Even if we think that we may have a sexually transmitted disease (STD), many of us would hesitate to go to a clinic, where the disease could be diagnosed and treated. To reduce these fears, this article will cover some questions asked of Dr. Alex Mitchell, a public health physician, about what happens in his clinic in Lawrence, Kansas.
Q.What happens when someone thinks they have an STD and comes to your public health clinic?
A.For many young people, the public health clinic is a very imposing place. However, many people who come here do not have concerns about STDs. Most individuals are here to get pregnancy tests or contraceptive information. For those concerned about an STD, this is the normal routine — the clients either step up to the reception counter or is asked by the receptionist if she can help them. Many clients are reluctant to say that they are concerned about an STD. Often they will say, "I want to see a doctor (or nurse)." The receptionist is quite perceptive about what they want. She often helps them by saying, "Are you concerned with VD or an STD?" The clients now have only to answer "Yes" to the question."
Once it is determined that the concern is about an STD, the client is taken into an examining room. A specially trained nurse asks questions about such things as symptoms and history of diseases. At all times, the nurse maintains an atmosphere of calm and reassures the clients that they are in good hands. The manner of the nurse indicates that an STD, if present, is not a stigma or anything bad. The client is merely a person who has come for help for a medical problem. If a blood test is indicated, blood will be drawn.
After this interview, the client will be seen by either a physician or nurse clinician. When I see clients, I try to put them at ease. I ask more specific questions after reviewing the chart, then I do my examination and tests.
If a diagnosis can be made, and most times it can, I administer treatment and discuss how we will get in touch with the client's sexual contacts. Clients usually provide the names. I explain that we will not mention the client's name when we call, but will ask them to come in, because we believe they have been exposed to an STD.
Q.Who is the typical person who comes to the clinic?
A.Virtually all of our clients are young, 15 to 25 years of age. They tend to be sexually active and thus are at greatest risk for STDs. We rarely see married, older individuals; they usually go to their own physicians.
Q.Do most people get anxious when you get to the treatment part of the procedure?
A.For some reason, people think our needles are much bigger than other physicians' needles. I assure you, they are not! In fact, this is not even a concern, because we can treat most STDs caused by bacteria with orally ingested medicine.
Q.What happens when you begin to discuss the sexual contacts of the client?
A.This is another area of misconception. Many of our clients have already called their sexual contacts and told them that they should see a doctor, because they may have caught an STD from our client. I am impressed by the social conscience of many of our clients. In very rare cases, a client will not name their contacts. If the contacts do not call us, we call them. In most cases, the sexual contacts come in when they are called by the client.
Q.How do you reassure the client that everything you do is confidential?
A.I tell my clients that there are three very important considerations as far as their case is concerned. First, I want to treat and cure the disease. Second, I want to see, examine and, if needed, treat all their sexual contacts of the past 30 days. I stress that everything is confidential and that we will not use their names when talking to a sexual contact.
In writing this article, I talked with a Yuma Public Health official, Cesar Reta, STD program coordinator. The Yuma County Health Department clinic (2200 W. 28th Street, Room 178) is run essentially the same way. The STD program is open 8 am to noon and 1-5 pm, Monday through Friday. Clinic days and times are Tuesday 9:00 am to noon, and Thursday 1:00 pm to 3:00 pm, with expanded days and hours in the winter and spring. You are encouraged to make an appointment by calling(928) 317-4580, X1736 for no waiting, but they also accept walk-ins. Tests for STDs are provided for $25.00, and this covers the visit, examination, diagnosis, laboratory tests and treatment. Tests for HIV (the AIDS virus) are $10.00. No one is refused services due to inability to pay. (They also speak Spanish there.) If you think you have an STD or want information about STDs, contact them. Remember that most STDs are curable, and all STDs are treatable.
You can also get more information about STDs and other aspects of sexuality by takingHuman Sexuality (Psy/Soc 170) at Arizona Western College. The course offers a straightforward approach to sexuality in an atmosphere open to honest, thought-provoking discussion.
* Adapted from Denney and Quadagno's Human Sexuality, Mosby Publishing, 1988, pages 456-457.
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