This fictional scenario is very loosely based on a 4-part BBC3 program called ‘Unsafe Sex in the City’ (watch an episode below). The program follows what happens on a daily basis in Manchester’s main STD clinic and it pulls no punches. This piece is meant to give you a flavour of the program and how it reflects reality in a sexually charged world.
08:15am Staff Room
“I like drippy willies best!”
The other women chuckled but Sue continued, “It’s just that with drippy willies, you know immediately what you’re getting and how to deal with it.”
Blowing the steam from her coffee mug, Bet chipped in.
“Yeah, me too; rather that, than those who come in with a spot and it’s a real battle to convince them that they’re not a danger to public health. You still have to look carefully though, God it could be anything!”
“I hate the ones where the pus is just oozing out from every hole!” Ruby pulled a face. “I’m gonna stay celibate me! I’ve seen enough for a lifetime!”
That set off a fit of giggling but this wasn’t embarrassment; more like gallows humour, to set them up for the day ahead.
“Is it busy outside?” Chief nurse Brenda Williams was checking her uniform in the mirror and adjusting her makeup. At the same time, she wanted everyone ready to open up at 08:30 and was never pleased if the morning coffee and gossip overran. “Is everybody ready to go; the queue’s building up already, I can see out the window?”
“Relax Brenda, we’ve got a few minutes yet,” but Sue recognised the tone in her superior’s voice and opened her locker to get her stuff ready.
“Brenda’s right Sue,” Bet added, “I wouldn’t like to be shit scared and standing outside an STD clinic where the doors don’t open on time. Most can’t wait to get in and get out without being spotted by their mates.”
Ruby pouted; “What an arse-licker you are Bet and right in front of Brenda too; shameless!”
They all laughed but everyone was ready to work. Brenda led them into the corridor with one last riposte:
“You shouldn’t joke about arse-licking; you never know how many were taking you literally last night!”
Room 3: Brenda
“Hi there, how can I help you today?”
First in was Dougie, an 18-year old boy whose friends had got him drunk and taken him to a club. He’d messed around with a girl but hadn’t had sex; just a little touchy-feely action. Nevertheless he was convinced he may have caught syphilis or HIV. Brenda went into reassurance mode.
“So there was no penetration of any sort?”
“And you just kissed and touched each other?”
“Yeah; we just snogged and she let me feel ‘er up. Just a finger inside, you know.”
“So what makes you think you might have caught something then?”
“My mates said...”
The boy then revealed all his insecurities and basic lack of knowledge of how sex and STD’s worked and Brenda put years of experience into action; calmed him down and gave him the talk and the right leaflets for his position on the sexual ladder.
“Listen love; you really need to get informed you know. Read these at home and try not to listen to your mates too much. You were drunk and they were trying to wind you up that’s all but if you read these, you won’t fall for it so easily the next time. Alright love, any more questions? No? Take care then.”
Brenda weighed up whether he would be back with the real thing at some stage in the future. Looked like a decent lad and was pretty scared; an innocent really compared to most who came in. Hopefully the pamphlets will get through to him but you never can tell. There’s a limit to what you can tell the people who come in. You may want to give them a cuddle and load them with advice but that can rebound before you know it. Stick to protocols and you can’t go wrong. She knew she had a great team of nurses here. They all knew when the rules had to be applied and when it was safe to add the personal touch. Misery and fear were all too commonplace and someone had to comfort them and reassure them that it would all be okay but it never paid to get too close.
Room 5: Sue
Sue showed absolutely no emotion as Jimmy told her quite brazenly about his recent escort encounters. Regular sex for money paid his rent. He was a regular, in for the results of his 6 monthly check-up. Nothing wrong with that; it’s what they always advised and she was pleased that despite his cocky demeanour that he was being sensible in that respect.
“Have you got any other symptoms that you know of? Any discharges, rashes, unusual lumps or warts?”
Poised pen in hand, she hoped the answer would be negative because she’d just spotted the following information on the sheet. He was only 21 and looked younger. He had too many tattoos; brown fingers from smoking and looked as though he could do with a good meal. This was going to be a difficult meeting and she would have to advise lots of lifestyle changes. She glanced down at his record: crabs, gonorrhoea twice and non-specific urethritis once but generally not bad considering his ‘job’.
