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Every Single Sexual Health Check Q U’ve Ever Had, Answered By An Expert

Access to information about our sexual health is probably one of the most important factors in setting us up as confident sexual beings (which most humans are). Unfortunately, sometimes the education we get is a little lacking. If your PDHPE classes felt more like an afterthought, never mentioned a sexual health check, queer sex, orgasms, sex toys, how to masturbate or, like, actually give someone pleasure, entering your sexual career can feel a lot more daunting than it needs to be.

Syrup sat down with Dr Lynne Wray, a sexual health specialist at Sydney’s Clinic 66. Wray has more than 30 years of experience in STIs (sexually transmitted infections), HIV and reproductive health. A note, even if you think you’re entirely fine and don’t need a sexual health check or STI screening because you’re “clean”, we’d like to dispel and destigmatise a little.

“One of the reasons that sometimes it’s very, very hard to get the safe sex message across is because people have the belief that their friends and the people they know and the people they socialise with and the people they had sex with are nice people, they’re clean and they wouldn’t have anything like that,” says Dr Wray. And people *not knowing* rather than being an irresponsible person is usually what contributes to the spread of STIs. 

“There’s actually nothing “clean” or “dirty” about it,” says Dr Wray. “Bacteria like to swap themselves from one person to another and so if you have contact with someone, without having safe sex, you can pick something up and nine times out of ten, that other person doesn’t know they had it either because they weren’t having any symptoms.”

Ultimately, “The only way to be safe is to either have no sex with someone until you’ve both gone and had a checkup, or to use condoms until you’ve had a checkup.” 

So, with that said, here are some of your FAQs about sexual health checks answered by an expert.

What is a sexual health check? Is that different to an STI screening?

“So first off, sexual health is really quite a broad term!” says Dr Wray. “Definitions from the World Health Organisation refers to more than just sexual activity, it’s also about mental health and social health and comfort within your gender identity and all those sorts of things. Sexual health could mean a lot of different things to different people depending on what their needs are.”

“For most young people, the point of contact is going to be: do I or don’t I, or will I ever need to have a test for STIs? So in that sense, a sexual health check would equate to having an STI screening.”

How do I get a sexual health check?

“The most important bit of information,” says Dr Wray, “Is that anyone who is over 15 is eligible to have their own Medicare card.” You don’t need your parents permission or anything like that, and because of that, “it’s so much easier for younger people to negotiate their health care, if they have their own Medicare card, rather than having to, you know, sort of sneak mum’s card and get your number and all that sort of thing.” 

After this, it’s a matter of deciding where you’d like to go and either booking an appointment or walking in. If you have one and feel comfortable going to them, you can see your usual general practitioner (GP) or you can look for someone else. HealthEngine is a good resource for finding a GP that bulk bills—that is, a doctor whose fee is totally covered by Medicare so you don’t have to pay anything extra. If you want, you can also phone a practise beforehand to check what services they offer and the cost involved. 

Having a google for sexual health clinics in your area is a good starting point too. Some specialise for various community groups, and will have resources for languages beyond just English.

When do you need to have a sexual health check or STI screening?

The first thing to ask yourself here is, are you sexually active? By that, “We usually mean that you’ve had skin to skin contact with someone else, and you might have had oral-genital contact,” that is, a mouth on someone’s genitals, “but you may not yet have had penetrative sex in the sense of anal sex or penis-in-vagina sex.”

“The only person who knows the answer to that question is the individual. And of course, if you’ve not had any sort of contact with someone else, you may not need a test yet, but you might like to get some information, about having safe sex and contraceptives for example.” 

If you did want to check out some online resources, we’ve consulted with couple of expert sex therapists and coaches for our deep dive into having sex for the first time, and Dr Wray also flags the site Play Safe as a resource (though some information is specific to NSW).

While you can pretty much have a sexual health check at any time you feel it’s necessary, Dr Wray stresses that, “If someone has symptoms, for example, discharge, burning when passing urine, or pain it’s important to see a doctor ASAP to find out what’s going on. Whether that’s your GP or a family planning clinic or a sexual health clinic, the sooner you find out what’s going on and get treatment the better. A prolonger delay in getting treatment could lead to more complicated problems later on.”

I think I might have an STI, what should I do?

Let’s start by dispelling and shame or stigma attached to STIs (as difficult as it is). We’re human, we’re lil messy water sacks, and sometimes we pick up things in our travels, and if you’re worried you might have an STI the most important thing you can do is get yourself the medical proper treatment and be kind to yourself mentally. More than 16% of Australians report having an STI at one point in their life or another, and given that number is self-reported, it could potentially be a lot higher. 

If you’re trying to figure out if you’re at risk, Dr Wray points to the Play Safe resource, which has an online quiz and a similar assessment tool from the Sydney Sexual Health Centre. Both of these ask many of the same questions you’d be asked by a medical professional.

