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Interview 47 - Katie & Alice

Age at interview: 22
Brief Outline: Katie first started taking the oral contraceptive Microgynon to help with her heavy periods. Now she takes Yasmin but also uses condoms. Katie and her housemates decided to go together to their local Genito-Urinary Medicine (GUM) clinic to have a Chlamydia test. Alice took the oral contraceptive Microgynon for a few years but decided to change it after she started experiencing headaches. At present she is on Yasmin but feels that she hasn't received adequate advice and informat
Background: Katie University student; single. At the time of the interview she was living in an all female student house. Ethnic background: White British. Alice Final year at university; single. Shares a house with other students. Ethnic background: White British.

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Katie

Katie is at university and lives in student shared accommodation. She was first given the oral contraceptive Microgynon to help her with her heavy periods. Her GP later changed it to Yasmin after her skin started to be affected by dryness. Her GP has discussed with her other family planning alternatives such as implants and the coil but to Katie such methods have not finished to convince her in particular implants. Her main concerns about implants are the sense of permanency and lack of control.
 
Katie uses the contraceptive pill and condoms at the start of a relationship but stops using condoms with a regular partner usually after finding out about the partner’s sexual health history. She says that however embarrassing it is important to discuss with your boyfriend the issue of sexual health. She thinks that her ‘matter of fact’ attitude to sexual health has to do with good information and advice, peer group and her surroundings. The city where she lives has a substantial student population and sexual health and family planning education and services were described by Katie as first-rate.
 
Katie described herself and her friends as ‘clued up’ when it comes to information about sexual health and family planning. For her, her main source of information about these themes was her school. She thinks it is essential that issues such as sexually transmitted infections and unwanted pregnancies need to be reinforced by an authority type of figure and not just discussed within a peer group. For Katie sexual health education in school should start around the age of thirteen or fourteen because most kids start thinking about relationships and sex around that time.
 
Unprotected sex prompted Katie and her house mates to decide to go to their local Genito Urinary Medicine (GUM) clinic to be tested for sexually transmitted infections (STI’s) including Chlamydia. In her experience the staff at the GUM clinic was sensitive and helpful, and they were given the option to use a made up name if they didn’t want to use their real one when being called by the nurse from the reception room.
 
Alice
Alice took the oral contraceptive Microgynon for a few years but decided to change it after she started experiencing headaches. At present she is on Yasmin but feels that she hasn’t received adequate advice and information from her GP about the contraceptives methods available. She remembers to have been given leaflets but what she really wanted was to talk to a health professional about all the methods available to her and the pros and cons of each of them so to be able to make an informed choice. Infertility is her main concern regarding long-term reversible contraception like implants. She says that most of her information about contraceptive methods comes from the media.
 
She feels that she and her friends are doing very well when it comes to sexual health protection and avoiding pregnancy. She knows where to go to access services and advice. She has attended a genitor-urinary medicine (GUM) clinic and requested to be tested for everything. The reasons that prompted her to go and be tested were unprotected sex and the need to know that everything was all right. Alice thinks that if you have had unprotected sex the most sensible thing to do is to get tested. Alice went with friends to the GUM clinic for ‘moral support’. She says that going to a GUM clinic can be a bit intimidating, especially because she found herself waiting for a long time in reception before being called to see a doctor.
 
The experience of the consultation and test itself were absolutely fine. Alice explains that the doctor asked about such things like sexual partners in the last 12 months, alcohol intake and method of contraception use. Then the doctor explained exactly the test procedures and what they were going to test her for, including a blood sample to test for HIV. She describes the tests as not at all painful and the Chlamydia test as uncomfortable. She says that the experience of testing is not at all scary and that the staff is very supportive and ‘nice and friendly’. She felt reassurance by the experience at the GUM clinic and would test again if she had any worries about her sexual health.
 

 

 
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Katie’s GP gave her leaflets to read about implants and IUDs but there was little discussion...

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Katie' I can’t say that they really discussed it with me. I was given a bunch of leaflets and told to go off and maybe if I want, you know, if I wanted to talk about it more then come back. Well, I think I would have preferred them to have gone through each method and actually told me, you know, what they thought that the pros and cons because I’m not a doctor and I don’t know exactly.
 
So in the end I just decided to stay with the pill but I would have preferred maybe to talk about it a bit more with them.
 
So, not enough information and advice has been given to you?
 
Katie' No, I just had the leaflets and that was it and I would feel more reassured if I had actually been able to speak to them personally, you know, to their face rather than just reading the leaflets by myself.
 
Because it’s confusing with all these?
 
