Episode 1 Unsafe Sex in the City

This programme contains strong language

Britain is in the grip of an epidemic

of sexually transmitted infections.

-Everyone's shagged everyone.

-Urgh!

Going to call him in.

Behind every rash, lump and itch...

Men will come in with puss coming out everywhere.

And you said there's some itching around the back passage as well?

..is a patient terrified they may have caught an STI.

What is scabies?

This series follows the staff as they treat patients

at the Manchester Centre for Sexual Health...

Some of the things you see,

especially when you see herpes and warts,

some of them look really nasty.

I'm going celibate!

-Come this way.

-..and we work with the clinic

to invite Manchester's young people to get checked out...

-Was it protected or unprotected?

-Unprotected.

One...two...three.

Ah, I could feel that!

That has actually come back positive for gonorrhoea.

THEY CHEER

..before learning how the fall out from unprotected sex...

It's going up in increments -

next you'll have syphilis, with holes in your cock.

..affects them...

I feel like it's ruined my life.

Hey, I just wanted to get my results.

..and their relationships.

I'm calling because I just got a message from the clinic.

Oh, don't do that!

Ooh!

This week, after a drunken one-night stand,

Kervin has some issues to address...

If I have, you know, give you something, then I'm sorry, innit?

But I didn't know I had anything.

..17-year-old Courtney heads to the clinic

for a comprehensive sexual health checkup...

-I've just...

-Where's the most adventurous place you've had sex?

-On the bus!

-On the bus?

No, in the cinemas, actually.

You've had sex on the bus?!

..and we'll follow the clinic's outreach programme

as they head into Manchester's gay village to carry out HIV testing.

'Obviously, HIV and AIDS, you've got that for life'

and, yeah, I am quite scared to see what the results will be.

A good half hour before

the Manchester Centre for Sexual Health opens its doors,

a queue has already formed outside.

-Morning!

-Morning!

The staff face another hectic day swabbing, probing and examining

up to 15 patients each.

'Is Carol in today?'

-No, she's off today.

-Right.

I like to get in early so I can have a brew

and get my head straight before I get going!

This morning, senior specialist nurse Tanya,

allocates jobs to the 25-strong team.

So, we need someone to do the lab in the morning and the afternoon,

someone to do HIV bloods,

someone to work in the health advisors,

HIV team and on the GU floor.

So we look at what staff we've got in

and, sort of, balance it out as best we can.

Right, so I want Nikki and Karen to be doing the HIV bloods,

Chris, I want you to be doing training with David.

So, Pam, you're going to do, into the HAs to do neggies

and everyone else knows where they're working

and what they're doing, yeah?

Please can I ask who's doing the lab tonight?

Erm, it is Lisa.

Thank you.

Does everyone want to get going then?

So, just a full sexual health check?

You've no current symptoms or concerns at all?

If you just take a seat.

Read the laminate front and back, fill all the forms in -

as soon as you finish just bring it straight back up.

Thank you so much.

'Hi, there, come through.'

Hiya, my name's Kati Perez, I'm one of the doctors.

We're just going to go through this way, OK?

22-year-old security trainee Kervin

recently indulged in unprotected sex

but not with his girlfriend.

'Well, I had a one night stand, didn't I?

'I suppose I should've strapped up, innit?'

But I don't like strapping up.

-Do you check your own testicles?

-Yeah, I do.

-You just, sort of, feel them every month or so?

-There's no...

The liaison left him with more than just a smile on his face.

For the last three days,

puss has been seeping from the tip of his penis.

-So, this is what's been going on with it.

-I can see that.

Well, what we need to do then is just to get a swab, if that's all right?

-It's a bit uncomfortable.

-It's a BIT uncomfortable?! Jeez!

It's over. Are you all right? Are you happy for me to do it?

Go on, go on.

It's over very quickly, just take a deep breath. Are you ready?

-Try not to jump off the bed. That's it well done.

-Whoa!

-All right there? Well done, OK?

-"Well done," she says!

Kervin will wait at the clinic to find out the results of his swab.

If it's bad news, he'll have to tell his girlfriend

and the one-night stand that he's got an STI.

'Do you not worry about these things?'

Of course I get worried about them things

but when you're drunk, you're not...

you're not really thinking about that are you, really?

Courtney and Danielle are both teenagers from Rochdale.

17-year-old Courtney is here for a checkup.

She sees one-night stands as a no-strings alternative to a boyfriend.

'If you don't want to be in a serious relationship

'and you just want to maybe have one-night stands, that's your choice.'

But if you want to be in a relationship

and would rather be with them and just them, then that's fine as well.

I'd rather be safe than, than sorry, to be honest.

'Do you ever try and tell Courtney? Give her a bit of a telling off?'

Yeah, I always tell her to use condoms

but if she doesn't want to use them, she's not going to use them, is she?

-Courtney, please.

-Yeah, that's me.

Yep, do you want to just come in here?

Courtney's appointment is with Clinic Support Worker Lauren.

At just 21, she's the youngest member of the team.

OK, when was your last sexual intercourse?

About four days ago

-OK, was it regular, casual?

-Just casual.

-Male partner, yeah?

-Yeah.

OK, was it protected or unprotected?

Unprotected.

Have you ever had sex with anyone that's ever injected drugs?

Would you class steroids as drugs?

Yeah. Yeah, such as it's still injecting.

-Do you know if he shared needles or anything like that?

-No.

-He used all his own needles, yeah?

-Yeah.

-OK.

Courtney will provide a self-taken vaginal swab

and have her blood taken.

These will be tested for chlamydia, gonorrhoea, HIV and syphilis.

Even without symptoms, it's possible she could have any of these STIs.

