What really happens at a clap clinic?

Malehealth's intrepid reporter find outs.

There's a scene in Four Weddings and a Funeral where a wistful Hugh Grant and a soon-to-be-married-to-someone-else Andie Macdowell get to talking, in slightly roundabout terms, about their respective sexual histories. Macdowell's character refers to her own number of past partners as a 'decent average'. To which the comically inexperienced Grant asks: 'What exactly is a "decent average" nowadays?'

Hardly an exercise in gritty realism, Four Weddings raises the subject of sexual conquests in terms that are blissfully ignorant of the realities of HIV, AIDS, or even common-or-garden STIs (sexually transmitted infections). But here in the real world, we have all come to understand much more fully the sometimes lethal risks which attach themselves to the choices we make about who we sleep with.

To undertake a casual encounter with a stranger, for instance, is to link yourself to a network of other lovers whose number, identity and orientation you cannot possibly fathom: if you think about the maths, the potential permutations are terrifying. Frankly, we just don't know where we've been any more.

But for all their anonymity, those connections have a reality that is visceral, physical, even medical. They are formed of bodily fluids like blood and sperm, and their means of travel is the way of infection. The infections that we 'give' to one another in this way range from pretty harmless conditions like non-specific urethritis (NSU) - symptoms include a cloudy fluid from the tip of the penis and a pain or burning sensation on peeing; a course of antibiotics is usually all the treatment you need - all the way up to HIV, the 'ultimate' STI (though the condition is not, of course, transmitted only sexually), which has to date infected around 50 million people around the world.

At a time when sex is probably easier to come by and less heavily policed - socially, morally or religiously - than ever before, sex is actually riskier than ever. Nowadays it's not 'decent averages' we should be aspiring to, but safe ones.

Recently, I decided to go along to my local NHS sexual health clinic for a full check-up. I told them (they always ask) that I wanted to draw a line under my sexual past so if possible to be able to present a clean bill of sexual health to a new partner. I asked for all instances of drunken carelessness to be taken into consideration too.

I told my doctor the number of sexual partners I'd had, and asked whether the fact that my sexual history was entirely heterosexual reduced my risk of HIV. 'Not necessarily,' she replied. I opted to be tested for HIV; Hepatitis A, B and C; gonorrhoea; syphilis; chlamydia and anything else they could think of. In for a penny, in for a pound - and besides, it's not exactly a place you'd want to come back to more often than you really have to.

I had an afternoon appointment and, on a quiet day, I was seen very quickly. Much better than the walk-in sessions, I thought: according to a whiteboard in the waiting room, the last walk-in waiting time had been 'two to three hours'. Rather too much time to sit around, wondering what every else has got, trying not to feel shifty. (It is not the done thing to meet another man's eye in the waiting room of a sexual health clinic, an etiquette which applies equally to urinals and porn shops. The tacit message in such situations boils down to: 'Look, you know I'm here, I know you're here. We'll say no more about it, OK?')

But I did have enough time, while waiting, to flick through some of the myriad leaflets on display. (Again, not something you want to do too conspicuously.) I learnt that herpes simplex virus can cause both cold sores and genital sores; that antibiotics will not get rid of genital warts (because they're caused by a virus, not a bacteria); that the Health Education Authority is allowed to use the word 'wanking' in its leaflets (it's one of the suggestions for enjoying safer, non-penetrative sex); and that pus cells indicating gonorrhea can be detected under the microscope immediately after giving your sample.

Ah yes, the samples. I gave urine (it had to be divided between three containers, which was no mean feat) and I gave blood. But I lived in fear, as every man I know does, of THE SWAB. Those who'd had it already described the sensation as 'unexpected', 'horrible'. Surely it's just like the dentist, I reasoned, a minor but necessary discomfort. My friends went quiet and looked at the ground.

My fears about the swab are mixed up with a welter of vague male superstitions. I'm told that there is an excruciating treatment for one STI which involves sending down the urethra a kind of mini-umbrella, which is then opened up 'indoors' (in defiance of the superstition) and scraped back out. Somehow in my mind this nightmarish scenario is mixed up with those mythical tales of Amazonian fish which swim up your urine flow and into your dick if you're silly enough to piss in the river.

But the swab, I'm relived to say, isn't really like any of that. I was led into a small room. With one practised gesture my doctor turned the lock in two connecting doors. Click-click. She told me to drop my pants. I did. She told me to lie down. I hadn't removed my boots, so this meant hopping over to the table, a classic NHS job with a length of coarse paper-towel stretched over it. Clumsily, I lay with my bits to the wall. Turn over, she said, in a tone which seemed to suggest: 'What am I gong to do with your arse?'

At once, in went the swab, a sort of very long, thin cotton bud, to take its sample. You can't imagine how it feels until you've had it, but once you have, you realise it couldn't have felt any other way: like someone inserting a tall thin foreign object down your doo-dah. But let me reassure you: it's over almost before it's begun. It's uncomfortable but it's very quick, not so much invasive as 'inva-'.

Next, there was a separate counselling session before my HIV test, a useful chat where your anxieties are sensitively handled. Then, I was told what the Centre knew from my samples already. Provisionally, from an examination of my urine, I was already cleared of NSU, chlamydia and gonorrhoea. Now the blood, urine and swab samples would be sent off for further tests, to confirm these findings and rule out the other nasties.

A week later, I made an appointment to go and get my HIV result. You can't be told by phone or letter - and the result is entirely confidential. This was a much more anxious moment than I'd expected, and the wait, amidst a roomful of very glum-looking men, was rather longer. But when my counsellor called me into her office, she didn't beat about the bush - she told me I was OK virtually before we'd sat down. Never had being negative seemed so positive! But then the alternative outcome hit me, and I realised that the job of an HIV counsellor must be heart-breaking.

For my other results, I was asked to make a phone appointment for a fortnight after my first visit. A word of advice: don't miss your window - I did, and had to wait another three days to find out. Then I was told I was negative for gonorrhea and chlamydia. But my blood tests - syphilis and hepatitis - were not back from the lab yet. So I made another phone appointment - for a day three weeks after my initial appointment. I'm still waiting for my clean bill of health.

Sexual health/GUM clinics provide a completely free, confidential and non-judgemental service. If you're worried about any symptoms, visit your local (or any) clinic. Because some STIs can be symptom-free, clinics also offer routine sexual health checks.

Dan Fielder

Have your say about sexually transmitted infections

Have you visited a sexual health/GUM clinic? What was it like? Have you ever had a STI? What happened? Whatever your experience of STIs and sexual health clinics, we'd like to hear your views. All contributions will be published on malehealth.co.uk.