Sexual health is one of those topics people love to whisper about, avoid, or turn into awkward jokes — but honestly, it deserves better. Especially for trans women.
As a trans woman, I know how complicated sexual health can feel sometimes. Not because we are “difficult” or “different in a bad way,” but because the world does not always explain things with us in mind. A lot of health advice is written for cisgender people, a lot of clinics still ask clumsy questions, and sometimes you walk into a medical appointment feeling like you need to bring a PowerPoint presentation just to explain your body.
And let’s be real: nobody has time for that.
Sexual health is not just about avoiding STIs. It is about confidence, boundaries, pleasure, safety, self-respect, emotional wellbeing, and knowing that your body deserves care without shame. Whether you are dating, working in the adult industry, in a relationship, exploring your sexuality, or simply trying to understand your own needs better, your sexual health matters.
This guide is written in a practical, honest, and trans-friendly way. No scare tactics. No judgement. No “you should already know this” energy. Just useful advice every trans woman should have access to.
For more related guides, you can also explore our Sexual Health section, Safe Intimacy & Boundaries, and our guide to STI Testing in London.
1. Regular STI Testing Is Self-Care, Not Shame
Let’s start with the big one: STI testing.
Getting tested does not mean you are dirty, careless, or “doing too much.” It means you are responsible. It means you respect your body and the people you connect with. Honestly, I wish we treated STI testing the same way we treat getting our nails done or going for a haircut: normal, regular, and nothing to be embarrassed about.
Many STIs do not always show obvious symptoms. You can feel perfectly fine and still have something that needs treatment. That is why regular testing is important, especially if you have new partners, multiple partners, casual dates, or adult work bookings.
A good basic sexual health screen may include tests for:
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HIV
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Syphilis
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Chlamydia
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Gonorrhoea
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Hepatitis B and C, depending on risk
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Other checks depending on symptoms or sexual activity
The important thing is to be honest with the clinic about what kind of sex you have, not because they are judging you, but because they need to know which tests are actually useful. For example, if you have oral sex, anal sex, or use toys with partners, different swabs may be needed.
If you are in London, you can use Sexual Health London for free home STI testing if you are eligible. If you prefer a clinic, the NHS sexual health clinic finder can help you find local services.
You can also read our full guide: STI Testing in London: What Every Sex Worker Needs to Know.
2. Choose a Clinic That Respects Trans People
Not every clinic experience is perfect. Some staff are amazing, some are awkward but trying, and some make you want to disappear into your handbag. The goal is to find places where you feel safe enough to be honest.
A good sexual health clinic should:
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Respect your name and pronouns
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Ask questions without judgement
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Understand trans bodies and different types of sex
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Offer confidential testing and treatment
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Explain your options clearly
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Not make assumptions about your body, partners, or identity
In London, 56 Dean Street is well-known for LGBTQ+ sexual health services, and their trans and non-binary service is designed for people who prefer a dedicated space.
Terrence Higgins Trust also has a helpful section on sexual health for trans and non-binary people, including information for trans women and trans feminine people.
If a clinic ever makes you feel uncomfortable, you are allowed to try somewhere else. You are not being dramatic. Your comfort matters.
3. Know About PrEP: HIV Prevention Before Exposure
PrEP stands for pre-exposure prophylaxis. It is medication taken by HIV-negative people to reduce the risk of getting HIV.
For many trans women, especially those who have sex with men, have multiple partners, work in the adult industry, or sometimes struggle to negotiate condoms, PrEP can be an important part of sexual health.
One thing worth saying clearly: PrEP is not only for gay men. Trans women can use PrEP too. If a clinic makes assumptions or does not explain it properly, ask directly:
“Am I suitable for PrEP?”
PrEP may be a good option if:
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You have casual or multiple partners
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You sometimes have condomless sex
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You do adult work
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You have partners whose HIV status you do not know
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You have had recent STIs
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You feel anxious about HIV risk and want extra protection
PrEP protects against HIV, but it does not protect against other STIs like chlamydia, gonorrhoea, syphilis, or hepatitis. That is why testing still matters.