OK, there is an incubation period on chlamydia and gonorrhoea, OK?

So, basically it can take up to two weeks to be detected

-so cos you only had sex four days... Was it four days ago?

-Yeah.

Four days ago, you might want to get re-screened if you are worried, OK?

-Yep.

-And also, do you never use protection?

-No, not regularly.

-Is there are reason why, or...?

-No...

-Just heat of the moment?

-Yeah.

Thing OK? Well, obviously your contraceptive covers you

for, obviously, not getting pregnant but not with STIs

-so we do advise that you use condoms, OK?

-Yeah.

-Do you want any today?

-Erm, yes, please.

Yeah? That's fab. Just press down on there for me.

(Cheers.)

-OK, that's everything. Do you have any questions?

-No, that's it.

-OK, then. Thanks very much.

-Cheers, bye.

'Will you be at all nervous about getting the results?'

Yeah, a bit.

Not so much the chlamydia one but the HIV one, yeah, definitely.

'Do you think you are at risk of that?

'Do you think there is a chance of you having it or...?'

Erm...there's a chance with anyone, but I don't really,

I don't sleep with anyone that's not from this country

or...that are high risk.

And I would think that if they did have it then they would tell me

cos it's a big deal,

it's not just like chlamydia where you can just go and get rid of it.

It's something that you can't get rid of.

If you come across as lecturing you find that they just agree with you

and they'll say, "Yeah, yeah, I will next time, I will,"

and then they'll come in in three months time

and it's just the exact same situation as last time.

So I suppose they make their own choices,

all we can do is try and guide them.

Courtney might've been unwise

to trust the word of the men she's been sleeping with,

and she could find out the hard way

if she tests positive for a sexually-transmitted infection.

-Hiya, is it Chantelle?

-Yeah.

For shy and retiring types, the clinic can be intimidating.

The staff probe into the patients' most private areas.

Have a seat, Chantelle.

-OK, have you ever had sex with anyone that's bisexual?

-No.

-No.

-Is there any oral sex with your partners?

-Yep.

And have you ever paid for sex?

Have I paid for it? No.

Have you ever had sex with a man?

-No.

-No. OK.

-And you don't use sex toys to have penetration at all?

-No.

-Fine.

-When you have sex with your partners, do you give oral sex?

-Yeah.

You do, OK.

'We do ask quite intrusive questions'

but if you, if you make them feel comfortable and at ease,

then it's not a problem for them.

And do you receive any anal sex?

-Sometimes.

-Sometimes, OK.

Have you ever had sex with someone that wasn't born in the UK?

Er, Italy...

-Greece, Sweden.

-Sweden.

-And do you have oral sex?

-Yeah.

-Is that both ways? You to her and her to you?

-No, it's just me.

-You to her...?

-Mm-mm, yeah.

-OK.

Kervin may not receive oral sex

but it turns out he has been in receipt of an STI before.

Apart from the chlamydia,

-have you ever had any other sexually transmitted infections?

-Nope.

-No.

Well, actually, no...

genital warts, or something like that, I think I had.

Yeah, we've got that down here, actually, yep.

'When you're drunk and you cheat on your girlfriend,

'I call that a mistake.'

Like, you're not in your right mind.

So if you go and cheat on your girlfriend when you're drunk...

it's not excused but it's not as bad as when you're sober, obviously.

So...it can be excused sometimes.

Kervin could soon be weeping as much as his penis.

He has all the symptoms of gonorrhoea.

Gonorrhoea looks like, on a slide,

it looks like little kidney beans.

Kidney, kidney shapes,

and they're kind of in pairs, kind of dotted round.

So I don't know whether you can see this,

but that's what I'm kind of looking for on the microscope.

That's what you call pus cells.

Usually if you look under a slide and you see more than 10 pus cells,

you're then looking for gonorrhoea.

Last year the number of people diagnosed with gonorrhoea rose by a quarter to over 20,000.

It's an adaptable STI that thrives anywhere from the penis,

the vagina, the anus and even the throat.

And when you see gonorrhoea under a slide,

although they look like little kidney shapes,

they have to be inside the cell for you to call it gonorrhoea.

And then when you do call it gonorrhoea,

you've got to get it right, cos obviously it's this person's relationship

that you're, you know... It's like, their relationship in your hands.

Sorry, I'm taking extra long on this.

With it's distinctive discharge,

it's the STI of choice for many clinic staff.

-I love drippy willies!

-SHE LAUGHS

Cos then I know it's easy to diagnose.

When they come in and say, "I've got a spot," you think, bloody hell, it could be anything.

When they come in with drippy willies, you know exactly what to do with them.

Simple. Gonorrhoea.

I wasn't aware of most of the stuff until I started working here,

and then I was like, "Oh, my God!" Do you know?

How easy it is to catch infections

and obviously how common HIV was and stuff like that.

It is really scary, you know, and you just try and advise, like, your friends and stuff.

Cos half of your friends and that don't even know what it's like

and how serious things can be.

I'm going celibate!

Celibacy is the last thing on the mind of most young Mancunians,

and their sexploits have led to patient numbers at the clinic exploding.

It was May 2008 that we actually moved to this new clinic,

we used to be in this really, little tiny place in the hospital.

So this is where we store all the records and they thought

this would be enough to store all the notes. And I think it was

within a couple of years, by 2010, early, we ran out of space.

On a daily basis we print out all the results from the previous day,

and then we have to go through them, see which ones are positive and who's negative.

If you look at here, this is meant to be a photocopier room

but when we ran out of space,

we had to start using this again to store more notes.

This is the biggest pile, which are all the negatives,

so we're doing not so bad.

These are positives for things such as chlamydia,

so they have chlamydia detected, or gonorrhoea or herpes,

there's a lot, a lot of herpes at the moment.

