Many STI clinics offer free, confidential STI and HIV testing. Some clinics will see clients on a drop-in basis, although appointments are recommended. Treatment, prescriptions or immunizations may be given, and referrals can be made to appropriate specialists. Information on STIs and HIV, safer sex, and risk reduction is available. The clinic staff is happy to discuss any questions you may have regarding sexual health. Free condoms are usually offered.

Diagnosis and Treatment of Infections

Clinics focus on the diagnosis and treatment of STIs. They are not family planning clinics - birth control is not offered. Routine Pap smears are not done routinely at a clinic, and women still need to have these done through a family physician.

A routine visit would include tests for:

• Chlamydia
• Gonorrhea
• Syphilis
• Candidiasis/yeast (females)
• Trichomoniasis (females)
• Bacterial vaginosis (females)

HIV tests are done on request

After taking your history, the nurse may recommend other tests for:

• Hepatitis A
• Hepatitis B
• Hepatitis C
• Non-gonococcal urethritis (males)
• Herpes Simplex

Some STIs are diagnosed by examination only. These include:

• Yeast balanitis (males)
• Genital warts
• Molluscum contagiosum
• Pubic lice
• Scabies
• Non-STD rashes and skin conditions affecting the genitals

Other Services

Some clinics offer Hepatitis vaccinations as a part of STI care. Others may include a needle exchange.

At the BCCDC STI Clinic, an STI information line is available 24 hours a day with recorded information on STIs, including HIV, and safer sex practices. If you want to speak with a nurse, phone between 1 and 3 p.m. Monday to Friday. In the Lower Mainland call 604-872-6652. For the rest of B.C. phone 1-800-661-4337.

What should I expect at the clinic?

An STI clinic provides free, confidential testing and diagnosis for STIs and HIV, and treatment for most STIs.

This page describes the procedure for an STI check up at a clinic. If you are unsure if you need STI testing, have a look at the "When do I visit a clinic" page.

Consultation

The health care provider will call you, and take you to an examination room. After discussing the reason for your visit, the health care provider will ask questions about any symptoms you may be experiencing, as well as assess your risk for STIs. This involves personal questions about your sexual history, sexual partner(s), and practices including condom and drug use. These are necessary to determine exactly which tests should be done. Yourconfidentiality and privacy will be protected.

1. Examination and Swab Tests

After your history is taken, the health care provider does a genital examination. Some STIs can only be diagnosed this way. The health care provider will examine your skin in general, and more specifically, the area around your genitals.

For women, the examination is similar to having a Pap smear. You lie on the examination table, unclothed below the waist and covered with a paper sheet, and your feet rest in special supports with the legs apart. When you are comfortable, the health care provider checks the lymph nodes in your groin and examines the external genitals with gloved hands and a cotton swab. An instrument called a speculum is used to hold the walls of the vagina apart to view the cervix. The speculum is shaped a bit like a duck bill and is about the size of 2 outstretched fingers. The speculum is lubricated with water and is slowly inserted into the vagina and opened slightly. Insertion of the speculum should not be painful if the vagina is relaxed. The usual sensation is a slight pressure as the vaginal walls are held apart.

The health care provider takes swabs for chlamydia and gonorrhea from the cervix, and swabs from the vaginal walls for yeast, bacterial vaginosis and trichomoniasis. A Pap test may be included. After the swabs, the speculum is removed. The health care provider then will do an examination by hand, which involves placing 2 gloved and lubricated fingers inside the vagina and feeling the abdomen on the outside with the other hand. This helps the health care provider determine whether there is any tenderness or abnormal masses in the pelvic area.

The examination for men is simpler. A man lowers his pants and underwear to mid-thigh, and the health care provider examines the genitals and pubic region with the man standing at the foot of the examination table. The health care provider checks the lymph nodes in your groin as well as feels the testicles for lumps or discomfort.

It is important that men do not urinate for 2 hours prior to an STI exam.

Most men are then sent for a urine specimen to test for gonorrhea and chlamydia. If a man is experiencing symptoms highly suggestive of either of these infections, or has come in because a sex partner has them, a urethral swab is done before the urine test. This involves inserting a thin swab a short distance into the urethra and gently rotating it to collect any organisms or inflammatory cells. This test is uncomfortable, but lasts only a few seconds. There may be some discomfort for a short time afterwards, especially when urinating (a slight burning sensation).

2. Blood Tests

Some infections are tested through blood tests. These include HIV, syphilis and hepatitis.

Results

Some results may be ready before you leave, others will be available in one week. With the exception of HIV, all test results are available over the telephone. HIV results must be given in person.

Treatment

If the examination or tests indicate an infection, treatment may be started on the same day. Treatments for reportable STIs - chlamydia, gonorrhea, syphilis - are provided free of charge, as is liquid nitrogen treatment for genital warts. Over-the-counter medications may be suggested for some conditions, and prescriptions may be available for initial herpes outbreaks. Hepatitis vaccinations may be offered to clients at risk.

STI Information

You are encouraged to ask questions about STIs, safer sex, and sexual health. This site and our information phone line also have information about these issues.

Confidentiality

Information that you give to a health care provider and the results of any tests you have, are confidential. Some STIs (chlamydia, gonorrhea, syphilis) are reportable, which means that you and your sexual partners are required to receive treatment.

For treatment options for a specific disease, please see the treatment section under that disease.

If you are a woman and had unprotected vaginal sex, you may be pregnant. One of your options is emergency contraception, which are ways of preventing pregnancy after unprotected sex. You will find information on Emergency Contraception here.