I want to destigmatise HIV and encourage more people to get tested

Sarah Mulindwa, 36, from London, is a practising sexual health nurse at a world-renowned sex clinic in central London. She was a presenter and sexual health nurse on the C4 series The Sex Clinic and is an ambassador for Terence Higgins Trust and many other brands, teaching people of all ages about sexual health.

I remember vividly the moment I decided I wanted to work in sexual health. I was 21 and already a qualified, practising nurse, but working in acute medicine at the time, wondering what specialism to do.

One day, I went for a sexual health check-up. I was very anxious and had been putting off the appointment for ages, convinced I’d caught something incurable. I may have been a nurse but was pretty clueless about sexual health – a result of bad sex education at school and not doing much about it in my nursing degree.

That day, however, I saw this most amazing doctor. She really took her time to educate and reassure me and I left the clinic feeling so relieved.

I thought if I can make people feel like that, I’d be so happy, and so I decided I wanted to become a sexual health nurse, and within two years, I’d got my dream job working as a lead for young people’s sexual health services.

Tackling taboos

I’ve now been working in sexual health for 12 years. Right from the start, it’s been about education for me. After all, I thought, if I’m a healthcare professional and have such limited knowledge in this area, what must it be like for other people?

So, my mission at first was to challenge sex education within the school curriculum and to empower and educate young people. I was young myself when I qualified as a nurse (only 17) and so I could relate to their needs and the questions they’d have.

At first, my work concentrated on increasing awareness around STIs, and normalising conversations about everything that comes under the umbrella of sex, such as body autonomy, consent and the pressure of being overly sexualised online – things that myself and my friends had experienced only a few years previously.

However, throughout my career I have come to realise that we focus so much on young people. We assume once you’ve passed a certain age, that you know it all, but nothing could be further from the truth!

With divorce rates rocketing, there are more older people than ever having active sex lives and often their sex education is out of date.

So, now, my target audience is anyone who’s sexually active, and my work covers everything from menopause to erectile dysfunction.

Changing perceptions of HIV

For the last five years, I've been an ambassador for the AIDS and HIV charity Terence Higgins Trust and it’s probably the work I'm most proud of.

My mission here is to get more people to test more often and also to destigmatise HIV, because whilst we have come on leaps and bounds in terms of medication and preventative measures, what hasn’t changed enough unfortunately, is how people view the disease.

HIV still really frightens people. It’s shrouded in fear. So, my work is about educating people to know that if you do get a positive diagnosis, there’s now effective treatment that can lead to a normal life expectancy.

Medication such as PrEP (pre-exposure prophylaxis) can stop those who are high-risk, such as sex workers, from becoming HIV positive. New treatments also mean you can be HIV positive and not pass the virus on. If you are an HIV positive woman you can get pregnant, carry a baby to full term, and that child will not be HIV positive.

I work for one of the busiest sexual health clinics in the country and in the last decade, we have seen a massive decrease in the number of HIV positive diagnoses, so things are working!

Encouraging people to test

Every February, we do the National HIV Testing Week with billboards all over the country and every year, friends and strangers alike will message me saying, 'Oh, I’ve seen your campaign. This is my yearly reminder to have a test.'

For me, this is my proudest thing, especially when those people do not consider themselves to fall under the 'high risk' category – it shows our efforts are worth it.

I’ve seen a decline in people’s anxiety about getting tested too. If I go back 10 years, I remember the look of fear on people’s faces when they came to get tested or to get their results.

I’d spend so much time reassuring them and saying, "Look, you not testing isn’t going to change your status, what is going to change is your health." But now, I see a lot less anxiety, and it’s down to those campaigns.

One message I am driving now is that sexual health is all our responsibility – it’s important to not just think about things that affect you directly. For example, when we talk about menopause or periods, we shouldn’t just target women, because it affects everyone. Similarly, in schools, we shouldn’t just teach the boys to put a condom on because that affects everyone too.

By us all taking responsibility and an interest, we can have empathy and I strongly believe that in itself breaks down stigma.

Spreading the message

I still practise as an NHS sexual health nurse, which is so important to me and keeps my skills up to date.

However, I'm also an ambassador for lots of different brands, who ask me to talk about sexual health on social media and podcasts. I'm doing a podcast with Gareth Thomas, for example, who came out as HIV positive in 2019.

Some of those brands, such as Love Honey, are sex-related, but not all. What I love recently is that other brands, such as fashion and beauty brands, are taking responsibility for educating different audiences about sexual health, and I am proud to be able to help by being a spokesperson.

It means you can pull in a different audience who may not be looking for that kind of info but it’s usually the people who aren’t looking for it, who need it the most.

Appearing on Channel 4’s The Sex Clinic really changed the trajectory for me. I’d always worked part-time as a sexual health nurse and also a fashion editor and radio presenter. I never dreamt I could marry the two, but The Sex Clinic did just that. After the programme, my sexual health nursing career really took off, which was a surprise, because although people are used to seeing TV doctors, it was the first time people had seen a sexual health nurse on TV.

People who knew me on the red carpet as a fashion person were suddenly saying, "Did I just see your head on Channel 4 between someone’s crotch?"

Sharing my own experience

After the show, I went back to the frontline of sexual health and now this is where my passion is. I try to be open about my own experiences. I believe this goes a long way to normalising conversations.

A few years ago for example, I wrote a feature about my experience with PMDD (pre-menstrual dysphoric disorder), which is basically when you have an extreme reaction to the fluctuation in hormones before your period and can become suicidal.

The outpouring of thanks from other women who had experienced this but never seen it talked about was phenomenal.

One woman in particular contacted me saying my article had saved her life, because suddenly she realised she wasn’t crazy, that other people felt like this too and crucially, that she could do something about it. I was able to put her in touch with support groups that had helped me.

Protecting young people online

There is so much more work to be done with sexual health. We need to reassess the way we approach sex education, but also we need to look at how sex is represented on TV.

One of the things I'm most passionate about is challenging the way we protect young people from over-sexualised and harmful content and engagement online.

People feel freer to post more explicit content and language on social media apps like TikTok and SnapChat, than they do in real life. There are people screenshotting sexual images of young girls, especially, and sharing them online. Children as young as 12 are being groomed – being asked to send nude pics then being threatened with them being shared online.

We live in such a sexually heightened society – young people are being exposed and exploited. We have an epidemic of child sexualisation on our hands and it’s our collective responsibility.

I believe for example, that social media apps have a duty of care to young people to protect them. But I also think we need to educate people not just about STIs and sex, but also how to treat each other, what’s ok and what’s not ok. I'm determined to do all I can to spread that message.