You can read more about PrEP from Terrence Higgins Trust or speak to a sexual health clinic.
4. Know About PEP: Emergency HIV Protection After Exposure
PEP stands for post-exposure prophylaxis. It is emergency HIV medication taken after a possible exposure to HIV.
This is important to know because if something goes wrong — a condom breaks, someone removes a condom without consent, or you have an unexpected risk — time matters.
PEP should be started as soon as possible and usually within 72 hours. The earlier you start, the better.
You may need to ask about PEP if:
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A condom broke during sex
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A partner removed a condom without consent
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You had condomless sex with someone whose HIV status is unknown
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You were sexually assaulted
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You had a high-risk exposure and feel worried
You can get PEP from sexual health clinics, some A&E departments, or emergency services depending on the time and location. Do not wait around hoping the anxiety goes away. If you think you may need PEP, act quickly.
Our article on Stealthing: What Escorts Need to Know and How to Protect Yourself also explains what to do if a condom is removed without consent.
5. Condoms Still Matter — But So Does Lube
I know condoms are not glamorous. Nobody is writing love songs about them. But they are still useful, especially for reducing the risk of many STIs.
For trans women who have anal sex, lube is not optional. It is important. The anus does not self-lubricate in the same way a vagina does, so using enough lubricant can reduce friction, tearing, discomfort, and risk.
A few practical tips:
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Use water-based or silicone-based lube with condoms.
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Avoid oil-based products with latex condoms because they can weaken the condom.
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Check condom expiry dates.
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Use the correct condom size.
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Change condoms between partners or between different types of sex.
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Never feel embarrassed to pause and add more lube.
More lube is not “too much.” More lube is peace, comfort, and less drama. Honestly, lube is the friend who always shows up prepared.
6. Do Not Ignore Throat and Rectal Testing
This is something many people miss.
A urine test alone does not check everything. Depending on the sex you have, you may need throat swabs or rectal swabs too.
For example:
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Oral sex may require a throat swab.
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Anal sex may require a rectal swab.
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Urine tests may check some infections, but not all areas of exposure.
This matters because infections like gonorrhoea and chlamydia can live in the throat or rectum without obvious symptoms. If you only do a urine test, you might miss something.
When you go to a clinic, you can say:
“I need a full STI screen including throat and rectal swabs.”
That sentence alone can save you a lot of confusion.
7. Learn the Signs — But Do Not Wait for Symptoms
Some possible STI symptoms include:
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Unusual discharge
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Burning or pain when peeing
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Sores, blisters, or lumps
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Itching or irritation
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Pain during sex
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Bleeding that is unusual for you
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Pelvic, testicular, or rectal pain
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Flu-like symptoms after a possible HIV exposure
But here is the tricky part: many STIs have no symptoms at all.
That is why testing regularly is better than waiting until something feels wrong. If something does feel wrong, do not panic — just get checked. Most common STIs are treatable, and clinics have seen everything before. Trust me, you are not going to shock them.
8. Sexual Health Is Also About Boundaries
Sexual health is not only physical. It is emotional too.
A person who pressures you, rushes you, ignores your limits, makes jokes about your body, or refuses to respect safer sex is not just “a bit difficult.” They are a risk to your wellbeing.
Healthy intimacy includes:
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Consent
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Respect
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Clear communication
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Privacy
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Safer sex
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No pressure
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No guilt-tripping
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No fetishising
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No disrespectful language
You are allowed to say no. You are allowed to change your mind. You are allowed to stop. You are allowed to ask for condoms. You are allowed to leave.
For more on this, read our Safe Intimacy & Boundaries section.
9. If You Are Dating, Talk About Sexual Health Early
I know, I know. Nothing says romance like “When was your last STI test?” But honestly, mature conversations are attractive.
You do not need to turn a date into a medical interview, but if intimacy is likely, sexual health should not be a mystery.
You can say:
“I like to be careful with sexual health. When was your last test?”
Or:
“I test regularly and prefer partners who are honest about testing too.”
Or:
“I’m happy to talk about boundaries before anything happens.”
