Check up and Consultation

The check-up When you arrive, you should report to reception where you will be booked in and given a numbered ticket depending on the system. You then wait until your ticket number or name is called. If it's your first time, you may need to answer a few questions or complete a short questionnaire. Some guys feel the need to give a different name which is okay as long as you remember it and respond when it's called out. At some point you will be given a reference number. Don't lose it as it links you with your clinic file which sits amongst tens of thousands of other records. Although they can be found by your name and/or date of birth, looking for records in this way causes delays and extra waiting time for you. Visits take up to two hours, sometimes longer, but don't be afraid to ask how long it is expected to take. Longer waits usually occur in clinics that provide a 'walk-in' service where it can be difficult to match demand with staff. If the waiting room is packed and the clinic is short staffed, you could be there for several hours - it's unavoidable. Pre-arranged appointments are more likely to keep to time but are not always available for routine check-ups. Everyone is there for the same reasons and nobody is likely to feel any less awkward than you. Just get on with it and take a book to pass away the time. The consultation Practice varies between clinics but you can usually expect the following during a routine check-up:

You will be called by name or number and shown to a consulting room by the doctor; while the consultation is taking place the door should be closed.

The doctor should introduce him/herself. (Sometimes there is a student present and you should asked whether this is okay. If you'd rather see the doctor alone - say so, particularly if it's your first time at the clinic or if you are feeling in any way nervous).

The doctor will ask you about any problems or concerns you might have.

Explain in your own words what seems to be the matter and describe any symptoms.

The doctor is also likely to ask you the following questions: - How many people you've had sex with recently and their sex. - Whether your partners were casual or regular. - The kind of sex you've had and whether you protected yourself. - Whether you've had STIs before and if you have any general health problems or allergies, including recreational drug use. Difficult and embarrassing though they might be, try to answer them as specifically as possible. If you hide anything (eg say you always use condoms when in fact you don't) or are economical with truth you may be not be tested for something you have.

The doctor will need to examine you and this is likely to include the cock and balls, the throat, the arsehole, the glands in your throat and the skin.

The doctor or a nurse will need to take samples to find out whether you have a sexually transmitted infection. Using swabs , samples are taken from the rectum, throat and the end of the cock. These are used to test for chlamydia, gonorrhoea and NSU which are routine tests. The presence of chlamydia can also be tested using a urine sample.

The smear from the rectum is taken using a proctoscope (a finger sized plastic tube). To do this, you will be asked to lie on your side with your knees pulled towards your chest. If you have a big arse, you may be asked to hold your arse cheeks apart. The arsehole is lubricated with some jelly and the proctoscope is gently slid into the entrance of the arsehole where the sample is taken. If you've never had anything up your arse then this will be a new sensation for you. Above all: relax. It doesn't take long and is rarely unpleasant.

A blood sample is taken from the arm to test for syphilis; again this is routine. After discussion with your doctor you may also be tested for hepatitis B to find out whether you need vaccination or, if you've been vaccinated for a few years, a booster.

You will not be tested for HIV unless you have discussed it with the doctor, consented to having the test and received counselling.

If the doctor suspects that you may have other STIs you will be tested for these too.

The doctor may suggest you see a health advisor

Some of the test results will be available during your visit, others will take a week or so and you will have to go back to get them. However, you can usually phone up to find about routine tests but you will always have to see a doctor or health advisor if you're getting an HIV test result.

After you have been examined and provided the necessary samples you are likely to be returned to the waiting area for a short time before seeing the doctor again. Depending on the diagnosis and whether you have to wait for further results you may be given a course of treatment (usually antibiotics) and a follow-up appointment. A thoughtful doctor will close the session by checking that everything's okay and give you an opportunity to ask any other questions. This online advice guide is an extract from the book TOGETHER, by kind permission of Patriic Gayle and Gay Times Books. The book itself is over 300 pages long and contains:

several chapters more useful advice and information

more in-depth information in some chapters

more pictures and tables

further contacts at the end of each chapter

a comprehensive listing of gay and health organisations Described by Qx magazine as a 'Gay Bible', Together Book is a practical reference work no bookshelf should be without.

Available from Prowler Stores and all good bookshops, or click the link below for price and ordering details.

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