Sexual Health (young people)
STIs: ideas about risk and decisions to test
Sexually transmitted infections (STIs) include chlamydia, genital warts, syphilis, herpes and HIV. If caught early most are easily treatable with antibiotics, but if left untreated they can have serious consequences including infertility (not being able to have children) and ectopic pregnancy.
Many people we spoke to avoid catching STIs by using condoms, or did not have unprotected sex till both partners had been tested for STIs. The only way to keep safe is to use a condom, particularly if having sex with casual partners.
Explains why she and her partner decided to go for a check up before they stopped using condoms. (Actor)
Explains why she and her partner decided to go for a check up before they stopped using condoms. (Actor)
(The accompanying video and audio clips are played by an actor)
The person I'm going out with now, that's been a couple of years, and what we did, well we'd been very good friends for a long time before we ever sort of had a more serious relationship. So we agreed that until we had both been to the STD clinic and been absolutely cleared, that we would use condoms, even though we both hated them. And then after that we went back to using the pill, once we both had a clear certificate of health.
We just thought that this is what we'd hoped was going to be a very important relationship and we hoped to stay together. And we wanted to make sure we did it right, from the beginning, and didn't sort of give the other one anything horrible that we had from our past. We'd never felt comfortable enough to sort of broach that sort of subject with anyone before.
He was the first person that I sort of felt comfortable enough to say 'actually, I'd rather you went and got tested'.
I think it was because I'd had a scare with someone previously who I had a relationship with and we'd relied on the pill and after we split up I had a lot of low abdominal pain, there was no discharge or anything else like that, but I was scared enough to go and get tested and everything. And there wasn't anything, actually it was fine and they decided it was sort of stress.
I thought I had Chlamydia or something, I really did. I was really quite scared that I'd done something very stupid.
Says that unprotected sex with casual partners is very risky for gay men.
Says that unprotected sex with casual partners is very risky for gay men.
Definitely at risk.
Why because you have had unprotected sex?
Yeah, in being a gay male I think you are more at risk if you have, if you have casual partners as well and you don't know where other people have been, if they have gone cruising in parks or, you never know what you're gonna pick up, so the best way I suppose is to use protection to be safe.
So why do you say gay people are more at risk?
Because a lot of people are frightened of coming out, or having relationships, or a lot of, a lot of gay people are, that are not out, have wives and kids and then they go to toilets or parks to have sex with different partners. And they do it, some people do it every day, some people do it, you know, twice a week, three times a week and have sex with their wife as well, so the different sexual partners they have, you could catch anything, you know, crabs, all sorts.
But young people are often surprised to find out that vaginal sexual intercourse is NOT the only way people can be infected with chlamydia. The National Chlamydia Screening Programme in its website said that people: “can get chlamydia by having unprotected vaginal, anal or oral sex with someone who is already infected. It can also be passed on by sharing sex toys which haven’t been washed or covered with a condom before each use. It can also be passed by a pregnant woman to her baby during pregnancy or at the birth.”
The National Chlamydia Screening Programme recommends that:
if you have oral sex, cover the penis with a condom or the female genitals with a latex or polyurethane (plastic) square (dam).
There are a number of reasons why people we interviewed decide to be tested for STIs. Sometimes they are prompted by symptoms, like pain or bleeding during or after sex, chronic stomach pain, lower abdominal pain, an unusual discharge, itching around the genital area, pain when passing water, heavy periods or bleeding between periods. A sixteen year old girl we talked to had pain when passing water and a blister appeared on the lip part of the vagina.
Victoria felt a lump in her cervix and decided to go to the GUM clinic.
Victoria felt a lump in her cervix and decided to go to the GUM clinic.
Yes I felt a lump inside me and it was especially uncomfortable when I used a tampon, I could feel it there and it was slightly uncomfortable and I'd been watching 'Embarrassing Bodies' which I found are very interesting, sort of, I like medical documentaries, I find it very interesting and so I felt where it was and I felt that doesn't feel normal to me. I didn't think it was normal. So I went to a GUM clinic to check which was a slightly interesting experience as I'd only gone in there for a lump and I got questioned about my entire sexual history which took you know, a good ten min, a good ten minutes with the two people in the world I've had sex with but they wanted to know what time each relationship started and ended and how long have you been sexually active, what protection had I used and everything. Finally we got to the examination room and they told me it was just my cervix and drew me a picture of why it felt so weird and then tested me for all the STI's. So they just inserted a swab into my cervix, one swab, about ten seconds in there, that was it and then took a tiny bit of blood to test for HIV. And they sent me a text, two of my test results saying, "All your test results came back clean." And then handed me a bag of free condoms and I went on my way.