The right person will respect that. The wrong person will act offended because you asked a responsible question. That tells you everything you need to know.
If you write about dating on your blog, you can internally link this article to Where to Date Transsexual Women in London and your LGBTQ+ dating content.
10. If You Work in the Adult Industry, Create a Testing Routine
For trans women in adult work, sexual health is part of professional self-care. It is not just personal — it is business, safety, and peace of mind.
A good routine may include:
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Regular STI testing
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Keeping clinic details saved on your phone
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Having condoms and lube stocked
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Knowing where to get PEP urgently
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Keeping screenshots of health-related incidents if needed
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Setting clear booking rules
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Refusing clients who pressure you about unsafe sex
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Having a trusted friend or safety contact
You may also want to keep a private note with:
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Last STI test date
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Next test reminder
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PrEP appointment details
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Vaccination history
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Clinic contact numbers
This does not need to be complicated. A simple phone calendar reminder can do the job.
And please remember: a client offering more money for unsafe sex is not offering “a better booking.” They are offering a bigger risk. Your body is not a discount aisle.
11. Understand Vaccines That May Protect Your Sexual Health
Vaccines can be part of sexual health too.
Depending on your age, risk, and local clinic guidance, you may be able to ask about:
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HPV vaccine
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Hepatitis A vaccine
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Hepatitis B vaccine
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Mpox vaccine, depending on current eligibility and local availability
The NHS HPV vaccine page explains that HPV vaccination may be recommended for higher-risk groups, including some transgender people and sex workers. The NHS hepatitis B vaccine page also lists sex workers and people with changing sexual partners among higher-risk groups.
Ask your clinic:
“Are there any sexual health vaccines I should have?”
It is a simple question, but it can make a real difference.
12. Know Your HIV Facts: U=U Matters
There is still so much stigma around HIV, and a lot of it comes from outdated fear.
U=U means undetectable equals untransmittable. This means that when someone living with HIV is on effective treatment and has maintained an undetectable viral load, they cannot pass HIV on through sex.
This is not just a nice slogan. It is an important public health message that reduces stigma and helps people understand HIV today.
You can learn more from Terrence Higgins Trust’s information on undetectable viral load.
Knowing this does not mean ignoring protection or testing. It means replacing fear with facts.
13. Protect Your Privacy
Sexual health is private. You have the right to confidential care.
If you are a trans woman, especially if you are dating discreetly, working in adult services, or not out to everyone, privacy can feel even more important.
Here are some simple privacy tips:
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Use a clinic or home testing service you trust.
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Ask how results will be sent.
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Use a safe email address and phone number.
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Be careful with screenshots of test results.
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Do not share medical information with anyone who pressures you.
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Keep work and personal communication separate if needed.
If you are using online dating or adult platforms, you can also read our related article on WhatsApp’s Ban Wave Is Hitting Sex Workers in the UK because privacy and communication safety matter too.
14. Look After Your Mental Wellbeing Too
Sexual health and mental health are connected.
Bad dating experiences, dysphoria, rejection, fetishisation, rude clients, secrecy, shame, or anxiety around testing can all affect your wellbeing. Sometimes the body is fine, but the mind is exhausted.
Please do not ignore that.
Good sexual health includes asking:
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Do I feel respected?
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Do I feel safe?
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Am I doing this because I want to?
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Am I comfortable with this person?
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Did I feel good afterwards emotionally?
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Am I using sex to feel validated when I actually need care?
That last one is a bit rude, I know. But sometimes the truth walks in wearing heels.
If confidence and emotional wellbeing are things you want to explore more, read Mental Wellbeing Tips for Trans Women in the UK and How to Build Confidence as a Trans Woman.
15. Do Not Let Embarrassment Delay Care
This might be the most important point in the whole article.
Do not let embarrassment stop you from getting help.
Clinics have seen everything. Doctors and nurses are not sitting there shocked because someone had sex. That is literally their job. You are not “too much.” You are not disgusting. You are not wasting their time.