Katie' Yeah.
 
Different methods, yeah, and in your case.
 
Katie' I was actually it sort of had an explanation on the implant and the coil and, and that sort of thing but, at that stage, I felt that sort of the contraceptive pill was all I really sort of wanted to look at and everything else seemed a little bit more permanent especially because at the time I was only taking it for sort of period reasons rather than contraceptive reasons.
 
Katie' I would have preferred to have discussed it more. I found like the doctor was trying to rush me out, giving me leaflets. So I would have preferred to have spent more time with them but, yeah.
 
Alice' I, well, I don’t agree with that only because I had a very different experience in my doctor was incredibly helpful and sort of every time I’ve been back in to get a repeat prescription they always sort of check that I’m okay with the contraception I’m on. And they do mention the alternatives to sort of warn me and stuff so I’ve I think I’ve had quite a different experience.
 
Katie' It depends, doesn’t it, on the doctor.
 
Alice' Yeah, I’ve always felt like my doctor has sort of had time to talk to me about it.

 

 
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Katie and Alice plus two other friends from uni decided to go together to the GUM clinic and...

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Alice' Well, we went to the [city] GUM clinic in town and…
 
Katie' You can just walk in.
 
Alice' Yeah, you can either walk in or book appointments and we actually waited.
 
Katie' We waited a very long time.
 
Alice' For nearly two hours.
 
Katie' Two hours.
 
Alice' Which.
 
Katie' Very.
 
Let me get this right. You went together?
 
Alice' Yeah, four of us all went together.
 
The four of you?
 
Alice' The. Yes.
 
Katie' Moral support.
 
Alice' Yeah. Exactly. It’s, although it’s not a scary thing to do, it is slightly sort of intimidating sitting in the waiting room on your own. It’s…
 
Katie' Not really sure what’s happening.
 
Alice' Not sure. And also worried if you’re going to bump into someone you know [laughs]. So it’s just nicer to have moral support [laughs] while you’re there. But yeah, and then you get called in by you when you fill in the form at the beginning you get to choose sort of what you get called in by, whether it’s your maiden name or sort of your first name or even a different name completely or your number or anything. So it can be completely anonymous in terms of the waiting room sort of thing. And then once you’re in there the doctor just sits you down and sort of does your sexual health sort of history with you and then talks you through everything that is going to happen. All the tests that you’re going to have done. Then [laughs]…
 
What does it mean; he does your sexual health history? He asks at what age you became active or…?
 
Katie' Not really.
 
Alice' Not that far back. It’s more questions of the last twelve months I think.
 
Katie' Sexual partners in the last twelve months.
 
Alice' Yeah.
 
Katie' And then they ask things like, “Do you smoke?” “Do you take drugs?” It’s that kind of thing.
 
Alice' Yeah, your alcohol intake in the week.
 
Alice' Sort of any homosexual partners, any sex in other countries or anything like that. Can’t really think what else.
 
Katie' No, can’t think of anything else.
 
Alice' Yeah, unprotected sex or not sort of thing. What contraception you’re on.
 
And how does he explain the test itself?
 
Katie' He just explained just explained exactly what they’re going to do, what they’re going to take like test for and then also about because you can have a blood test as well so test for HIV and things.
 
Alice' And so that’s the blood test. You get essentially I think there’s two swabs taken isn’t it, or is it three?
 
Katie' Yeah. Something like that.
 
Alice' And, I really, I’m not very good [laughs].
 
Katie' I, well, you just lie on a couch and then they take swabs although when I went last ti
 
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The only criticism Katie and Alice have about the GUM clinic is the waiting time. They found the...

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What would you advice them to do.
 
Katie' Just get tested.
 
Alice' It’s not that scary. It sounds scary.
 
Katie' But it’s definitely not.
 
Alice' It’s over and done with within sort of five ten minutes.
 
Katie' And so easy.
 
Alice' They’re so nice.
 
Katie' Yeah.
 
Alice' And friendly and they make you feel completely at ease. It’s not it’s not an awkward thing at all. And it’s just so much better to know than to carry on sort of.
 
Katie' Worrying.
 
Alice' With it niggling at the back of your mind.
 
Katie' Yeah.
 
Alice' Or anything.
 
Thank you. So you don’t need to give your real name?
 
Alice' No, you do need to give your real name.
 
Katie' But it’s all confidential.
 
Alice' It’s all confidential so it’s the only time sort of you could use a fake name was when you’re being called from the waiting room into the room. So that if anyone around did happen to know you it wouldn’t be repeated or whatever.
 
Oh, well I mean that’s very thoughtful.
 