Some go for a test even though they don't have any symptoms or, when invited to take part in the National Chlamydia Screening Programme, some worry they may have contracted an infection because they have not always used condoms. Other times a friend being diagnosed with an STI, or learning about the consequences, can prompt a person to get a check-up. Or they might find out that one of their partners ex's had an STI and have an anxious time waiting for the result.
Says that his main motivation for having a check up was to set his mind at rest.
Says that his main motivation for having a check up was to set his mind at rest.
Yeah.
And they were all clear?
All clear.
And you were tested for everything?
Yeah. Well I've only, yeah I was tested for everything, but I'm waiting for the HIV results. It was offered so I just took it.
OK, but I mean what was your main motivation to come and be tested?
Well my motivation was like I came to England only ten months ago and since I've been in England I have had quite a bit of sex with different women. And I didn't think I had anything, but it's just for a peace of mind, just to feel more relaxed about it, and just to get a test done.
And on those occasions have you used protection or not?
Yeah, only like just, as I say just maybe once or twice I haven't there hasn't been any with us and you just feel comfortable in that situation so you just go for it.
Explains that the experience of a friend of hers that contracted Chlamydia prompted her to go and have a check up.
Explains that the experience of a friend of hers that contracted Chlamydia prompted her to go and have a check up.
Can you tell me what prompted you to decide to be tested?
One of my friends caught Chlamydia from her boyfriend who had slept with someone else behind her back and she didn't realise she had it until quite late on and I suppose that prompted me and a couple of my friends who've had a few sexual partners, to go and be tested and things even though they didn't really think there was a risk.
Just come and be tested to make sure, because Chlamydia can make you infertile and we hadn't thought about it before until she had said and we'd seen how upset she was and things like that, so I suppose her experience prompted us to do it.
So do you feel at risk or not at risk of a STI?
I don't feel at risk now, no.
Why not?
Because I've been tested and because I know that if I had a new sexual partner I would use a condom and things like that. If I thought that there was any risk, if I knew that they'd been with someone else and they had had unprotected sex then yeah, definitely I would say that I wanted them to be tested and I'd probably withhold from sex until they were really.
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.
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 6th 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...
Explains how she and her ex-boyfriend had to go and be tested for HIV after he found out that an ex-girlfriend was HIV positive. (Actor)
Explains how she and her ex-boyfriend had to go and be tested for HIV after he found out that an ex-girlfriend was HIV positive. (Actor)
(The accompanying video and audio clips are played by an actor)
What led you to be scared of Aids, you were presenting some signs or symptoms?
It was, no, no it was a bloke I was going out with at the time, we'd been going out for quite a while and we'd been, well at first we were using condoms and then I went on the pill, we hadn't got tested for things which I know is a bit silly but you kind of, you know just presume.
I don't know, I just kind of, when you've been seeing someone for a while you start presuming, and I don't think that's really the case. And then he found out that a girl he'd slept with, a couple of years before we'd started seeing each other, was HIV positive. And he didn't know because he'd found out through a friend of hers, she didn't tell him so he didn't know whether she had Aids, I mean she might not have even known whether she had Aids when' or HIV, at the time.
But he knew that she was HIV positive now and so wasn't sure if she might've been then, and they hadn't used any contraception. So he tried not to tell me, he tried to go and get tested without telling me but I thought he was being a bit funny and I ended up getting in a bad mood with him, so he had to tell me.
And then we went and got tested together. I remember it seemed to take quite a while, it took about three or four days because it was the weekend and we couldn't find anywhere to get a test at the weekend. But eventually we did, and it all came back and it was all absolutely fine, we were both fine.
But that was quite scary and it kind of made me realise I've got to be a bit more sensible. I mean like he's twenty eight, he's quite a bit older, so well it's kind of, he obviously has a bit more experience and probably should have, I don't know' been aware of that.
Describes the first signs and symptoms of herpes. (Played by an actor.)
Describes the first signs and symptoms of herpes. (Played by an actor.)
I think the first time that I felt the problem it was the day after my sixteenth birthday. I had a pain and I went toilet and it was really, really stinging. So, I didn't pay too much attention because I thought it wasn't that bad, and then the following day I was going on holiday I was going with my family to Cyprus, and then I noticed on the plane, when I went to the toilet, that the stinging got really bad every time I went to the toilet. And then, when I got to the holiday, now, that's when I think it completely - the blisters really got big. Because then I couldn't walk, I couldn't do anything. I was laid up for, for the first week of my holiday. And I had a cousin with me, and then I confided in her, "I think I might have a problem", and we went to the chemist over there and we tried to get creams and then to try and stop the stinging, but I knew that there was a problem.
