Interview 50 - Hannah

Age at interview: 18

Brief Outline: For the last three years Hannah has used the combined pill and hasn't had any problems with it. Now she is considering long term contraception; the three years implant. She has discussed this with her GP and a Family Planning nurse who is a friend of the family.

Background: Full time university student, single. Her top priority at the moment is to avoid an unwanted pregnancy. Ethnic background' Mixed Race.

More about me...

Hannah started using oral contraceptive; combined pill, aged 15 after discussing it with her GP. For Hannah, the benefits of using the combined pill have been the prevention of unwanted pregnancies as well as helping her regulate her periods. Hannah is now considering the use of long term contraception; the three years implant. Her main reason for wanting to change her method of contraception is a change in lifestyle. Hannah is now a university student and said her life is ‘hectic’. The university drinking culture has meant that she is consuming more alcohol than before. What worries her in particular, is that the protection of oral contraceptive may be reduce by sickness. For Hanna, the prevention of pregnancy is top of her list. Hannah thinks she has the facts about implants but would like to read more about the experiences of other women using it. One issue that she is particularly interested about is the effect of long term contraception on fertility.

Once a month, Chlamydia testing was offered in Hannah’ High School but she felt uneasy to go and have a test because everyone at school knew what was going on. Hannah’s experience of Chlamydia testing happened when she and her friends were in the park and two nurses approached them and invite them to have a test which they accepted. Equipped with their little pots, the group of girls went to the pub in the corner and then handed the sample to the nurses with a form containing their personal details. Hannah said that three weeks later she got a text informing her that she was clear and that her Chlamydia test was negative. Hannah’s attitude has always been to use condoms at the start of a relationship.
 

Life has a student can be hectic and that's why Hannah has been advised to consider having an implant rather than using the pill, but information about it can be confusing.

Sometimes I’m a little forgetful and a few times I have forgotten to take it which I get very annoyed at. So I’m thinking of switching from the combined pills simply because it’s. I want something that I don’t have to remember to take every day, something that I don’t have to think about every day.

 

So which one do you think you will, are you considering?

 

I was considering getting the implant, the one that lasts for three years? And that releases slowly yeah? Yeah I was thinking of getting that because then I don’t have to think about it and it would do me for like half of my time at university.

 

Have you spoken to a health professional about it or?

 

Yes I’ve spoken, I spoke to my GP and I spoke to a sexual health nurse who’s a friend of the family. And I was advised that it would be a good idea. A lot of people, it’s advised for a lot of university students at the minute because life is so hectic and with things like alcohol and stuff like that disrupting your usual food cycle so you might end up throwing up. And if you’ve taken a pill. I used to take the pill in the evenings but now that I’m drinking more alcohol if I throw up it won’t have the effect so now I have to start taking the pill in the mornings instead so I have time to absorb it. So I think if I had the injection or the implant even that would be easier.

 

How much information have the doctor or the sexual health nurse that is a friend of the family given you?

 

I think I got quite a lot of information. I didn’t quite get, because certain people have been telling me like there’s rumours like my friends have been telling me that they had friends who had the implant and it’s not as effective as the pill and they’ve got pregnant while on the implant. And I don’t know who to believe because they, they fully, they tell me that their friends have definitely got pregnant while they were definitely using the implant which obviously is a little bit worrying. But then I’ve had the health professionals that I’ve spoken to have actually told me that it is effective. It’s like almost as effective at the pill. So it’s, it’s difficult to know who to believe.

The National Chlamydia Screening Programme does little to de-stigmatise STIs, but it is good at targeting young people who may not feel confident enough to go to a clinic for an STI.

I don’t think it’s helping de-stigmatise Chlamydia. No because it’s, there’s always going to be that stigma like. Well I think there’s always going to be a lot of stigma around sexual, sexually transmitted diseases and I think that just people going in to get tested that in itself is a stigma. So instead of like decreasing the stigma it’s just attracting it to the specific people who you know have gone to be tested.

 

So like that’s what I meant in college like among my friends it was fine because we were all pretty sure that we were Chlamydia free so we thought, why not we’ll go and get tested. But if someone in a larger environment if someone is known to have sex quite often then if they’re seen to do something like that it will link up in people’s minds and just. Even if they come back with a negative, with a negative test it still there, people have that association in their mind. ‘She’s gone to get the Chlamydia test. She sleeps around’.

 

I don’t know. I think. I’ve always been very open about sexually transmitted infections but I’ve always been pretty certain that I don’t have any. While if I was worried that I did have any kind of infection I probably wouldn’t be so open about it. I could, I think if I like was worried that I had something like Chlamydia or HIV or anything I would probably not want to talk about it and clam up. Just because of things like that stigma.

 

Ok so that is the main thing. Do you think that the screening has reached, has been able to reach sort of young people that otherwise wouldn’t have thought about having a Chlamydia test?

 

Yeah I think when it comes, in terms of just things like how I was feeling, just why not, I’ll just go check. I think it’s a good idea simply because there’s so many people who might not know and if they do have it and then if they just think, why not I’ll go do the test. I think it’s because it’s so, because the testing is so open and like you can see quite a lot of it now. Like it’s there at the universities and the colleges. I think it’s because it’s so much easier to get it done more people will get it done just simply because they haven’t thought of it before. Well when they see the stalls or if they are approached in the park they’ll just go, why not I’ll get tested. And I think it’s a really good way just for. I don’t think people, a lot of the people who are worried about it. I think the people who are worried will find it easier to get themselves tested in a more private way as opposed to planning it and going to the clinic or the family planning centre. They can just do a test on the spot which I think is really good.

