Sexual health check-ups

Key points

  • Regular sexual health check-ups are recommended for people living with HIV.
  • Screening can identify infections which don’t cause symptoms.
  • Treatment at sexual health clinics is free and confidential.
  • You can choose which clinic to attend.

Looking after your sexual health is important for anyone, but particularly so if you are living with HIV.

If you are sexually active, it is important to have regular sexual health check-ups. In the UK, HIV doctors recommend that people with HIV have a sexual health check-up at the time they are first diagnosed, and then every year after that. It is recommended that men who have sex with men, and who are sexually active, should have a sexual health check-up at least once a year. For men considered to be at high risk of sexually transmitted infections (because they have had sex without a condom with a new partner, or been diagnosed with an infection previously, or because of drug use), the recommendation is to have a check-up every three months. You may be asked about your sexual activity at routine HIV check-ups as well.

In recent years, there has been a big increase in the number of sexually transmitted infections in the UK, most notably the bacterial infections syphilisgonorrhoeachlamydia and LGV. Many of the people diagnosed with these infections have been gay men living with HIV.

Why check-ups are important

If you are sexually active, there’s a chance that you can pick up a sexually transmitted infection (STI).

Having an STI can increase the risk of passing on HIV if you are having sex without a condom.

Having an STI can cause illness, even if you don’t have any evident symptoms. Left untreated, they can cause long-term health problems.

Because STIs don’t always cause symptoms, a check-up and tests are often needed to tell if you have an infection.

Sexual health check-ups provide an opportunity to test you for, and vaccinate you against, the hepatitis A and hepatitis B viruses.

Hepatitis C seems to be more easily passed on sexually to and by gay men living with HIV, and you can also be tested to see if you have this virus.

Condoms and lubricants are available free of charge from sexual health clinics.

Where to go

Glossary

sexually transmitted infections (STIs)

Although HIV can be sexually transmitted, the term is most often used to refer to chlamydia, gonorrhoea, syphilis, herpes, scabies, trichomonas vaginalis, etc.

symptom

Any perceptible, subjective change in the body or its functions that signals the presence of a disease or condition, as reported by the patient.

 

hepatitis A virus (HAV)

The hepatitis A virus is transmitted through contaminated food and water, as well as human faeces. It can be passed on during sex, particularly rimming (oral-anal contact). Symptoms usually last less than two months, although they continue in some people for up to six months. Drug treatment is not needed. A vaccine is available to prevent hepatitis A.

 

hepatitis C virus (HCV)

The hepatitis C virus can be spread through sharing contaminated needles, syringes and other equipment to inject drugs, sharing straws to snort drugs, needlestick injuries, and during childbirth. Sexual transmission does occur, primarily between gay men. Hepatitis C can range from a mild illness lasting a few weeks to a serious, lifelong illness. Untreated chronic hepatitis C can cause serious liver damage, cirrhosis, liver cancer, and even death. While there is no vaccine, treatments are available to clear the virus from the body, leading to its cure.

syphilis

A sexually transmitted infection caused by the bacterium Treponema pallidum. Transmission can occur by direct contact with a syphilis sore during vaginal, anal, or oral sex. Sores may be found around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth, but syphilis is often asymptomatic. It can spread from an infected mother to her unborn baby.

Many HIV clinics have a sexual health clinic attached. Some HIV clinics offer sexual health screening to their patients as part of their routine HIV care. Otherwise, you can go to any sexual health or genitourinary medicine (GUM) clinic. These specialise in sexual health, and can provide tests and treatment for many STIs.

Some GP (family doctor) surgeries will also offer sexual health screening.

What to expect

All tests and treatment offered by NHS sexual health clinics are free of charge. You can choose which sexual health clinic you go to – you do not have to go to the one in your local area or the one associated with your HIV clinic. You don't need to be referred by your GP or your HIV doctor.

Some sexual health clinics operate on a walk-in basis. If you go to a walk-in clinic be prepared for a long wait. If your chosen clinic operates an appointment system, then you may have to wait a few days for the next available appointment. If you have symptoms, or think you are at high risk of a sexual health problem, say so when making your appointment. There may be a number of emergency appointments available allowing you to be seen sooner.

When you go to the clinic, you will be asked to give your name and address. Your details will remain confidential. You don’t have to use your real name.

First of all you will usually be seen by a doctor or nurse, who will ask you about the kind of sex you have been having, ask you if you have any symptoms and then examine you. Try to answer these questions as fully and truthfully as possible – this will ensure that you have the right tests. Staff at the clinic should treat you without judgement, whatever you tell them.

"If the test shows you have an STI, you will be asked to come back to the clinic to discuss the results and get any treatment you need."

If you don't want to tell the doctor or nurse about your sexual history, you could just ask for a full sexual health screen. It makes good sense to mention if you are taking any medication, including HIV treatment, or are allergic to any medicines.

You can ask to see a female or male doctor or nurse if you prefer, but you might have to wait longer to see them.

You will then be seen by a nurse for the tests the doctor thinks you need to have. Men can expect to have at least one swab taken from the tip of the penis, and women at least one swab from the vagina. If you have had anal and/or oral sex, swabs will be taken from your anus and/or throat. It’s likely that blood samples will be taken to check for syphilis and, if you are a gay man or inject drugs, for hepatitis A, hepatitis B, and hepatitis C.

If you have sores on your genitals, these may also be swabbed to check to see if you have herpes.

You will be asked to provide a urine sample.

Some of the test results will be available immediately, and you can get any treatment you need at the same appointment. If you have had tests where the results take longer, the clinic will ask you how you would prefer to receive the results.

If the test shows you have an STI, you will be asked to come back to the clinic to discuss the results and get any treatment you need.

Staff at the clinic can give you information about safer sex and how to protect your own and other people's sexual health. They will also ask you to contact any sexual partners who may also have an STI. If you would rather not do this, clinic staff can do it for you (‘partner notification’) without letting them know your name. It is important your sexual partners are told so they can be tested and treated too. Clinic staff can provide referrals to other services, such as drug services or counselling.

If you have genital warts, you may be given treatment to use at home, or you may be asked to come in regularly for treatment provided by a nurse.

All treatments at sexual health clinics are provided confidentially and free of charge.

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