Now this is our admin manager's office,

and things are so desperate that we're having to store notes here, now. These.

After a tense wait,

Kervin is about to learn the medical term for drippy willy.

His results are ready.

Right then, OK, we've had a look at the slide in the lab next door,

and we have found some infection there, we found gonorrhoea.

-Gon...? Wow, that's a first.

-Have you heard of that before?

-Yes, I've heard of that.

-Yeah?

-That'll be the first time. Wow.

OK, so gonorrhoea, it's a common bacterial sexually-transmitted infection, OK?

So it's not something that we see infrequently.

Um, we need to give you an injection, if that's OK.

-Where?

-Where? Usually we give it...

-In me arse!?

-HE LAUGHS

OK?

It's very quick, and when it's over that means you've had all the treatment that you need.

-In me arse. OK.

-You know where you're going?

Yeah.

-Right and right again. Bye bye.

-Bye.

Bloody hell.

Seriously, gonorrhoea. First time, first bloody time.

First one-night stand, first gonorrhoea, never again,

no way, no how.

Me, drunk and sex ain't going right no more.

Disappointed. Can't believe it.

Gutted. Going to have to get a needle in my arse.

At the moment, um, gonorrhoea is building up a resistance to antibiotics,

so since I've been here, I've been here nearly 4 years now,

since I've been here, the treatment has changed.

We give them, like, a double whammy of treatment, basically.

Tell you this, feel like I'm prison bait, now.

Kervin's terrified of needles.

I'm going to have some cold sweats.

You'll be fine. Keep still, keep turning that way.

Oh gosh, wait, hold on. Hold on.

You need to keep still, pet, because I've got a needle in my hand.

Yeah, I realise that, let me just... Go on. (Oh, my days.)

Keep still, just relax.

Kervin must keep it in his trousers for the next week.

If he doesn't, he risks spreading the infection to his girlfriend

or any other future mistakes.

I'll pop a plaster on it, OK? You all right?

-Is that a joke with the plaster?

-No.

-Oh, you really are putting a plaster on?

-Yeah.

-Oh, right.

If it's left untreated, gonorrhoea has got long-term side effects.

It can cause testicular pain and swelling,

it can cause ectopic pregnancies in women,

pelvic inflammatory disease in women, you know, and you can be hospitalised

with pelvic inflammatory disease if it's that bad,

and it can cause problems with fertility in the future in men and women.

You know, it's got far-reaching long-term side effects if it's left untreated

or if you keep getting it, you know, on a regular basis.

We've always seen a lot but, you know, we are seeing more and more gonorrhoea now.

Kervin should now be on the road to recovery,

but he needs to let his one-night stand know about his STI as soon as possible.

Hello?

Um, hi, it's Kervin. Do you remember me?

It's Kervin, do you remember me?

All right, well, I'm just letting you know I'm in the clinic,

and I've got... Um, I've got gonorrhoea,

so I have to let you know.

I've just... I'm in the clinic right now.

And I've just found out that I've got, like, I've got STI, so...

I don't know, I'm just letting you know. I'm supposed to let you know, innit?

All right, then. Well, if it's...

If I have, you know, give you something,

then I'm sorry, innit? But I didn't know I had anything.

Just go and check. Get that checked out.

So make sure you're cool.

All right, later.

She sounded so guilty. Yeah, that was her dad's phone.

So, the phone she'd been texting me off, or, like, chatting me up on,

frigging father's, her dad's phone!

Imagine if I'd text her, like, "Er, I've got gonorrhoea."

You imagine?!

Oh, no!

Kervin's gonorrhoea should be on the way out.

The question is whether or not his girlfriend will follow suit once he spills the beans to her.

So, ask Alison about when she first started here.

They know about patting the willy. They know about that.

-What happened?

-What happened?

I'd not been here that long, so I was just training,

and I did a urethral swab like you do,

and I finished it and I put it on the slide and everything

and I still had hold of his willy. I should say "penis," shouldn't I?

So I still had hold of it, and I didn't know what to do then, cos what's polite?

You can't just sort of fling it to one side and leave, can you?

So I just went like that, "There you go," and walked off!

I was just trying to be polite. Right.

STIs are spread by unprotected sex, and the more people drink alcohol,

the less likely they are to bother with condoms.

Grant, do you want to finish that vodka, then I'll give Courtney a Kopparberg?

I feel like I've non got enough make-up on.

With her test results still up to a fortnight away, Courtney is relaxed and ready to party.

Where's the most adventurous place you've had sex?

-On the bus.

-On the bus?

-No, in the cinemas, actually.

-You've had sex on the bus!? I just clicked on.

-I know, you were like, "Oh, on the bus."

-You've actually had sex on a bus?

-Yeah.

How did you manage to have sex on the bus?

It wasn't full on sex. I was just trying it to see what it was like.

-You had sex on a bus.

-Yeah. And in the cinemas.

-And in the cinemas. Oh, dear.

-Film was boring.

-Was there not people in the cinemas?

-Ooh, whoops! Whoops!

When I met you, how many people had you slept with? Like 25?

-Yeah.

-Now it's 34? 33?

-33.

-33. That's a lot of people, that.

When did you lose your virginity?

-I don't know, I was quite young

-How old?

Year 7, Year 8. How old are you then?

-Shit, Year 7 and 8?

-How old are you then?

-12, 13?

-He lived on my street. He was at my house every day.

That's quite young that, to lose your virginity though, mate.

How many are you planning to sleep with by the time you're 18?

-Another like...

-Are you going to get into the 50s?

No. 40, maybe.

-How many months is that? What month are we in?

-Three.

