You've noticed something. A discharge, a sore, an itch, a rash, pain you can't explain. Or maybe nothing — you just know there was a risk exposure and you're waiting anxiously.

This is the guide for that moment.

First: Don't Wait

The instinct to wait and see if it goes away is natural. For most STIs, it's the wrong call.

Most STIs are easier to treat the earlier they're caught. Some (syphilis, gonorrhoea) can cause serious complications if left untreated. And if you have an infection, you can transmit it to other people while waiting.

The anxiety of not knowing is also real and almost always worse than the reality of what you find out.

Symptoms That Warrant Same-Day or Next-Day Contact

Some symptoms should be seen promptly, not monitored at home:

  • Syphilis sore (chancre): A painless ulcer, usually firm-edged, on the genitals, anus, or mouth. Painlessness is what makes people miss it. If you see an unexplained ulcer, get seen.
  • Penile discharge: Any discharge from the urethra — yellow, green, or white. Gonorrhoea or chlamydia.
  • Painful urination combined with discharge.
  • Rectal pain, discharge, or bleeding that's unexplained.
  • Mpox lesions: Painful, fluid-filled spots that start like blisters and scab over, potentially with fever and swollen lymph nodes.
  • Severe genital or anal pain.

These don't require A&E unless accompanied by fever, systemic illness, or severe pain. They require a sexual health clinic visit, same day if possible.

Symptoms That Can Wait a Few Days (But Still Get Seen)

  • Genital warts: Soft, flesh-coloured bumps. Not urgent but needs confirmation and treatment discussion.
  • Unusual rash (flat, non-itchy rash, especially on palms or soles) — can be secondary syphilis. Worth seeing within a few days.
  • Milder itching without visible lesions.
  • Swollen lymph nodes in groin without other symptoms.

The "No Symptoms But There Was a Risk" Scenario

This is the most common situation — and the most important one to address.

A risk exposure might be:

  • Condomless anal sex with a partner of unknown status when you're not on PrEP (or had missed doses)
  • A broken condom
  • Known or suspected PrEP non-adherence during a period of sexual activity
  • A chemsex session where adherence to protection practices was uncertain

HIV: Your window for PEP (if this happened in the last 72 hours) is the priority. See PEP: The Emergency Brake and use the decision flowchart. If it's past 72 hours, PEP isn't an option — test at 28 days.

Bacterial STIs: Book a 3-site STI test (throat, rectal, genital) at 2 weeks post-exposure. That's the earliest a gonorrhoea/chlamydia test will reliably detect an infection.

Syphilis: Blood test at 3–6 weeks post-exposure.

If you have DoxyPEP in your cabinet: Take it within 24–72 hours of exposure for bacterial STI protection. See DoxyPEP: The Morning After Pill for Bacteria.

Where to Go

Sexual health clinic: The right first stop. They do full 3-site testing, same-day emergency appointments in most cities, and won't judge you. This is their entire job.

GP: Can refer you and can do some testing. May not do 3-site rectal/throat swabs unless you specifically ask. May have longer wait times.

Online home testing: For routine screening when you don't have symptoms, home test kits (postal swab and blood test services) are convenient and private. For symptomatic presentations, a clinic visit is better — a clinician can actually look at what's there.

💡 Tip

When you call or register at a sexual health clinic, you don't need to give detailed information over the phone. "I had a risk exposure and I'd like a full sexual health screen" is sufficient to get booked in.

What to Tell the Clinician

The more information you give, the better care you get. Relevant things:

  • What you think the exposure was (receptive anal, insertive, oral, skin contact, etc.)
  • When it was
  • What protection was used
  • Whether you're on PrEP and whether you've been consistent
  • Any symptoms you've noticed and when they started
  • Recent partners' known status if you know it

You will not be judged for any of this. Sexual health clinicians hear everything. Their job is to help you, not evaluate your choices.

After the Test

If everything comes back negative: Take a breath. If it was a single exposure with identified risk, you're clear. Keep your routine testing schedule going forward.

If something comes back positive: See Protocol: Positive Result for the full step-by-step guide — informing partners, starting treatment, understanding what it means.

While waiting for results: Avoid sexual activity that could transmit whatever you might have until you know your status. This is a short window. It matters.

A Note on Shame

The anxiety that builds up between "something happened" and "I have a result" is made significantly worse by shame. Shame about having had the exposure, shame about having to go to the clinic, shame about what the doctor will think.

Sexual health clinics are not staffed by people who are surprised by human sexual behaviour. Nobody is going to visibly judge you. The discomfort you feel is your own — not a reflection of how you'll actually be received.

Going is always the right move. Waiting to see if it goes away, or avoiding testing because of how the result might make you feel, is how treatable things become complicated ones.

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