Alice' Yeah, no it’s actually very impressive the way they do it and…
 
To put you at your ease?
 
Alice' Yeah.
 
That’s great. Anything you think that they can do to improve the system?
 
Alice' I mean the only thing for us was.
 
Katie' Waiting of time.
 
Alice' We booked appointments and we waited for over an hour and half I’d say.
 
Katie' Yeah, and when you book an appointment that’s not what you want.
 
Fair enough if you’ve walked in from the street and didn’t have an appointment but we were not happy about that. 
 
Alice' But I think someone explained to us I well, someone overhead a conversation that they had a lot of people off ill from swine flu. So you can’t blame them really but it was just a bit annoying sort of when you plan it and you think it’s going to be over and done with quite quickly but apart from that, in terms of the actual service. 
 
Katie' Yeah.
 
Alice' I don’t think I don’t think it get could get any better. It’s very efficient sort of thing [laughs].

 

 
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Alice and Katie had a swab taken by the doctor and described it as “uncomfortable but definitely,...

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Does it hurt to have the Chlamydia test?
 
Katie' No.
 
Alice' It’s not painful sort of.
 
Katie' It’s uncomfortable.
 
Alice' It’s not pleasant, yeah. It’s uncomfortable and it’s a bit sort of awkward.
 
Katie' It’s only because you’re thinking about it.
 
Alice' Yeah, but the thing is I mean there are the Chlamydia tests available that you can sort of just, pee in a pot and that tests you perfectly adequately I think sort of thing. So that’s I mean what we did.
 
Katie' It’s not painful.
 
Alice' Was a full scale check sort of thing.
 
Katie' It’s just uncomfortable.
 
Alice' Yeah, it’s yeah, it’s certainly not painful. 

 

 
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Unprotected sex and a wish to make sure that everything was fine, prompted Katie, Alice and other...

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Katie' I think we’re quite clued up on it.
 
Alice' Yeah [laughs] we’re doing quite well.
 
Katie' Yeah I mean we know where like the clinic is in, you know, here so we know where to go if we want information.
 
First, what I would like is for you to tell me the reasons why you decided to go and have a Chlamydia test
 
Katie' Well, unprotected sex and then just wanting to make sure everything was okay.
 
Okay. Was that with a with a partner or?
 
Katie' Yes, it’s just not from, yeah, from not using a condom that so, yeah, wanting to get checked out.
 
Okay, and you.
 
Alice' Yeah, mine is a similar reason. Sort of I mean yeah, well, I’d just sort of unprotected sex with a partner and just sort of thought it definitely should be done sort of thing.
 
Okay.
 
Katie' Because you don’t know if you’ve got.
 
Alice' Yeah.
 
Katie' Anything so.
 
Alice' There are not necessarily signs and I’d rather know. And either be able to do something about it or sort of know that I am clear rather than thinking, “Oh, well, I hope I am.” Sort of thing.

 
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Katie compares her home friends to her uni ones when it comes to attitudes regarding STI testing,...

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Alice' We’re all quite open about it.
 
Katie' There’s one regularly, gets tested regularly and…
 
Alice' Although that’s, that’s not university friends. At home, I mentioned to a friend that I’d been to the clinic to be tested but their sort of jaw dropped and they were like, “Really.” It was so it’s, it’s bizarre because within our group it’s very sort of normal to sort of, you know, [laughs] “I’m going to go and sort of get checked out.” Sort of thing. Whereas a lot of my friends from home haven’t ever considered doing anything like that so, I don’t know, it’s bizarre. I think different social crowds but I’ve persuaded quite a few of them to go, which is quite good [laughs]. So…
 
So do you think it’s something sort of that a student sort of population?
 
Alice' [mm] I think it’s a lot more.
 
Katie' Oh, yeah. Definitely.
 
Alice' Common definitely and I mean when we were in halls in the first year Chlamydia pots were sort of, the urine sample pots got handed round.
 
Katie' They were people coming down our road.
 
Alice' Yeah.
 
Katie' The other day.
 
Alice' Yeah, to give out the pots so.
 
Yeah [laughs].
 
Alice' Yeah, so it’s all, you’re made very aware of it I think as a student, which is very good.
 
 
Alice' It’s free as well and I think that’s, I mean when I spoke to home friends about it they didn’t realise it was free.
 
No.
 
Alice' No, so.
 
Katie' That’s strange.
 
Alice' And they didn’t know where they would have to go for it or anything, they just knew very little about it so I think, I don’t know, but I think we’re quite sort of clued up on it. But I think maybe for other people it’s not.

 

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