Three months and you want to sleep with seven more people? Wow.

It's an unhappy fact that the greater the number of sexual partners you have,

the greater your risk of contracting an STI.

Kervin has been living with his gonorrhoea diagnosis for several days now.

He's met up with best friend Joe, a self-proclaimed player

who has never yet been diagnosed with an STI.

Birds were just coming up to me,

-it was so, like...

-It's nice, though, innit?

I were just smashing it, mate.

It was a case of all eyes on me.

What happened at the clinic the other day, then?

-Pressure.

-Pressure!

You're laughing, it's funny, but still...

That frigging... That little thing they put in your pee hole?

Is it like a little parasol or an umbrella kind of thing?

It looks like a Q-tip, man. You know what a Q-tip is?

Yeah, yeah, yeah. You mean a cotton bud?

-Yeah, a cotton bud.

-Oh! Right down your bell-end?

It weren't that big, it weren't that big, but shit hurt, it stung.

It stung, man, it was like someone was pinching or a bee stung me on my dick head or something, man.

As a good friend, I should say, don't be a fool, wrap your tool.

You don't know what's going around. You've had clap, well, chlamydia.

-Clap!

-HE LAUGHS

Now you've got gonorrhoea. It's going up in increments mate,

next you're going to have syphilis with holes in your cock, or something.

Yeah, you're going in, man, you're going in.

I hope this is a lesson to you.

Does it hurt?

What, now?

-Yeah, does it hurt, like?

-No! it's been dealt with now.

-So you're clear?

-Well, I've got to go back to make sure everything's all clear,

but I've not had sex or anything like that.

Not even been wanking, man, fucking hell.

Courtney lives with her mum, Sherry.

She is exasperated by her daughter's behaviour.

This day and age, protection, it doesn't even come into

the conversation. It's like, "Oh, I'm OK, you know, he looks all right."

Or "I know her, she's fine we don't need to use anything."

And then that's it, you know, before you know it, chlamydia, gonorrhoea, syphilis.

-What can you do?

-I've tried.

I've bought condoms and said, "You know, here's..."

I've even been out and bought condoms, I've left her leaflets on the bed

when she's come home from college, about AIDS, syphilis, gonorrhoea, herpes.

I don't think she reads them. I think she says, "Yeah, Mum I've looked at them,"

but I don't think... She makes her own decisions, and I don't think me,

unless I'm behind her when she goes out and saying,

"Right, Courtney, if you're going to sleep with him, use protection!" I don't think it's going to happen.

With Courtney failing to act on a leaflet's advice,

Sherry hopes a more personal approach might help.

-So, Saturday, you're going to Danielle's?

-Yeah.

You're going out around Rochdale. Do you take lads back to her nana's?

-No, I go back to theirs.

-You go back to their house?

-Yeah.

Normally before, before I was with Vinnie, if they'd have said,

"Oh, come back to mine," I probably would.

-Just go back to a stranger's house. You don't know them.

-Yeah.

You're drunk, you get in the taxi and go to their house?

-Yeah. With Danielle, obviously.

-Oh, Danielle's there as well?

-Yeah, with Danielle.

But if Danielle wasn't there and Danielle had gone home with a lad,

and a lad said to you, "Oh, come back to my house," would you go?

-Probably, yeah.

-On your own in a taxi to a stranger's house?

Yep. If they was good-looking enough.

Good looking!? You don't even think about your safety?

Do you not think, "Oh, this lad could be... He could have loads of lads back at his house."

You just think, "Oh, yeah, he's good-looking, I'll get in his car!

"I'll get in the taxi with him."

-COURTNEY GIGGLES

-Yeah.

And then what happens when you get back there?

Whatever happens, happens.

Sleep with him.

And do you use protection?

-No, cos it don't feel as good.

-Lads will say anything.

-I don't... It's not lads that say it, it's me.

-You say it?

-Yeah.

-Is it just bang, bang, bang, let's get on to it?

-Yeah.

So the conversation about protection doesn't even come up?

No, it's just kissing leading to in the bed, leading to sex.

Come on, Courtney.

The next time you sleep with someone, I would like you to use protection.

And if they say to you, "I'm not using condoms,"

then don't be with them, Courtney.

If they're not willing to put a condom on, then just leave it.

I think if I say, "Have you got a condom? I won't do it without a condom."

Then they'll go, "She's shy, her, she doesn't do anything unless you've got a condom."

And...? What's...?

I just don't want to be known for that.

But why can't you go out and have fun and not have sex?

-I can do that!

-So why don't you do that?

I do, sometimes.

But most times you go home with lads.

Or with lads when I'm out, end up wherever.

-Exactly.

-Whether it's in a park, in a house...

-A park?

-Or wherever you end up.

-In a park?

-Yeah.

That's disgusting.

Tough.

Girls will be like, "Slag. Look at her, she's a slag.

"Sleeping with lads in parks."

That was once.

Once? Once doesn't matter. Once can still get you an STD.

Once can still get you AIDS.

Yep, probably.

Probably? That's a really good attitude, isn't it?

I know she's only trying to, like, protect me and things like that,

but if I'm going to do it, I'm going to do it, and obviously she can't stop me.

So... Just annoying sometimes.

It's like, "Let me just live my life, you live yours."

For Joe and Kervin, there are pros and cons to having safe sex,

but mainly cons.

No, no, like... It's just... You know what?

You know when you're with a girl and you've got a condom on

and it feels like crap.

Mate, it's not, it's not... Right, it's not my fault that

she's, like, riding me and then I'm like,

"Yeah." Feel like I'm going through the motions, like, "This is shit."

and next second she jumps up, just rags it off my dick and chucks it.

They need to invent something better.