What does a doctor ask during a sexual health check?

Having a look at the above quizzes is a good indicator for what a doctor is going to ask says Dr Wray, “They’re exactly the sort of questions you’re going to be asked. When you when you guys talk to either a nurse or a doctor about, about having an STI screen, so sometimes it’s a lot less threatening if you’ve already seen the questions that they’ll ask you: When did you last have sex? Did you use a condom? Are you using any hormonal contraceptives?”

“Some questions are more ‘embarrassing,’ often when you’ve never been asked them before,” says Dr Wray, “What sort of sex did you actually have? Did you only have oral sex? Or did you have a penis-in-vagina sex? Or did you have penis-in-anus sex, or did you use some sex toys? Those sorts of things. That can be really quite confronting the first time someone has ever asked you those questions.” 

Do you have to say how many people you’ve had sex with?

Dr Wray does note that one question that some doctors are moving away from is how many people you’ve had sex with, “I think that’s always a difficult one. People are always going to be anxious about answering that question, and have a fear of judgment, whether it’s one, zero or 20.” 

She notes that some doctors now are instead asking, “‘When was the most recent time you’ve had any unprotected sexual activity?’ and ’When was the last time you had a check up?’ Because that’s really what it’s about, and is much more relevant than the actual numbers. If someone’s had unprotected activity, they could potentially have been exposed to an STI, because lots of STI have no symptoms.” 

One exception that Dr Wray flags, though, is if you’re a young man having sex with men. “If they’re having a lot of partner change, and particularly if they’re having sex without condoms, then that’s flag for maybe as well as an STI check, they need to be having a conversation about whether or not they should consider having PrEP, which is taking anti viral medication to reduce the risk of exposure to HIV.” 

Will a doctor tell my parents anything?

Under most circumstances, no. Your medical care is confidential, though Dr Wray says that, “In any age group whatsoever, the only time that a doctor might need to breach confidentiality is if the person is at serious risk of harm themselves, or if their behavior is putting others at risk.” 

“The other tricky one is, of course, if you’re under the age of consent. It can be difficult if the person that you’re sexually active with is significantly older. Because then, of course, there’s concerns about assault, coercion, all those sorts of things. Even in that case, nothing would be discussed without it being disclosed to you that we did have to pass on this information to someone else, because we were concerned about your safety.”

If you’ve got more questions about your rights at the doctor, a good resource is the Youth Law Australia, which breaks down your rights by state. 

What kind of physical examinations are done during a STI check?

“If someone comes in who has no symptoms, they might not actually have to have a physical examination,” says Dr Wray. 

“If a male person or person with a penis presented (and assuming they’re a straight male) the most common specimen being collected would be a first pass urine sample—so, the very first part of the urine stream—is all that would be required. If it was an asymptomatic penis-owner who was having sex with men and other people with penises, the Sexually Transmissible Infections in Gay Men Action Group (STIGMA) guidelines reccomend a throat swap, a first pass urine test and an anal swab.”

For the uninitiated, a swab is simply collecting material from an area by running over it physically with a collection device—usually with a cotton swab, aka, a cotton bud. All of these swabs can be self-collected if you really wanted to, but for people who don’t feel confident taking their own, clinicians are more than happy to do them. 

For women or vagina-owners presenting for an STI screening, Dr Wray says you can do a urine test, but the better test is a vagina swab—which again, can be self collected or done by the clinician. 

“Some STIs need to be checked for with a blood test, and of course, if someone presents with symptoms, whether it’s a rash or itchy irritation or a blister, that’s also where a clinician would take a swab from.”

How do you get results?

When it comes to getting your results, Dr Wray says this can vary depending on the speed of how quickly things are sent and processed at a pathology lab, but in most urban cities you’d likely be expecting results in about 48 hours. 

If it’s a positive result, that is, if you do have an STI, your doctor or clinic will likely get in touch as soon as possible to organise treatment as soon as possible (as well as letting you know to avoid it being passed on further). They’ll also likely advise you to let partners or past partners know, because they will also need to get tested. 

“Many people feel okay about telling their partner in fact, often when they come along to get their antibiotics, they bring the partner with them so they can get their test and treatment done as well,” says Dr Wray. Another option, if you’re no longer in touch with some people or don’t feel comfortable speaking with them directly is Let Them Know, which sends contacts an email or text.

In the end?

The main takeaway we’d try and impress here, is that life is long and you’re probably going to be having sex in various ways for a while. Being proactive about your sexual health and your sexual pleasure is only going to make it easier and more comfortable to navigate as you get further in your sexual career. If there’s a q you have we didn’t answer, send us a DM! Be safe, be healthy! Love u.

Monisha is a writer with a background in publishing and digital media. A chronic Pisces, she’s into trying to be a better person and sparkling water.

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