There are two components to sexual health testing: firstly the testing that you get done yourself and secondly the sexual health checks you perform on your clients.
Vaccinations
The vaccinations that I recommend to anyone who is in the industry are Hepatitis B, A and HPV (the virus which causes genital warts and cervical cancer). If you haven’t already been vaccinated I strongly recommend that you speak with your GP about whether this will be suitable for you.
Testing
There are three types of sexual health tests available, blood tests, urine tests and swabs.
Bloods
- It is recommended for sex workers to get blood tests for HIV, syphilis and hepatitis every 6 months. If you have immunity to Hepatitis B and A then this test can be performed once a year to check your immunity levels.
Urine
- Urine tests pick up Chlamydia and Gonorrhoea and they should be done every 3 months.
Swabs
- Swabs can be taken anally, vaginally or orally and they are used to pick up Chlamydia and Gonorrhoea. These can be done as frequently as monthly. It is strongly recommended that if you are provided oral sex without a condom that you insist on getting throat swabs every month as this service whilst becoming popular is a higher risk service.
You can go to specialty sexual health clinics in your state, which will treat you anonymously if you are a sex worker. However I prefer to find a GP that I’m comfortable with and go to them exclusively for my sexual health tests. I find that building a strong relationship with one GP about my sexual health helps. However this is my personal preference, as long as you are getting tested regularly that’s all that matters. When you’re discussing your sexual health with your doctor make sure to ask them anything you need to know about STIs and HIV; your knowledge of this is as crucial to your tests and treatments.
Sexual Health Checks
These are the visual checks you perform on your client prior to commencing a service. What you will need to be able to perform these checks – is a really bright torch, I swear by the LED little torches you can normally pick up for $10 near the registers of most $2 shops. You will also need to study the signs of the STI’s so you know what to look out for. However the absolute rule for sexual health checks is if something looks suspicious to you and makes you question it, then simply say no to the booking. I know there are times when you are relying on that booking for money, however if you think about the lost income you will have to endure should you contract an STI it’s never financially worth the risk.
Here’s my guide to sexual health checks
As soon as your client has arrived before you kiss them hello, quickly check around their lips for cold sores.
After the money has exchanged hands, before your client has been able to go to the bathroom or showered, inform them that now you will do a quick check.
It is crucial you do not allow your client to go the bathroom before you do this as I have caught many clients with a discharge based infection such as Gonorrhoea trying to clean the discharge off their penis.
Firstly you ask your clients to lower their pants and you use your LED light to examine for any skin based infections as these are the ones that you will not be able to continue any type of service with them if they are present. You are looking for anything that seems abnormal. Anything that is open, weeping or any pimple looking things that contain yellowish pus. If your client has any band-aids in the area, ask to remove them. I’ve seen clients with herpes cover them with band-aids thinking that if you cover a herpes blister then it’s not contagious. This is totally false. Remove all band-aids and look at all the skin in the genital region, the penis, and the scrotum and underneath the scrotum. (Always carry band-aids in your workbag so if the band-aid is covering something innocuous you can reapply it).
Once you’re satisfied that the area looks normal, the next thing to do is to milk the penis. To milk a penis you gently massage it like you’re trying to squeeze toothpaste, in most cases you will be able to get fluid out. The fluid should be clear and relatively odourless.
Checking women is much the same. I ask my female clients to lie back on a bed, I check the skin, and then with the discharge you just check that it’s not offensive or resembles anything like cottage cheese. With women you do need to be more sensitive, I often will explain the process to them and say I can help them check me first so they can see what we are looking for.
Once you’re satisfied, send your client off to the shower.
I have heard that some sex workers with higher hourly rates do not do the health checks as they find it to break the fantasy. In my career I have worked at many different levels of hourly rates with the most expensive been $3000 for 1 hour, the cheapest being $300 in my brothel days. I check every client regardless of payment. There is nothing fantastical about taking sexual health risks. Clients have also sought me out specifically for my strict sexual health policies, they know that I don’t take risks with my health and therefore I’m not going to risk their health. If you think about the number of our clients who have partners they certainly do not want to risk taking something back home to their relationships.
The other practice that I see is sexual health checks being performed in a casual manner; I just take a quick look as we start foreplay. This is incredibly ineffective, once foreplay commences the lights are usually dim so your chances of noticing that that ingrown hair is actually herpes is very low, plus your client has hopefully had a shower so any discharge is gone, and with arousal his pre-cum will be watering down any signs.
The final thing with sexual health checks: It’s important to realize that your client is going to be nervous and uneasy about it, so it’s the perfect time to really focus on your rapport building with them. My bedside manner around health checks is always light and confident. When I’m checking the skin I will usually make jokes around let’s see what you have in store for me, or if my hands are cold I may say something like I really like to play nurse. During the milking of the penis, I only need to do this very quickly, but slowing down in this part and turning it into slowly pulling his penis so he heads off to the shower already aroused is a great start.