Some kind of gel shit, man, that don't fuck about with the feeling.

You know, the feeling's what matters, isn't it? Really and truly.

Yeah, I mean, even to escape gonorrhoea, you know,

you can't even talk her into doing anal, can you?

No, fuck that man. You're going deep, you.

-Something different, innit?

-Yeah.

It's always great, as well, when you find a bird that's like,

"Yeah you can stick it in my backside."

I suppose you've got a point.

I'm lucky I've not caught anything. I admit it. I need to go.

Wait, wait, let me get this straight - so you put your bare dick in someone's booty?

You serious!? That has to be worse than me! It has to be!

-How's that worse? You've got gonorrhoea.

-Yeah.

The only thing in my favour is one of the girls I slept with about two week ago,

well, I've been sleeping with her on and off for about six week,

I've quit now, but she went and got herself checked out and she's got nothing, she's all good.

-Wahey! So that possibly means you're all good.

-Possibly means. I need to go and get checked out.

Joe may like it, but unprotected anal sex

is the riskiest sex you can have when it comes to catching STIs.

Tell James his results are ready.

Where's that asym, Alison, do you know?

For every patient like Kervin the clinic put back on the road to recovery...

Hi, Steven, it's Cheryl again.

I'm ringing you from the clinic at Manchester Royal Infirmary.

..there's plenty more who still need help.

Um, we need to give you some more of those injections just to make sure

that you have no long-term problems from the syphilis infection.

A phone call from this place isn't one you want to receive.

And you know we do two rectal swabs and one's on a culture plate?

That has actually come back positive for gonorrhoea.

We'll just take a little prick from your finger.

Fiona has found herself in a tricky appointment.

-So I'm just going to clean your skin.

-I'm scared already, you know. HE LAUGHS

So take deep breaths for me.

Her patient, Rolla, is terrified of needles.

To calm his fears, Fiona is using the finger prick method.

-Are you ready?

-Yeah.

-One, two, three.

-Oh, now, it didn't even hurt!

See? Well done, you.

Fiona has spared Rolla the trauma of having a full-sized prick in the arm.

Excellent, good. Thank you very much. So that's it, you're free to run away.

-All right, thank you.

-You take care.

-I'll see you.

-Bye.

I probably would've had it done a long time ago

if I knew that I could get it done with just a little prick in the finger

and they didn't have to get any needles out, but... Yeah, man.

Just waiting for the results now, innit?

Get me wellies on.

Nearly 3,000 patients a month come through the doors of the clinic,

but the staff are not content to simply wait for the problem to come to them.

-That's it, are we ready?

-We're ready.

One afternoon a week, two staff members take the fight against STIs out into the community.

-Well, we're off to... um...

-LGF.

Which is the Lesbian and Gay Foundation,

and we do 30-minute HIV tests there every Thursday night between three and six.

So I mean, what exactly is a 30-minute HIV test?

It's a rapid HIV test so we can test the blood on a little strip

and we get the result back in 30 minutes.

There's a lot of people come because they feel they've been at risk

so they come to get their results straight away because they want to know.

And sometimes some of them if they get a negative result

-they're jumping up and down, aren't they? Give you a big hug.

-Big hugs.

-And they're just full of tears and really happy, aren't they?

-Yeah.

And then those that it does come back positive, everybody's different there.

You get some that say, "Yeah, I thought I might've been,"

-and they're OK, and you get others that just fall to pieces.

-Yeah.

Give you this and I'll get the change.

-Thank you very much.

-Thank you.

-See ya.

-Bye-bye.

They're not letting us in.

-'Hello?'

-It's the nurses.

BUZZER

This afternoon, Pam and Alison can expect to see up to 14 patients.

Adam? Just come in and take a seat, OK?

All hoping for a negative result on their rapid HIV test.

And not a lot of people wear condoms for oral sex, OK?

So you never wear a condom?

Never wear a condom.

OK. That's what I thought.

When I'm giving anal.

OK.

Manchester has a thriving gay community.

The Lesbian and Gay Foundation was set up to serve their needs.

I've come in today to get a rapid HIV test.

It gives me peace of mind because I can get the results within an hour

whereas at the hospital you have to wait two or three weeks,

so it's something I come and do quite regular.

I'm an escort, so keeping fit and healthy is really important.

I get an average of about four to five clients weekly.

One of my clients, he's quite young,

he comes to the apartment

and he'll want me to kick him with full force into his penis

and, er, he likes that.

And I have to kick him several times whilst he masturbates to that.

So, yeah, that can be quite fun!

Tim? Hiya, come in, have a seat.

Thanks very much.

Sorry, brought my cup of tea in with me.

That's all right, not a problem.

Right, I'm Alison.

Is that a Welsh accent I can hear?

-It is. From Swansea.

-Oh, are ya?

-Right, OK, so your last HIV test was in April, yeah?

-Yeah.

That was negative, yeah?

-It was, yes.

-And you've been treated for syphilis in the past.

-Was that at Manchester Royal Infirmary?

-It was. The infection was detected by yourself.

-Yeah.

-But I had... I had the full symptoms of it so...

Right, OK.

And you have had sex with someone that's HIV positive, is that right?

-I have, yes.

-Right, OK.

-And you both give and receive anal sex, yeah?

-Yes.

Do you always use condoms?

Um... not with my partner.

-OK

-But with everyone else, yes.

Has your partner been tested for HIV?

He has.

He's negative. OK.

I'll do your finger prick first and then I'll take your blood if that's OK.

That's fine.

-Do you know much about HIV?

-I do, yeah.

You've read up on it and everything?

It's not something anybody wants, but there's loads we can do now.

-Yeah.

-You know we can look after people really well

and it's treated like a chronic condition now.