Get checked if:
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Something feels unusual
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A condom breaks
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You are worried after sex
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You have symptoms
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You were pressured or assaulted
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You need emergency contraception advice for a partner
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You think you may need PEP
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You just want peace of mind
Peace of mind is a valid reason.
16. Learn the Language That Helps You Advocate for Yourself
Sometimes, knowing what to say makes clinic visits easier.
Useful phrases:
“I’m a trans woman and I’d like a full sexual health screen.”
“I have oral and anal sex, so I need throat and rectal swabs.”
“I want to talk about PrEP.”
“I may have been exposed to HIV and I need advice about PEP.”
“I want to ask about HPV and hepatitis vaccines.”
“I need confidential advice.”
“I felt pressured into something and I need support.”
“I use this name and these pronouns.”
You do not need to apologise for explaining your needs. Clear communication helps you get better care.
17. Avoid Bad Online Advice
The internet is full of sexual health advice, and not all of it is good. Some of it is outdated. Some of it is written by people who think confidence means typing loudly in forums. Some of it is just nonsense wearing a lab coat.
Use trusted sources such as:
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Local NHS sexual health clinics
Your friends can support you, but medical decisions should come from qualified professionals.
18. Your Body Deserves Respect
Being a trans woman means moving through a world that often has too many opinions about your body. People may project fantasies, confusion, judgement, curiosity, or disrespect onto you.
But your body is not a public debate.
Your body deserves care. Your pleasure matters. Your boundaries matter. Your safety matters. Your health matters.
Sexual health is not about being perfect. It is about being informed, prepared, and kind to yourself.
You can be sexy and responsible. You can be soft and strong. You can be confident and still ask questions. You can be experienced and still need support. You can be a trans woman and deserve healthcare that sees you properly.
No shame. No silence. No nonsense.
Just care.
Quick Sexual Health Checklist for Trans Women
Before intimacy:
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Do I feel safe with this person?
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Have we discussed boundaries?
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Do I have condoms and lube?
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Do I know my PrEP/PEP options?
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Do I feel able to say no?
After intimacy:
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Did anything happen that worried me?
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Do I need STI testing?
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Do I need PEP advice within 72 hours?
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Do I feel emotionally okay?
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Do I need support?
Regularly:
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Book STI tests
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Check vaccine eligibility
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Review PrEP if relevant
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Update safety routines
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Protect your privacy
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Look after your mental wellbeing
Final Thoughts
Sexual health is not something to be ashamed of. It is part of loving yourself properly.
For trans women, good sexual health means more than tests and condoms. It means being respected in clinics, having access to accurate information, setting boundaries, protecting your peace, and knowing that your body deserves care exactly as it is.
So book the test. Ask the question. Carry the lube. Say no when you need to. Take up space in the clinic. Protect your joy.
And remember: looking after yourself is not boring. It is powerful.
FAQs
How often should trans women get tested for STIs?
It depends on your sex life and risk level. If you have new or multiple partners, work in adult services, or have condomless sex, regular testing is important. Many people test every three months, but a sexual health clinic can advise you based on your situation.
Can trans women take PrEP?
Yes. Trans women can take PrEP if they are at risk of HIV. Speak to a sexual health clinic about whether PrEP is suitable for you.
Does PrEP interfere with hormones?
Current guidance from sexual health organisations says PrEP can be used by trans people, including people taking gender-affirming hormones. If you are worried about interactions, ask a clinician for personalised advice.
What should I do if a condom breaks?
If a condom breaks, consider STI testing and ask for urgent advice if there may have been HIV exposure. If HIV exposure is possible, ask about PEP as soon as possible and within 72 hours.
What should I do if someone removes a condom without consent?
Removing a condom without consent is a serious violation. Stop if you can, get medical advice, ask about PEP if needed, and consider speaking to a sexual assault support service. You can also read our guide on Stealthing: What Escorts Need to Know.
Are sexual health clinics confidential?
Yes, NHS sexual health services are confidential. If you are worried about privacy, ask the clinic how they store information and contact you with results.
Where can I get STI testing in London?
You can use Sexual Health London for home testing if eligible, or find a local clinic through the NHS clinic finder.