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Do you feel anxious about the idea of getting tested for sexually transmitted infections and diseases? Some of our readers certainly do.
Some never had adequate sex-education and did not realize that sexual activity with a partner -- and not just anal or vaginal intercourse -- can pose STI risks in the first place. Some are not sure where to go for testing or how to ask for it. Others feel uncomfortable discussing STIs with a partner or potential partner. We get it: this stuff can be hard, and it is usually not the kind of thing where someone just takes us by the hand and leads us through.
This is why we're doing this new series at Scarleteen's blog. In it, some of Scarleteen's volunteers share their own stories of how they deal with different aspects of STI testing and reproductive healthcare.
This summer, I went to my clinic to see a general practitioner (GP) for an annual check-up.
This clinic is affiliated with a local university so the way it works is a little different than many others. Officially I’m a certain GP’s patient, but I see the residents that she supervises whenever I go. This has meant that the level of care has varied, but in general has been fairly high. When I made the appointment, I did not have any particular concerns, but I wanted to get a pap smear and STI testing.
In the past, I have made some unsafe decisions, and I have also been in situations where a partner has not respected my condom-use wishes. Since then, I have had several clear results from pap smears and STI tests, but I have been going at least once a year as a precaution. My last pap and STI test were in February of 2011. I should also mention that I live in Ontario, Canada, and that this visit and the tests were covered by the Ontario Health Insurance Plan (OHIP).
As I mentioned, this appointment was performed by a resident. Overall, she seemed a little awkward and I got the impression that she didn’t really like performing annual exams and all that they entail. She was however, very nice, nonjudgmental, and very good at checking in with me throughout and making sure everything was good -- for example, "Is this ok?," "When you’re ready...," "If that’s ok with you…" -- which I really appreciated.
After checking my ears, throat, lungs, and heart, the doctor palpated my abdomen and performed a breast exam. Then it was time for the speculum exam.
Having been tested several times before, this part was no big deal for me, but there’s still a little bit of awkwardness with the process. It’s also not something that’s overly pleasant, but I don’t generally find it painful.
The doctor instructed me to lie back, I put my feet in the stirrups, and she told me that I would feel her touching me. She did a quick visual exam, and then inserted the speculum. She told me that my cervix popped right into view and that sometimes it hides, which provided an amusing mental image for me. Through previous exams, I’ve also learned that every cervix is in a slightly different spot so doctors sometimes have to go look for it. I enjoy learning these little tidbits about the human body and it made the whole speculum experience more interesting.
At the start of the exam, and throughout, the doctor showed me which swabs she would be using before using them. Other doctors I’ve seen had not done that before, and I really appreciated her effort to keep me informed throughout the process. The swabs she took were to test for chlamydia, gonorrhea and bacterial vaginosis, as well as the pap (to check for cervical changes that could indicate HPV). Normally after the speculum exam, other doctors I’ve seen have performed a bimanual exam, but this one opted not to do one because she said my cervix had been able to move around without any pain.
In addition to the swab tests, I requested the blood tests for syphilis and HIV. I could have requested a blood test for HPV, but it is expensive – around $90 if I remember correctly and not covered by OHIP – and they usually don’t do them unless the pap comes back abnormal. I opted not to at this time, especially considering my previous clear paps. I have not had a chance to go for those blood tests yet, but plan to shortly.
At the end of the appointment, I asked the doctor to check my previous pap and STI test results and we realized that I had already had 3 all clears. The clinic’s policy is that after 3 all clears like that, a person can go every 2 years instead of every year unless they change partners. The doctor apologized for not having checked before hand and for the unnecessary tests, but I didn’t mind. I like the extra reassurance that this visit provided.
Overall, my latest testing experience was positive. I’m extremely thankful that I live in a city with quite a few available options for STI testing and pap smears. I have also rarely encountered judgement and barriers from healthcare professionals in terms of getting the tests I wanted. I know that not everyone has that privilege, and I really hope that one day everyone will have the same level of access to care.