Where exactly was the blister?
It was on - it was on my vagina, but it was on the lip part of the vagina and it looked - it looked like, when I was looking in the mirror it looked like a big -someone had cut me. So that's the excuse I gave to my mum, when she wondered why I couldn't walk, why I wasn't coming down to the pool, or why I was in bed all day. I just said I cut myself with my fingernails.
To suspect you have an STI can be overwhelming for teenagers and often those we talked to did not talk about it with their parents. This often meant dealing with clinic visits, tests and results on their own. But young people, particularly young women may decide to go as a group to a clinic and get tested. Katie, Alice and a couple of other friends from university decided to get tested for STI’s and went to the GUM clinic together. They felt reassured by the mutual support and companionship and it made the experience easier to deal with.
Says that her cousin was the only family member that knew and supported her. (Played by an actor.)
Says that her cousin was the only family member that knew and supported her. (Played by an actor.)
She was the only one who knew. I didn't tell my mum, but it was really strange, because when we was on holiday and we was all sitting talking, she brought up about her friend who - whose husband had given her genital herpes, and she was saying how she couldn't walk and everything. And me and my cousin was kind of giving each other the eye, like "Oh my God, is she hinting or something"? but she didn't relate anything to me, so I just kept it between me and my cousin, then, but now a lot more people know. Because it's something that I wouldn't say I'm ashamed of, but of course you're choosy about who you tell because some people are very small minded, and they'd just be - they'd think you're this really nasty person, when I'm not.
Was your cousin supportive?
Yeah, she was at the time, she was. Yeah, I mean, no-one came with me to the clinic or anything, but she was. If she wasn't there it would have been a lot harder, because we would sit down and think of excuses to tell my mum, and just - yeah - yeah she was supportive.
In general, media campaigns about STIs were seen as a positive thing: it helped young people to be aware of the health risks involved in sexual activity and to talk among friends about it. Some of the young people we talked to attribute their decision to have a STI test to media awareness and peer group discussion.
Stefanie indicates that hers and her boyfriend's decision to test resulted from the awareness brought about by media campaigns about the health risks of STI's.
Stefanie indicates that hers and her boyfriend's decision to test resulted from the awareness brought about by media campaigns about the health risks of STI's.
When you were tested for Chlamydia you asked him [partner] to go to the clinic with you or?
Chlamydia is the most common STI infection among young people but Sarah thinks that more information is needed about other STIs as well.
Chlamydia is the most common STI infection among young people but Sarah thinks that more information is needed about other STIs as well.
When I went in for the pill they asked if I wanted to do like a Chlamydia test or anything like that because I’d obviously never had one before and I think they were quite informative. But then again, I think you only hear about Chlamydia. I think there’s very little information or general information on the other STIs. So I think Chlamydia is definitely the most well known.
Students we spoke to said they were ‘clued up’ when it came to STI testing and that this has resulted from public health campaigns and media programmes and knowing where to go to get tested.
Sometimes though media campaigns were seen as adding to the stigma of having an STI. One young woman suggested that scary media campaigns were responsible for some of the misinformation about STIs.
Encourages other young people who are living with genital herpes not to feel ashamed. (Played by an actor.)
Encourages other young people who are living with genital herpes not to feel ashamed. (Played by an actor.)
If a young person said, "What message have you got for me about all this?"
Well that it's not - it's not a bad thing you know, you don't feel ashamed about having it on your lip so why should it be any different? If anything, it's a thing, where, you know, if you've got it on your lips young people are ignorant in the sense that they would be like, "She does this, she does that". So it's really obvious. If you've got it there no-one doesn't know anyway, so it's a lot more - it's a lot - in a sense its not better, but don't feel in any way ashamed or dirty or anything, because it, it's not that, it's just an inconvenience. Same way you know if you get thrush - that's an inconvenience, that's what this is. Sometimes it just comes about for a couple of days and then it goes. If you learned that, it - this is what you've got, then just accept it, then it, I guarantee it won't even count, so'
One thing I really hate, you know, you hear sexual health adverts and you read articles, and they like to put fear into young people about catching these things, but what they need to understand is that this fear leads to stigma and a lot of people - the way that they think, and it's just, you know you think about it'. I heard an advert once, about the 'sex lottery', and you get herpes. It's like so what, you know, why make it into some big scary thing? If you give people the correct information, then they would know about it but they wouldn't look down on other people who's got it. Yeah, they wouldn't look down on other people who's got it, and that's kind of the whole thing that I want to do now, is let people know that it's not dirty, it's not a bad thing that other people make it out to be. It's not.
Last reviewed January 2016.
Last updated August 2012.
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