Lesson plan

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We are learning about:

• The importance of a sexual health check
• How people can seek help to access testing and treatment

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We will be able to:

• Describe what happens during a check-up at a sexual health clinic
• Know when it is advisable to get a check
• Name some common STIs that are tested for in a sexual health check and describe how these STIs are checked for
• Describe how some STIs are treated, including HIV

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• Ask students to consider the below opinions and note down which person’s opinion below they agree with:
  • Person A: I’d go to the sexual health clinic, but the tests are painful and really embarrassing.
  • Person B: I will go to the sexual health clinic, but I’ll do it when I need to and I’ve only had one sexual partner before and I haven’t got any symptoms.
  • Person C: I’ve got a new partner so we’re both going to get tested, it’ll cost a bit of money, but it’ll be worth it
• Students should also imagine Person D and answer the question “What other opinions do people have about sexual health clinics?”

• No feedback is necessary here – the students will be able to reflect on their answers at the end of the lesson.
• You should clear up any misconceptions when students revisit this.

• Explain to the class that you are about to play a 7 minute video with 2 doctors
• After the video, they’ll be asked to complete a quiz
• If students have any questions they should write them down and put them in the anonymous questions box

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• Play the ‘Sexual health check’ video

• Be sure to watch the video prior to the lesson.
• You should assess the video for suitability and appropriateness to your specific class and that the content aligns with all school policies.

Plus:

• Content flag: The doctors make a very brief reference to anal sex in relation to STI testing
• The doctors also refer to HIV. Be mindful of any students/ students’ families that are living with HIV.

• Go through the 9 question quiz
• Ask the question on the slide and give students a chance to write down their answer
• The next slide will show the correct answer
• You should read through the answers and any additional information as a class
• Students should make any corrections or additions in a different coloured pen

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• Split the class into small groups.
• Each group should each be assigned a person below
• Each group should then discuss the concern and come up with advice to give that person.
• After 5 minutes, get feedback from each group.
  • Person 1: “I was having sex with my partner and the condom split, what am I meant to do?”
  • Person 2: “My partner has just told me that they have HIV – we haven’t had sex but I’m so confused about what this means for us.”
  • Person 3: “I’m really worried that if I ask my partner to go to the clinic with me they’ll think I’m judging them or accusing them of having an STI .”
  • Person 4: “If I have got an STI and go to a clinic, won’t the people working there tell my parents? The thought of my parents knowing, and telling my previous partners makes me feel really bad.”

Possible answers:

• Person 1:
  • This needs to be considered as ‘unprotected sex’ as the condom could have allowed sperm to escape from the condom.
  • If it is a male having sex with a female who is not on any other form of contraception, she will need to contact her GP or local sexual health service to see if she requires emergency contraception (the morning after pill or copper coil).
  • For couples of any gender, they will need to consider that the split of the condom could have increased the risk of transmission of an STI and should seek advice from their local sexual health service or GP.
  • It is worth mentioning here that using an in-date condom correctly means that the chances of the condom splitting are lower.
• Person 2:
  • The partner should be encouraged to be very supportive because telling someone about this diagnosis can be very difficult because of real, and perceived, stigma.
  • If the person who has HIV is on treatment then it can be tested if they have an “undetectable viral load”. With an undetectable viral load there is ZERO risk of transmission of HIV to any sexual partners. This is also known as U=U (Undetectable = Untransmittable).
  • If the partner does not have an “undetectable viral load” then there will be a risk of HIV transmission. If so, a course of Pre-Exposure Prophylaxis (PrEP) medicine should be considered for the partner who does not have HIV.
  • Condoms should still be used to reduce risk of other STIs and regular testing is encouraged.
  • It is important to remember that most human beings need intimacy, love and relationships to have a fulfilling life. Having an infection, such as HIV, should not affect this.
  • If someone has HIV then they can take medicines to have an “undetectable viral load” and stay healthy. And therefore they can live a normal life.
• Person 3:
  • This is a worry which is often founded on perceptions and stigma surrounding sex. The people who attend regular STI screening are taking responsibility for their own health and caring and looking after their partners.
  • We should view going to the STI clinic like we do going to the dentist for a ‘check-up.’
  • The purpose of the visit is to keep people healthy, rather than waiting to go when we have a problem.
  • If someone’s partner shames or judges them for taking care of their health, it is worth questioning whether they are mature enough to have a relationship with.
• Person 4:
  • If someone attends a sexual health clinic it is completely confidential – that means the clinic won’t tell the person’s parents or GP.
  • The only exception is if the clinic thinks the person has a safeguarding risk.
  • If someone gets diagnosed with an STI and doesn’t want to tell their partner or ex-partner themselves, clinics can help. Clinics often have an anonymous partner notification system so it’s the clinic that contacts your partners and ex-partners and asks them to get an STI test.

