How to make your next sexual health check less, erm ... awkward

Many people find the idea of a sexual health check awkward or embarrassing. After all, it’s not every day someone you barely know asks you intimate details about your sex life or asks to examine your genitals.

But sexual health checks don’t have to be awkward (and many don’t even involve us examining you).

Knowing what to expect - and remembering that nothing you say will shock or embarrass us - will help make your next sexual health check more comfortable.

Do I need a sexual health check?

A sexual health check isn’t just for when you have symptoms of a sexually transmitted infection (STI), like a discharge from the vagina or penis, genital blisters or warts, bleeding after intercourse or pain when urinating.

A check up can also be useful even if you don’t have symptoms. For instance, if you:

• have had unprotected sex with a new partner
• are in a relationship and are deciding whether to stop using condoms
• have a partner who has been diagnosed with an STI.

Regular screening for STIs is also recommended for people at higher risk of STIs:

• sexually active people under the age of 29
• men who have sex with men
• Aboriginal and Torres Strait Islander people.

Most STIs have no symptoms, so regular testing will ensure people in these population groups are diagnosed and treated early.

If you don’t know if you are at risk of an STI, you can take an online questionnaire such as Am I OK? to find out.

You can choose where to go

Your GP will be experienced at conducting a sensitive and confidential sexual health check. But you may prefer to keep this part of your life separate from your other health needs. So, a specialised service is an option.

Depending on your needs, you can go to a local sexual health or family planning clinic, an Aboriginal community controlled health service, a multicultural health centre or a youth clinic.

A sexual health check can be especially challenging for survivors of childhood sexual abuse. So if this applies to you, you can ask to book into a specialised sexual health service where you will receive expert and sensitive care.

Counselling services are also available for adult survivors of past child and adult sexual abuse. People who have been recently sexually assaulted will often have an STI check as part of their care.

You can also ask to see a male or female doctor or nurse.

Know what to expect when you get there

Unless you have symptoms of an STI, a doctor or nurse will not usually examine you.

We simply ask questions about your sexual history to work out which STIs to test for and give you information about how to keep yourself safe. While it is your choice to answer our questions, honest answers will help ensure you receive the best advice and care. We’ll probably ask:

• when was the last time you had sex and was this with a casual or regular partner?
• if regular, how long have you been in the relationship?
• was this a male or female partner and what type of sex was it: oral, vaginal, anal?
• how many partners have you had over the past 12 months and were they male, female or both?
• did you use condoms always, sometimes or never?
• when was your last sexual health check; have you ever had an STI?

Some sexual health clinics have computer-assisted “self-interviews” to make giving us your personal information less awkward.

Checking for STIs usually involves either a urine test or, for women, a self-collected vaginal swab for chlamydia and, in some cases, gonorrhoea. You may also have a blood test for HIV, syphilis and hepatitis B.

At the end of the check you should know which STIs you have been tested for and why. You should also be clear about how you will receive any test results.

Understand we won’t be shocked

Health professionals are trained to help make you feel at ease regardless of your background, age, gender or sexual identity. Nothing is off-limits and nothing you share will surprise or shock us. You will never be judged and you are in control of the direction of the consultation.

It can feel overwhelming to try to fit everything into a single consultation. So, you can book a long consultation to give you a chance to discuss all your concerns. You can always come back again if there is more ground to cover.

Be assured it’s all confidential

All medical professionals are bound by privacy and confidentiality laws. So, everything that occurs during the consultation will be kept confidential and not shared with anyone without your consent.

Young people have the same right to confidentiality as older people. The only exception to this is if we have serious concerns about your safety or someone else’s.

You can take along a ‘buddy’

Some people prefer to “go it alone”. But enlisting a buddy can give you emotional support and help you remember the questions you want to ask. There are no rules about who you can bring along. It can be anyone who makes you feel safe and can provide emotional support such as a partner, an older sibling, or a good friend.

Just be aware that we will need to see you alone for part of the consultation to make sure you are able to speak freely and are not being coerced.

You don’t need to be ‘groomed’ down there

Don’t feel worried about not being perfectly “groomed” before a sexual health check. There’s no need to apologise for being unshaved, unwaxed or not freshly showered. Even if we need to perform a physical examination, we understand you may have dashed in during a busy work day.

Just as you will never be judged for what you tell us, you will never be judged for how you present. We simply appreciate that you have taken the time out to take care of your sexual health.

If you want to find out more about what’s involved in a sexual health check, about STIs, or for support, Playsafe and Family Planning NSW can help.

For survivors of sexual assault and family violence, you can also contact the National Sexual Assault, Domestic and Family Violence Counselling Service.

Deborah Bateson is Medical Director, Family Planning NSW.