Yeah, it's just like diabetes.

Yeah, it's a chronic condition like diabetes is.

If a diabetic doesn't take their insulin they become really poorly and possibly die, so...

It's similar with HIV.

If you don't attend for treatment, if you don't get monitored regularly

and if you don't take your medication then you could potentially die as well, yeah.

-Right, so that's your test done.

-Right.

What we need you to do is go and wait out there for 30 minutes

and as soon as we've got your test results back I'll come and get you.

-OK, yeah, that's fine.

-OK?

-Great.

-OK.

Waiting for HIV test results is not a new experience for Tim

and the wait is always agonising.

Oh, yeah, don't forget your brew.

-Thank you.

-You're welcome.

Bye.

'Obviously HIV or and AIDS, you've got that for life'

and yeah, I am quite scared to see what the results will be.

I mean, he gets tested really regularly.

We would never say to anybody, "Oh, there's no risk, you're absolutely fine."

There's always a risk, which is why it's important you come and test.

-Cover it up with the towel.

-That's what colour my case is. It is.

No one's going to miss me on the beach, are they, with that towel?

Courtney's test results are due

but with her and Danielle off to sunny Spain,

a positive result would ruin her holiday.

Oh, it's off, er... it's off the clinic.

It says "Your most recent test results from MCSH are negative."

-Ah, that's good.

-Yeah, I'm quite chuffed with that, actually.

-Good.

-Whoooo!

You're free of an STI.

I know. Know that I'm safe now. Know that I've not got HIV.

-Are you happy?

-Yep, I am.

You are? Good.

Do you think you'll use protection now?

Yeah. I will try and use it a lot more.

Can't say for definite because sometimes it's just in the moment,

but, yeah, I will try and do it a lot more just to be safe.

As Courtney had unprotected sex four days before the test,

her results are in fact no guarantee she is all clear of infection.

When she returns from her Spanish adventure

she will need to retest again in three months' time.

At the Lesbian and Gay Foundation,

after a nerve-racking 30-minute wait, the HIV test results are back.

OK, Adam, just wanted you to know that you've come back negative, OK?

So that's, er, that's good news.

-Thank you for all your help.

-It's all right, that's what I'm here for. It's a pleasure.

I feel, like, really great, cos I told you I've not been tested for a year so that's a very long time.

-Mmm.

-And at the back of your mind, knowing that, like...

but now with the...gone, I feel a lot better.

Come in!

Bit warm.

It is warm, isn't it?

I'm not complaining.

Have a seat for me.

Can I just double-check your date of birth for me, Tim?

Yep, 'course you can. It's the fifth of the fourth, 1982.

OK. Right, your HIV test has actually come back positive.

-Has it?

-Yeah. How do you feel? You OK?

-Has it really?

-Yeah.

It's a very, very faint line, OK, but there's a line there.

My colleague's checked it as well, so what we're going to do,

we're going to send that blood off I took to the lab

and we'll check it again for you. OK?

You OK?

-Has it really?

-Yeah. I wouldn't tell you that if I didn't think it had.

Do you want me to show you? Or do you not want to see?

So what's the next process?

What happens now is we'll send your blood off, OK,

and we'll get that blood back as fast as we can.

Hopefully tomorrow.

If you want to come in to clinic tomorrow, you can do, OK?

And we can take some bloods for you tomorrow at clinic.

-Sorry.

-It's fine, honestly, it's fine, it's fine.

Let me get you a tissue.

Are you OK? There you go.

I don't want you to panic cos I'm going to...

It's a very faint line, OK, and I'm not saying that doesn't mean it's positive

but what I'm saying is we're going to send your blood off

and check and double check that that's an accurate result, OK?

I just don't know where I could've caught it from...

..cos...

Sorry.

Honestly, honestly,

you've got absolutely nothing to be sorry for at all.

I know you don't know what to do at the minute.

I don't know how I'm going to explain this to my partner.

Right, OK.

'When they're really shocked, of course it affects you, you know.'

'I'm only human and I don't, like, as a person, cos I'm really soft,

I don't like to see anybody upset or in pain or anything like that.'

'So it is difficult but you know, it is part of what we have to do.'

You do care about them and obviously you're sitting here

and you will it to be negative.

You don't want anyone to have a positive result, but unfortunately that's what's happened today.

Hi, you all right?

Was it difficult?

-It's never nice, is it?

-No.

-Having to give someone a positive result.

Alison has just given Tim the most difficult news

anyone in sexual health work has to deliver.

As night falls on Manchester

the clinic's work is done for another day.

Tomorrow, Kervin's mate Joe will be going to the clinic

for his first sexual health checkup in months.

He's at high risk of having an infection,

but enjoys the challenge of seeking out new partners to have unprotected sex with.

I've said daft shit in the past like joking, but got away with it.

Like, one girl I walked up to and was like,

"Don't want to know your name, don't want your phone number,

"but you come home with me, you'll have the best night of your life and in the morning you'll go home."

You know, you get laid off stuff like that, it's crazy.

-I like the fact that your eyes are colour co-ordinated with your hair.

-Yeah, that's what I do.

See, you got it going. You got sense, girl, you got sense.

What do you do for a living?

Don't ask that! I go college and I work at the same time.

-Where do you... what do you study at college?

-Nail technician.

I had my nail done today, this one thumbnail, this one nail. Right.

Basically, I started a blog.

Now the reason behind me doing this blog is you have so many articles written for women

but no-one ever does it for guys.

So I started a blog talking what men care about,

you know, as far as relationships go - love, sex, everything.

So I did "How to get laid in under five hours."

Which was my spin on... my thoughts on what I've learnt over the years

and what other guys have writ for years before, you know? The Game.