“No nothing. I’m just in for my results.”
Sue was all prepared.
“Okay Jimmy, here’s the thing. We’ve got your results back and although everything else is negative... I’m afraid you’ve tested positive for HIV.”
There was never a gentle way to say it and there was no point beating around the bush, still...it hadn’t registered.
“I’m okay then?” he grinned and started to put his jacket on.
“No love; I don’t think you heard me. I’m afraid you tested positive for HIV.”
The cheeky-chappy demeanour fell away instantly.
“Are you sure?” His voice shrunk to a murmur.
“Listen love, we wouldn’t tell you something like this unless we were sure.”
“Yeah okay but are you certain? Really?”
She wanted to hug him and tell him everything would be okay but even though it probably would be and he wasn’t going to die, there was a whole barrow load of heartache to go through before that. It was always the happy, cheerful boys who took it the hardest. He would have known the risks and he would have known how to avoid them; he was an escort after all but she could see that he had never expected this news in a million years and the boy with a man’s lifestyle and street attitude had instantly become seven years old and needing his mum. She put her hand on his shoulder and stroked his back a little. She could feel him trembling but he didn’t cry, just hung his head in disbelief.
“What am I gonna do?”
At this point, Sue switched into professional mode and took him through the first few months of being HIV positive and reassured him that he wasn’t going to die and that this, that and the other process would lead him to safety and the routine of a life living with the virus. She knew she could call Mary, the Social Worker in if needs be but he gradually began to perk up and ask all the right questions. She made an appointment for him with an HIV specialist at the hospital and told him that after that he could choose which doctors he wanted but she knew he would be well–taken care of. HIV-care in the town was a well-oiled machine by now. After watching another client coming in with all the self-confidence in the world and leaving as a broken little boy, she knew she’d never get used to it. Life is full of hard lessons and dreams are so easily broken.
Room 1: Bet and Mary (social health worker)
Dean came in for his results. He’d been told that he’d be texted if there was any news and he’d received a message asking him to come in. In his late twenties, he considered himself a player. Handsome in a rough-edged way, Bet could imagine how sex came easily to him. As he walked into the consulting room, thumbs in the waistband of his low-slung jeans; he winked at Bet and gave Mary, the middle aged social worker, his tap-up leer. After his first sentence was another line out of the flirtation handbook, all guards were up for both women. Although she knew it was wrong, Bet couldn’t help smirking inside. ‘This one is going to get some deserved come-uppance’.
“Now then Mr. Symonds, I’m afraid we have some bad news for you.”
The smile dropped from his face and he frowned. Bet regretted feeling so smug and stayed professional.
“Your tests are back and have shown positive for both gonorrhoea and Chlamydia. Do you know what those are?”
The man shrugged ruefully.
“I knew it, that dirty bitch gave me this. I should never have gone with her. Everyone knows she’s a tart!”
Bet wasn’t going to let him get away with this.
“Well, according to what you said the last time you were here; you regularly have sex with multiple partners. ‘A new one every week’, I seem to recall. How can you be sure that just one person infected you?”
“I just know.” He hung his head.
Mary chipped in, using that quiet, authoritative voice of hers.
“The fact is Mr. Symonds; may I call you Dean? The fact is Dean that you can’t possibly be sure and that’s why I’m here today. We can treat you and in a few weeks you’ll be okay again but...”
She extended the time to try to make him wait longer before his next series of sexual conquests.
“...what you need to realise is that you have probably infected other people as well and because the symptoms are much less apparent in women, you may be putting them in danger of infertility as well as ensuring that the diseases spread further. This is not your first time either and you should realise that the more times you get an STD, the greater the risk of other health problems as you get older. What we’d like you to do for us, is give us the names and contact information of the girls you’ve recently slept with; let’s say the last two or three months. It’s very important but if you’re not prepared to do that, I want you to promise me that you’ll get in touch with them yourself and get them to go for a check up. I know it’s difficult and embarrassing but their health is more important than a bit of embarrassment. Do you understand what I’m saying?”