Hannah knows that if she is drunk and then sick, the effectiveness of the pill is reduced and she may get pregnant.

Well I know that when I drink alcohol and as a university student I drink a lot of alcohol and I know that when I go out and when I do drink and get drunk I will get forgetful and I will forget to take my pill if I took my pill in the evenings because I try and take them at the same time every day. And if I take my pill in the evenings and then I go out and get drunk what often happens is that I’ll get very drunk and I’ll end up being sick. And then I don’t think if it happens quick enough I was told that I wouldn’t have time to absorb the pill. So it would be as if I hadn’t taken it at all. So this was, this was a major concern of mine just in terms of if I drink alcohol and I do get sick will the pill still work but if it’s not fully in my system.

Avoiding an unwanted pregnancy is Hannah's main priority but she has concerns about how effective the implant is, and about the prospect of using a method that stops periods.

I’m still not quite sure what I want to do.

 

Why don’t you...

 

So I’m still on the pill at the minute but I, I am. I’m still considering swapping to the implant.

 

What are your main sort of concerns about that, the implant?

 

My main concern is that it won’t be completely effective and that by accident I will get pregnant because the entire point of the thing is to stop pregnancy for me. That is like my biggest worry when it comes to sex and yeah. So if it’s not completely effective it’s not worth it and I don’t want to have to. Also I don’t know. I still don’t quite know how I’ll react to it. Just in terms of having something inside my skin.

 

And you know the procedure?

 

[mmm]

 

So what has your doctor recommended or advised you?

 

My GP just said if I was at university it might be a better idea because I’ll get distracted and might forget to take the pill. So something I don’t have to think about and that is with me all the time is advisable. And the nurse that I spoke to, she really suggested I take it for the same reasons basically.

 

What other type of information will help you to make up your mind about or to decide for implant or not implant?

 

I’m not sure really. I think just talking. More experience stories would be nice. People like actually meeting someone and talking to someone who’s done it or who has got it and has had lots and lots of sex with no condoms or anything and has not got pregnant and [giggle] so just, you know like kind of reassuring it works.

 

I don’t know. I have a few friends. I have one friend who is on a progesterone only pill and so she doesn’t have periods at all and I, I’m not sure how healthy that is. Because I, the pill I take just regulates like my natural body rhythms but a pill that, or and I think the implant does it as well doesn’t it? It just stops periods altogether. I sometimes think that maybe that’s a little shaky just in terms of not being completely natural as opposed to controlling a natural phenomenon stopping it altogether.

 

So is that another concern you have about the implant or not?

 

Yeah actually I’d forgotten about that one beforehand. The whole idea of, because for three years not having any periods. I mean I don’t like periods, nobody likes periods but it’s somehow natural. And like the idea that it’s, I’m stopping something that’s natural and that my body wants me to do I’m not sure how that would affect my health.

Two nurses approached Hannah and her friend in the park and invited them to do a Chlamydia test. She found it easier to accept than at school.

My Chlamydia test was very, very spur of the moment because I’d seen when I was around at college because I went to a 6^th Form college there were people like saying, ‘Come do the Chlamydia test now’. And surrounded by all of those people at college I just didn’t want to like go into the bathrooms and pee in a tub and then give it to someone in front of everybody but...

 

So my Chlamydia test was very odd because I was sitting in a park with a few of my friends and two people actually approached us and were talking to the girls and said, ‘Do any of you want to go get this Chlamydia test done?’ And me and two of my friends were just sitting there and we thought, well why not. We’re here and we want to make sure we don’t have Chlamydia so we basically just filled in some forms. Took the tub and went to the nearby pub that was around the corner and filled the tubs, came back and [ha] gave them it. And them literally the forms we filled in just gave like names, details, all of that stuff and then a couple of weeks later, about 3 weeks later I think it was I just got a text on my mobile. I got two texts saying I’m clear and the test was negative. So it was pretty easy experience to be honest.

 

Ok and who were these two people?

 

They were two of my college friends both the same age as me so I was 17 and they were 17 and 18. And we were all doing the same course together and just hanging out and yeah we just got approached and thought, why not.

 

But the people that approached all of you, who were they?

 

I don’t know. I assumed they worked for the NHS. They had little NHS badges and things like that so nurses I should think. Two women, yeah, two middle-aged women just came up and were speaking to us just saying, ‘Do you want to get the Chlamydia test. It’s really easy. All you have to do is go to the local pub and go to the toilets and then come back in 10 minutes or less depending on how quick you are.’

 

And at college could you explain a bit more about when people were doing it, did you have to go to the toilet and where everybody was peeing into these little cups and that was not something that you wanted to do?

 

No that was a lot more uncomfortable. Like in a pub because it’s like, it was really noisy at the time so and nobody knew what you were there to do so you just walked in as if you were going to the loo and then came out again. Well when you’re at college everybody knew that it was the week that the sexual health people were in and that it was the week that they were doing the Chlamydia testing. So if anybody saw you walk into a toilet like trying to hide something in your bag they’d know exactly why you were there.

 

Ok [laugh].

 

[Laugh] so it’s just things like people staring at you going, ‘Oh god she’s gone for the Chlamydia test. Who’s she been sleeping with?'