Sunday 24 December 2017

Story Time: STI Test Adventures

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Happy holidays, guys! I realise this isn't exactly a festive topic, but it's the first time since my (very spotty) internet access has been available, so it's time to celebrate with a post I've had in a Word doc for a week or so.

Recently, I checked my medical aid balance and found it was pretty loaded (thankfully been blessed with good health this year), so it was a good excuse to go on a mass-test adventure. I like to get STI tested after every partner, but just hadn't gotten around to it after my last breakup. In the interim, I learnt some new things about the way STI tests work that allowed me to better educate myself, and it's not exactly what we've been taught in mainstream education. Gather ‘round children, while I tell you my tale.

Incomplete Information


Getting a full battery of STI tests should be pretty easy – I mean, we’ve been encouraged to be responsible since school. You know, you have some sex ed in Biology or Life Orientation and they tell you to get tested before or after every new sexual partner, even if you practise safer sex. Despite this, STI tests can be expensive and inaccessible – basically the opposite of what they should be. Sadly, it can be difficult to get decent information on what sort of tests are available.

After each partner, I dutifully made an appointment to get “a full spectrum” of tests with my doctor. Each time, she drew three little vials of blood, and each time I felt safer, empowered with my knowledge. That and regular pap smears left me feeling like I was doing the right thing, being informed about my sexual health, trying to make good decisions. I felt like I was being proactive.

Unfortunately, I was wrong. It turns out that even if you go in asking for all of the tests, it’s unlikely that you’ll get them. You need to make specific requests and basically go in with a checklist of everything you want looked at. Silly me – when I asked for every test and only had three vials of blood drawn, I was only getting three tests done. I thought I was being so responsible and informed, but layman’s ignorance gets in the way sometimes. I trusted my doctor to follow my requests, or at least talk me through the process when it was clear that there was a gap in my knowledge, but the most that happened was that I got a little judged for trying to be responsible. Yep. When I went in the first time, she obviously asked if I was getting the tests due to any high-risk behaviour, but because I don’t engage in penetrative sex she told me she wasn’t going to test me for syphilis. Which, like, okay, I understand the logic – it’s a lower-risk situation, and perhaps my doctor was trying to save me money. But it was going against my request, and she didn’t offer any explanation that would help me understand her motivation.

[also: I get irritated when medical professionals assume they know me with no prior information. Don't ask if I have a boyfriend right now because I might have a girlfriend, and don't presume I haven't got syphilis. I might. This is why I'm getting tested.]

Learning Experience

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I actually discovered the gaps in my knowledge through the sex-positive community online, and started reading up about all the tests available. I ended up using this nifty checklist as a guideline, but hey, each bod is different. In my case, I had already gotten a regular HSV pap smear earlier this year, so requested chlamydia, gonorrhoea, syphilis, Hepatitis A, B, and C, bacterial vaginosis, and trichomoniasis. I also asked to be checked for HSV (Herpes) 2 only, because I already know I have HSV 1 orally and that it is far less likely for an infected person to contract the same strain genitally, because your body has existing defences. My GP also explained that there was a way to see if you'd contracted chlamydia in the past, so I requested that as well. All were done via blood analysis, except for BV, which is tested through cervical swab as with a pap smear. The only other thing I knowingly didn't request was an HIV test, as those were offered for free at my previous institution and I had one done pretty recently.

You might be thinking, dang, that's a lot of tests. And you would be correct! Well done. It's a fair fistful of tiny vials, each of them contributing to the cost. I'm one of the fortunate ones who has medical aid that covers these claims, so I didn't need to pay for my consultation or the tests themselves. The total cost, including the appointment, came to a shocking R2866.00! I'm not sure what the South African alternatives would be, but I'm fairly certain you could get them done at a government clinic. However, it seems logical to assume that it would depend on the discretion of the doctor administering them. My GP knew going in that I was a low-risk patient with no symptoms and no concerns following an unprotected encounter, but that I wanted to do it anyway for my own personal satisfaction. Try telling that to a harried doctor in an understaffed government-funded clinic – they'd probably do a quick HIV finger-prick test and send you on your way. It's unfortunate that we're told as teens that it's so responsible to get tested, to be careful, and yet the facilities that assist with this are so inaccessible to most of us.

My appointment was on a Wednesday, and was told to expect my results via phone call that Friday or the following Monday. My GP ended up sending an email that Tuesday because I missed the call, but I felt very reassured to have gotten what I believe to be the most informed care I've yet to receive. Although it was probably unnecessary to get so many done, it made me feel better to be educated, and, should I continue my established practices with my current partner, I won't need to do so many tests in the near future.

Does anyone have any additional information or tips and tricks? Anyone ever explored the government/free options? Educate me!

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