As soon as he realised that apart from morally, he wasn’t actually obliged to do anything, the arrogance returned.
“I don’t know their fucking slag names; I’m always drunk; they’re always out of their brains too.”
Bet wanted to wipe the smirk off his face; ‘be professional Bet’ she reminded herself.
“So, can I have the tablets today?”
Brenda decided that antibiotics for the clap plus an injection for the Chlamydia were certainly more appropriate in this case. If nothing else they could give him a sore bum to think about and a repeat appointment to check up whether he’d contacted any of the girls. The approach would be less polite the next time if he hadn’t.
After they’d given him free condoms and lube, in the knowledge that they probably would be blown up as balloons rather than used for safe sex, he swaggered out the way he came in. Both professionals looked at each other and sighed. These men were ten a penny and there was little that could be done about it. The only way to curb the spread of STD’s was to treat them as soon as possible and hope that lessons would be learned but there was just no getting through to some people that sex carries any form of responsibility.
Room 6: Ruby
“Hi, come in and take a seat. It’s Lizzy right? I understand you want to have an HIV test; why do you think you need one right now?”
Lizzy was 28, well-dressed and by the way she talked, clearly intelligent.
“I’ve just started a new relationship actually and wanted to make sure I’m clear of any STD’s. My partner did the same last week.”
Ruby noted that down. “Well that seems like a good idea. Did he come here for the tests?
“Not ‘he’, it’s a she actually. I’m a lesbian.”
Ruby changed tack.
“What makes you think you may need an HIV test then? Have you had sex with men also? Or have you indulged in any activities you think might have put you at risk of HIV?”
“No, no sex with men and no dangerous stuff either.”
“Do you use sex toys for penetrative sex?”
“No!” Lizzy looked slightly offended. “Well, maybe a vibrator now and then. I don’t think we do anything risky though. We just thought it was best to start off with a clean slate.”
“What about oral sex?”
“Well yes but...”
“You don’t use a dental dam?”
“God no! Who wants to do that through a balloon!”
Ruby knew that of all the sexually active groups in society, lesbians were probably the safest of all but that didn’t exclude the possibility of transmitting STD’s.
“The only reason I ask is because herpes can be transmitted orally and there’s always a risk of thrush, warts, chlamydia and HPV even and vaginal discharge can often be infected. It often depends on your history and whether the sex you have is intense enough to bring you into contact with blood, especially during menstruation. Don’t get me wrong, I’m not suggesting anything at all but you are doing the right thing in getting tested, even though your activities are less risky than most. Let’s get you screened for everything, then you can enjoy your new relationship worry-free. Okay?”
Lizzy looked a little shell-shocked when she left. She’d clearly not considered all the possibilities but Ruby knew the importance of making people aware of where they stood in the sexual minefield. Nothing shocked her any more. She’d seen it all and seen every possible sort of relationship and sexual encounter. She’d seen most of the consequences too: broken marriages and families; people suicidal, aggressive even. The police had to be called on a regular basis when clients took out their frustrations on the staff.
At first, things like fisting and sadomasochism and a frequent lack of embarrassment or shame, had shocked her rigid but after a while, nothing seemed perverse any more. The difficulty was leaving it all at work when she went home to her little boy and husband. She was constantly surprised by new trends... who knew the bush had almost disappeared in both men and women, gay or straight! When did shaving down there become a majority sport? ...but she was rarely shocked any more.
You couldn’t fail to be moved by some stories, you were only human after all but the only way to negotiate the field of sexual health and keep your sanity was to stay professional at all times. Ruby was determined to do that and knew everybody else on the staff was too. They supported each other after the clients had gone home and that made the job so interesting and rewarding. Ruby wasn’t sure they were winning any sort of war with STD’s but without the clinics, she knew it would be so much worse.
Watch an episode of BBC’s ‘Unsafe Sex in the City’ in this YouTube video. It’s almost an hour long and probably better not seen while eating but definitely worth the effort.