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If you are sexually active, it is important to have regular visits to a health practitioner to have STO sexual health and STI check ups, and to discuss sexual and reproductive health and rights issues.

What is a sexual health check?

A sexual health check is a check-up by a health practitioner for sexual health issues like sexually transmitted infections (STIs). For women, this can involve a yearly pap smear. It also gives you a chance to ask questions about sexual and reproductive health and your rights.

Who can carry out a sexual health check?

It depends on where you are located and what services you have access to. A sexual health check is carried out by a health practitioner - your local GP, or a doctor or nurse at a sexual health centre, at a youth health centre, or at a family planning clinic.

Who needs a sexual health check?

Anyone who is sexually active is advised to talk to their health practitioner about having check-ups. How often and when you need to have a check-up depends on your lifestyle and sexual activity, so a sexual health check is advisable if any of the following circumstances apply to you:

• if you think that you might have an STI
• if you have had unsafe sex, including vaginal, oral and anal sex
• if you have had a condom break or fall off during sex
• if your partner has another sexual partner
• if you have more than one sexual partner
• if you have shared injecting equipment
• if you are starting a new sexual relationship.

What happens during a sexual health check?

A health practitioner will usually begin by taking a sexual history. Some of the questions they will ask may seem quite personal, such as:

• how many sexual partners you have had
• sexual activities you have engaged in
• if you have sex with men, women or both
• whether you have any symptoms
• whether you have injected drugs and/or shared injecting equipment
• whether you have tattoos or body piercing.

You might feel uncomfortable about telling the truth when answering questions. If you don’t give accurate information, you might not get the best advice or be given the appropriate tests - this could mean your health could be seriously affected. Some STI's can lead to long-term health problems if not treated properly.

Check with the practitioner to make sure that all the information you give them is confidential. You should also check if contact tracing will occur, and what the laws in your state are around it. Contact tracing is the process of identifying how an infection may have spread from person to person. The practitioner does this by asking you for the contact details of people you have had sexual contact with. It is important to note that contact tracing only occurs if you test positive for certain types of STI's, such as HIV.

During the examination (with your consent), your external genital area may be examined for any signs of STI's. A range of tests may be done including:

• Urine sample/and or blood test (eg. sample of urine taken or sample of blood taken from the arm)
• Swabs (eg. taking a sample of fluid or discharge on a cotton bud for examination on a slide under a microscope). Sometimes it may be necessary to take extra swabs from the throat or rectum (inside the anus).
• For women, a vaginal examination may also be performed, such as a Pap Test (swab of the cervix, which is inside the vagina. A Pap Test is a routine procedure that all sexually active women are advised to undertake every two years).

Asking questions

You can consider a visit to a sexual health practitioner as a good opportunity to ask any questions you have about your sexual health, or to discuss anything that has been worrying you. A good practitioner will encourage you to ask questions. It’s important that you feel like you are able to ask any questions you have. It is equally important that they answer your questions and explain all procedures in a way that you are able to understand.

Some of the questions you may wish to ask the practitioner before you have a sexual health check include:

• Will this service see young people under the age of 16 without their parent or guardian present? Is there an age limit at which a young person won’t be seen without parent or guardian?
• Does this service bulk bill? Does it reduce fees in any way to young people?
• Will it provide a young person with their Medicare number? Will it assist a young person in accessing their Medicare number?
• Does this service provide free or low cost Hep B vaccination? This is a vaccination that is recommended for young people.
• Will written information be given regarding the infections being screened and/or tested for?
• Does it have emergency appointments that can be used for pregnancy testing or emergency contraception?

Some of the questions you might like to ask during the check-up include:

• What exactly are the tests for? (eg. HIV, Hep B, Hep C, etc)
• Will the test be a blood test, or urine test? Many people mistakenly think a blood test will cover everything, and that once the testing and screening is negative, it’s all fine. In general though, regular screening and testing is recommended when you have sexual activity without using protection, with change of sexual partners, or when you engage in high risk behaviour (eg. drug user, multiple sexual partners, sex work).
• If any of the tests are positive, do I have to tell anyone? Will the clinician tell anyone? What is the treatment?
• Will this affect my future fertility, pregnancy or general health?

Feeling comfortable

Stay in tune with how you are feeling - if you are feeling uncomfortable with the practitioner, or you detect discomfort in the person you are consulting, you might like to see someone else.