-You come over as an idiot. I'm probably an idiot to you.

-I'm not an idiot!

But you laugh it off.

Don't walk away from me in a mood, cos that's...

-I wasn't walking away in a mood!

-That's arrogant!

Yeah, accessorising.

Now, accessorising, what I've put is,

"Now this is something that guys tend to believe is only for women

"and as I have done with all of the notions of style and what looks good,

I'm here to tell you to get your head out your arse.

"Men have just as much right to take time into looking good as our female counterparts,

"such as those little issues that make something go from looking amateur to professional."

So if you have like say, a dodgy ear, wear a lip piercing.

It takes the attention away from your ears to your lips.

If you're going out to get laid you want to use everything you can.

In about 20 minutes, when I'm having a drink inside maybe we can chat a little bit more and...

No, because I'd say to me friends, "Oh, that's that fucking knobhead from before that I was speaking to."

Yeah, but...am I still a knobhead now that you're chatting to me?

I put that cocky as being a really good thing in the one-night-stand game.

"Let's take a look at cockiness. This is a great trait to have, whether or not...

"When it comes to dating somebody, it's considered to be a massive no-no.

"We're not talking about dating and romance, we're talking about an overnight session."

You know, cockiness helps.

-Are you cocky?

-I'm cocky, yeah, I'm cocky! I'm cocky, I'll smile about it!

This is what I say, if you're going to be cocky you've got to get the cheeky smile.

You get the cheeky smile? Sorted.

Oh, see, you were giving me the cute face!

-You were like...

-Only because... Your teeth are clean!

Because my teeth are clean? It's not the smile then?

-Not the smile?

-No.

Morning! Morning, Lauren!

-Morning!

-What are you up to today?

I have not a clue where I am.

Don't know until I go down and see the board.

Unpleasant odours can on occasion

be an occupational hazard for the clinic staff.

Fiona has her own way of preparing the nostrils at the start of a long shift.

This is good for your skin.

It's poppers, Lisa. Poppers!

I spent three years training to be an aromatherapist.

It's... What's it, neroli?

That smells like the eau de cologne me nanny used to wear.

Friends come round and go, "Oh, my back aches, I'm feeling a bit run down, I've got this..."

So I go, "Come to Fiona's parlour."

Any men welcome. I shall massage you! Special massage!

Special massage! Come hither.

I got a job interview tomorrow though.

Kervin and Joe are at the clinic.

Today Kervin will discover whether he got away with only catching gonorrhoea

or if he's also infected with HIV or syphilis.

Or the worst case scenario, both.

One thing he doesn't have any more is the girlfriend he cheated on.

'For a while, it was a bit iffy.'

'I didn't know if me and her wasn't talking or we was talking, but then I saw her at a party.

'She completely ignored me. She's pissed.'

Like, quite literally pissed.

Probably still is pissed.

Do it every day, at least three or four times a day.

-Joseph, please.

-Hello.

First up, though, ladies' man Joe.

This is his first screening in a year. He could have anything.

All these questions are personal but we ask everybody them, OK?

-Are your partners male or female?

-Er, female.

So in the past three months, how many sexual partners?

I don't even know where to begin counting.

Give me a rough number.

-Er, 20s plus.

-OK. Have you ever paid for sex?

-No.

-Have you ever been paid for sex?

-No.

-Have you ever had a blood transfusion?

-No.

When was your last sexual intercourse?

-Two days ago.

-Two days ago.

Casual or regular?

Um, for me it was a regular because it's been about a week.

OK, protected or unprotected?

-Unprotected. It's not my fault, they rip 'em off me.

-No!

-They rip 'em off me.

-Yeah, OK.

-I can't take the blame for that.

Come in, have a seat.

I'm telling ya, I am dreading this.

What you dreading?

Just...because I'm not... I don't know about them blood results, innit.

Let me have a look for you, we can soon sort that out.

-Yeah, put a smile back on my face.

-Yes.

Let's have a look.

So your HIV test was negative and so was your syphilis.

-Everything's fine with regards to your blood test, OK?

-Oh, gosh!

Kervin has finally had some positive news

by testing negative for syphilis and HIV.

What were you feeling before you went in there?

Before I went in there my stomach was churning

because punk-ass Joe is, like, "You've got HIV."

"You might have AIDS. It might be syphilis."

And he just... he just got me paranoid,

so I was really worried what...

Once I got in there and she was like,

"You ain't got HIV, your test came back and you've not got any of this,"

I was like, "Fucking right! Fucking right!"

But obviously now that I've gone through all of this with gonorrhoea

I can't.. So I'm not going to not wear a condom.

I don't want to be getting swabbed again

or getting injected in my backside again or, you know, so...

Do you not like having needles?

Don't bother me, I just don't like looking at it.

Joe's blood will be tested for HIV, hepatitis and syphilis.

All I need you to do now is a urine sample.

But when it comes to doing his urine sample,

smoothie Joe can't resist trying out a line on Lauren first.

To Lauren, though, it's water off a duck's back.

Everyone's just totally different

so obviously you get people being a bit smarmy, some are a bit smug and think they're all dead cocksure.

I think they're quite embarrassed, to come here

so I think they try and make themselves dead cocksure to make themselves feel better.

So... it makes your day go a bit faster, so it don't bother me.

Right that's it. We're all done.

-We sorted?

-Yep.

-Wey!

Um, do you want me to leave this here?

Yep, just leave that there.

-All right. Well, is that it?

-Yep, that's it.

-Nice to meet you, then.

-Thanks a lot. See ya.

-Cheers.

-Bye.

-Have a good day.

What I need you to do is just...

Can you just pull your foreskin back for me so I can just...?

