Urban myth deters men in London from seeking sexual health screens

Men in London may be deterred from seeking a sexual health screen because they fear that an “umbrella”-like instrument will be inserted into their urethra to check for sexually transmitted infections, according to a study conducted at a central London clinic and published in the December 22^nd edition of the British Medical Journal. Staff at the genitourinary medicine clinic at St Thomas’s Hospital now plan to display posters to reassure men about what a sexual health screen really entails, but as they found that the myth of the umbrella was so prevalent, they recommend that “more informative advertising and media attention is needed to encourage people to attend clinics.”

An advertising campaign about sexually transmitted infections was recently launched in the United Kingdom, and individuals who believe that they may be at risk of such infections are being encouraged to attend sexual health services for appropriate tests. Low rates of presentation by men is a concern for sexual health staff, and investigators at St Thomas’s Hospital in Lambeth, south London, speculated that this is because of an enduring urban myth that sexual health screens involve the umbrella test.

This mythical investigation is usually described as inserting a swab that resembles a cocktail umbrella into the urethra, where it is then opened and withdrawn causing considerable discomfort.

In reality, urethral tests for sexually transmitted infections on men are much less intrusive. At St Thomas’s Hospital, asymptomatic men only have to provide a urine sample, and men presenting with symptoms have a swab tipped with cotton wool inserted a short distance into the urethra, a procedure which most men find tolerable and relatively painless.

Investigators wished to know how prevalent the umbrella myth was and if it was deterring men from attending their clinic. Accordingly, random male patients were asked to complete a questionnaire what, if anything they had heard about the umbrella test.

A total of 46 questionnaires were completed, 18 men had heard of the umbrella test, and 14 said that the thought of this test had deterred them from attending a sexual health clinic. Men believing in the umbrella test were more likely to be white, heterosexual and younger than 25.

Some of the men provided sketched illustrations of what they believed the umbrella swab looked like – these resembled an umbrella, an arrow, a hook, and a double-headed fishing hook.

Over 50% of the men said that there was a need for more public advertising to encourage men to attend sexual health services, and most men also wanted reassurance that tests would be relatively painless. Staff at St Thomas’s now intend to display posters to reassure patients about the tests the clinic uses. They also believe that “a wider refutation of the myth might encourage more men to seek screening for sexually transmitted infections” and suggest that advertising about sexual health should be more informative.

The investigators remain uncertain about the origins of the umbrella myth, but are in “no doubt” that readers of the BMJ “will enlighten us.”