ensure you’re seen in a way so that other people can’t hear what you’re saying. Sue Burchill, head of nursing for Brook, a sexual health service for under 25s, told HuffPost UK: “There may even be a screen or a dedicated consultation room depending on the service.
“If there is no screen or a dedicated room, many clinics – particularly young people’s clinics like Brook – will have a document or sometimes a digital display which you can point to, to avoid saying out loud what you’re there for.”
On arrival, you’ll normally be asked to fill in a form with your name and address, and may be asked to complete a triage form asking why you are visiting the clinic.
“This is so you can be seen by the right person and offered the right tests,” explains Karin O’Sullivan, clinical lead at sexual health charity FPA.
Some people feel more comfortable taking a friend or family member for support, and this is fine. Equally, you should be offered a chaperone - someone else to be present - if you need to have an examination.
In some clinics, like Brook, they allow you to take a friend or partner. However they will always talk to a young person on their own first as part of a safeguarding policy.
O’Sullivan explains that once you’re called into the consultation room, you’ll be asked some more questions about your sexual activity and lifestyle. “This is all confidential, non-judgmental and is necessary so that the clinician knows how best to advise and support you,” she adds.
What questions are typically asked?
Some of the questions typically asked by sexual health staff include:
:: Are you sexually active?
:: When was the last time you had sex?
:: Do you have any symptoms?
:: Are your partners known or unknown?
:: How many sexual partners have you had over period of time?
:: What type of sex are you having? (e.g vaginal, oral, anal)
:: Are you using contraception?
“You should also be asked questions about your lifestyle including whether you smoke, use drugs or drink alcohol,” explains Burchill.
“This is important when discussing contraception methods, and also identifying whether additional support is necessary.”
It’s possible that you might also be asked about your medical history, allergies and whether you are on any medication.
“If you are a young person under 18 you will have more of an in-depth conversation about your social situation and your relationships. This is to identify any area of need or vulnerability,” says Burchill.
O’Sullivan adds: “Remember, you’re not just there to answer questions. You should also ask as many questions as you need to – and make sure you get answers that you understand.”
What tests are carried out?
The tests that are carried out will depend on the answers you give to questions about your sexual history, and whether you have any symptoms or not.
O’Sullivan explains what the procedure is if you do not have any symptoms:
:: Men will usually be asked to give a urine sample. It’s very important that
you’ve not passed urine for at least one hour before this test.
:: Women can take a self-swab from their vagina, and you’ll be given
instructions on how to do this yourself, privately, in a bathroom. (A swab looks a bit like a cotton bud. It’s wiped over the parts of the body that could be infected and easily picks up samples of discharge and cells.)
:: These tests will check for chlamydia and gonorrhoea. You’ll also be
offered a blood test for HIV and syphilis. In some clinics rapid HIV tests can be taken, where you receive the results in less than one minute.
:: You won’t automatically be tested for all infections, so if you think you
should be tested for a particular STI then you should discuss it with the
nurse or doctor. All tests are optional and should only be done with your
permission.
What about if you have symptoms?
:: Tests for both men and women might include an examination of your genitals, mouth, anus and skin to look for any obvious signs of infection. It might also include testing a sample of your urine, having blood taken, or taking swabs/samples from the urethra and from any sores or blisters.
:: You’re less likely to need to have any swabs taken from your throat or rectum, but this is a possibility.
:: For women, the tests might also include having an internal examination,
or taking swabs/samples from the vagina and cervix.
:: Sometimes a small plastic loop is used to take a sample to look at under the microscope. Whichever sampler is used, it only takes a few seconds and is not usually painful – though it might be uncomfortable for a moment.
How long does the appointment take altogether?
The length of your appointment will depend on whether or not you have any symptoms.
O’Sullivan explains: “If you do, you may need to wait for results and treatment. If you don’t, you’re likely to need fewer tests.”
The Faculty of Reproduction and Sexual Health (FSRH) standard is 20-30 minutes per consultation, but this is really dependent on what you present with.
“Some services offer appointments whereas others may be drop-in only,” explains Burchill. “We know that waiting times can be off-putting for people, especially as services are struggling to operate under public health cuts.
“Many sexual health services are responding to this by introducing online waiting apps, where people can put their name down and are given an approximate time so that they can leave and come back.”
O’Sullivan estimates that, overall, you’ll usually be in the clinic for a couple of hours, “depending on how many other people are waiting to be seen in the clinic, and how busy it is”.
How long do the results take to come through?
In some cases, people receive their test results straight away, while others might have to wait. This is because samples will need to be sent away to a laboratory.
In this case, you will usually be contacted in one or two weeks.
“The service will explain how you’ll get the results, and what the next steps will be,” O’Sullivan adds.
What happens if you need treatment?
If you’re diagnosed with an STI or have attended the clinic because you had sex with someone who told you they have an infection, the clinic will discuss – and often give you – any treatment you might need straight away.
“Many STIs can be easily cured with antibiotics,” says O’Sullivan. “Others will need creams or lotions to treat the infection or relieve symptoms. With some STIs, you might need further tests or to go back for follow-up tests to check that the infection has gone.”
In this case, the clinic will advise you on when to go back.
“It is really important to follow the advice you are given by the clinic about completing the course of antibiotics or treatment, and not having any sexual intercourse (even with condoms) until both you and your partner(s) have finished the treatment and know your test results,” she continues.
“This will prevent passing the infection back to each other or on to other people, and is really important to prevent resistance developing to the antibiotics, which is a serious problem.”
Some types of gonorrhoea are now resistant to antibiotics, making it very difficult to treat, so it’s very important you take heed of advice.
Burchill adds that clinics can help you notify a sexual partner (or partners) that they need to get tested too: “The clinic will help you find the best way to talk to other people if you need to, and can notify even contact them on your behalf – sometimes using a digital tool such as SXT partner notification.”