• Ask students to revisit their baseline assessment opinions. Do they still feel the same about these opinions?
• As a class, discuss each opinion – what is the person misunderstanding? What should they know instead?

• It is important to emphasise that all of the characters below have misconceptions and to explain why.
• Person A: “I’d go to the sexual health clinic, but the tests are painful and really embarrassing.”
  • Students may have heard ‘horror stories’ about the kinds of tests that happen in clinics. Explain that these days tests are a urine sample, swab (for females) or blood test and so they don’t hurt
  • Tell students that any clinic visits and tests are done with their dignity in mind
  • Tell students that tests are so simple – many can be done at home.
• Person B: “I will go to the sexual health clinic, but I’ll do it when I need to and I’ve only had one sexual partner before and I haven’t got any symptoms.”
  • Someone can often have an STI without showing any symptoms.
  • It’s important that people who are in a new relationship and/or considering having sex without a barrier method like a condom get tested first
• Person C: “I’ve got a new partner so we’re both going to get tested, it’ll cost a bit of money but it’ll be worth it.”
  • It’s great that this couple are both getting tested, but they don’t need to worry about the cost as they can often get tested for free at NHS sexual health clinics
  • Likewise some home tests for young people can often be ordered online for free.
• Person D: “What other opinions might people have about sexual health clinics?”
  • “The tests are slow” – however most results can be given during the same visit or same day.
  • “I’m going to be judged or told off by a doctor” – the staff at clinics understand the possible embarrassment – they are there to help you and not judge you.
  • “If I have an STI, they will tell my parents” – a visit to the sexual health clinic is completely confidential, unless there is a safeguarding risk.

• The students will now need their final assessment sheet from last lesson
• Ask students to complete the statements on their final assessment worksheet in the ‘Before the lesson’ column. i.e. for:
  • Before the lesson, I thought…
  • Before the lesson, I knew…
  • Before the lesson, I believed…

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• Answer the questions collected during the lesson from the anonymous question box

• You may wish to answer the questions in the question box at the start of the next lesson once you’ve had a chance to review them.
• If there are no questions then you could give a couple of questions e.g.

Q) Do you have to make an appointment to have a sexual health check?
A) You can make an appointment to go to a sexual health clinic. Some sexual health clinics also offer a drop-in clinic, so you may not need an appointment. But it is a good idea to call the sexual health clinic or check their website first.

Q) Can you choose who does your test at the clinic?
A) You can let the clinic know if you’d like a woman or a man to do the test or if you’d like someone else to be in the room with you (a chaperone). This could be someone you know, another nurse or a trained member of staff.

Q) How do you get your test results?
A) Most results can be given during the visit. For any test results that take longer – the clinic should ask how you want to receive them e.g. over the phone, by text, or in an unmarked letter.

• Ask students to return to their ‘Final assessment’ sheet
• Ask students to complete the statements in the ‘After the lesson’ column beginning:
  • After the lesson, I think…
  • After the lesson, I know…
  • After the lesson, I believe…

• You’ll need to collect the ‘Final assessment’ sheets or students will need to keep them safe. The sheets will be needed at the end of each of the 5 ‘Core Sexual Health Facts’ lessons.

• Explain to students that they have been given the task of reassuring and educating their peers on what is involved in a sexual health check.
• They should design a poster or social media post to help improve awareness amongst their fellow pupils.

• This activity is optional. You may wish to skip this slide or set the task for home learning.

• Give each student a copy of the Sexual health check fact sheet
• Ask students to read through the fact sheet at home – it can help clarify any questions from the lesson
• Tell students they can read more about the topics discussed today. Useful websites are listed on the fact sheet.

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