Poor old Kervin thought he'd seen the last of the penile swab.

Don't panic.

Oh! Don't do that!

Don't jump cos I could slip and I could hurt you.

Unfortunately there is one more for him to endure.

-Go on, go on.

-Ready? Keep really still.

-All right.

-Cos if you keep jumping about...

-Promise.

-I'm worried I'll catch you.

-Promise.

-Promise?

-Promise.

Nurse Alison has dealt with thousands of penises in her career

but it doesn't make it any easier for Kervin.

-That's all it is, done.

-Do you know how much it stings?

-Listen, I've had three babies.

-Ah, here we go!

That's the thing our male patients hate the most.

They come in here a lot of the time with tales from their friends,

"Oh, you'll have an umbrella up your willy." We don't use umbrellas.

It's a little tiny loop and I know I've not got a penis

so I don't know what it feels like, but it's really small

and we are really quick and gentle.

But obviously some patients can get a bit agitated and a bit concerned

and frightened that it's going to hurt so they get a bit jumpy.

It's good!

You all good? You're not going to die on me?

Is this going to teach you some lessons?

-Let's hope yours comes back all good.

-I'm clean as a whistle, mate. Clean as a whistle.

You don't know that. You've just got your test.

You've just got your test. You've just got your test.

All right, I've never seen you so bouncy and happy.

I'm all good.

Aw, I can share my cig with you now.

-What do you mean NOW?

-I'm not going to anything.

With 6,000 STIs been diagnosed every week in the UK,

Joe may need more than a cheeky smile when he gets his results.

Last week, Tim received the devastating news that he had tested positive for HIV.

I left the clinic and went to catch the train home.

My mind was just all over the place.

I couldn't focus, couldn't think, didn't know who to talk to.

Luckily, I had my partner who was being supportive.

Never cried so many tears.

I just wanted to forget about it so I went to the shop

and bought a large bottle of vodka

and just got really drunk that night.

The day after, though,

Tim's blood was sent for routine secondary screening at the labs.

When the testing was complete, nobody could've predicted the astonishing results.

The test that was positive in LGF

on the point-of-care test, um, was a false positive

as the blood test actually came back negative.

The rapid HIV test is unreliable in around one out of every 200 samples.

Incredibly, Tim was that very rare one.

Pam just said, "You're a very lucky boy."

"Your results have come back negative."

And I couldn't believe it and I burst into tears.

Tears of joy, to be honest, and I just kept asking her "Are you sure?"

"Are you sure it's right?"

and she was saying, "Yes, we've had several doctors look over it."

"We've used the full blood sample and every test has come back negative."

I'd never ever had the happen to me before

and I've been going to outreach for about two years now. That's never happened to me.

Getting HIV now, it's... it's a big reality

and, yeah, it's totally changed my life and totally going to practise safe sex,

totally going to keep my health in order,

and yeah, it's totally changed my life.

It's the moment of truth for ladies' man Joe.

A week ago, he was cocksure, but now he's not sure at all.

For the past few days, it's like, like just been up there,

on my mind like circling around like... I've never...

Usually I get checked up regularly

but because I've left it so long

and I've been with so many girls now,

I actually kind of like, not even thinking have I got chlamydia,

I'm thinking have I got something else or something that's like...

like gonorrhoea or syphilis or... I could have anything.

All right, come in. Have a seat.

You seem chirpy. You've got all my dirty little secrets in that folder.

So, going over your results from your blood test, OK,

your HIV and syphilis was negative, OK?

-OK.

-Which is good, that means you're OK.

-Yeah.

-And your urine test for gonorrhoea and chlamydia has also come back negative.

Joe's in the clear and it's straight back to being Mr Cocky.

Oh, Trish, go on, high-five me.

High-five me! Oh, yes, I'm the man.

But the thing is at the minute,

if you keep having unprotected sex, you are playing Russian roulette.

Yeah, I've got it, I'm being stupid.

Well, I don't want to say anybody's stupid, you know,

and it's up to you how many partners you have, absolutely,

but if you keep having unprotected sex with lots and lots of partners

then potentially, eventually, you're going to get an infection.

-Definitely.

-Have you any questions you want to ask me?

Do you want to go out for a drink to celebrate?

(LAUGHS)

He's been given the all clear and a stern warning from Alison,

but if sex-mad Joe doesn't change his ways

it's only a matter of time before he'll be back in the clinic.

You look after yourself, all right.

I'll look after the fella as well.

Yes, make sure you do. Keep him covered.

I'm ecstatic, you know.

I didn't have no symptoms or anything

so I was like, I don't really think I've got anything

but there's always a chance and, you know,

when you're actually waiting for the results you're like, oh, my God.

You convince yourself you're going to have summat,

then they're, like, "You haven't got anything," and I'm like, "Why did I even worry?"

Why did I even worry? I've got the man thing.

Don't get nothing. Don't get illnesses of any kind.

I'm sweet, I'm sweet.

I'm actually over the moon now. I think I need to go get laid.

Nah, I've gotta do business and then I'll get laid.

Have you ever high-fived a patient?

I have never high-fived a patient in my life.

But you know, you just go with the flow, don't you? (LAUGHS)

Joe's results are good news for now.

See you later, love. Ta-ra.

As he had unprotected sex yet again in the last few days,

he'll need retesting in three months' time.

The clinic's never-ending battle against STIs continues.

Next time on Unsafe Sex in the City...

How many partners have you been with in the past three months?

Just as a guess, is it more than 100?

No, 80.

The highest I've known is 150 and they were HIV positive.

Just under the sack, yeah.

What the fuck is scabies?

If I'm told that I can't have children, I'm going to be very sad.

Hiya, I just wanted to get my results.

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