History – Sexual

Taking a sexual history is an essential part of a comprehensive medical evaluation. This allows GPs to assess risk for sexually transmitted infections (STIs), unintended pregnancies, and other potential health issues, as well as provide counseling on safe sexual practices. It’s important to approach this topic in a non-judgmental, confidential, and sensitive manner. Here’s a list of relevant questions:

  1. Introductory Statements:
    • Before beginning, it might be helpful to say something like, “I ask these questions to all my patients to provide the best care possible. Your answers are confidential.”
  2. General Health:
    • Do you have any concerns or questions about your sexual health or sexual function?
  3. Sexual Activity:
    • Are you currently sexually active?
    • At what age did you first become sexually active?
    • Over the past year, how many sexual partners have you had?
    • In your lifetime, how many sexual partners have you had?
    • Do you have sex with men, women, or both?
    • What kinds of sexual activity do you engage in (vaginal, oral, anal)?
  4. Protection and Contraception:
    • Do you use any methods of contraception? If so, which ones?
    • How often do you use condoms or other barrier methods? Are there specific situations where you don’t use them?
    • Have you ever had an unplanned pregnancy?
  5. Past Medical History:
    • Have you ever been diagnosed with an STI?
    • Have you ever been treated for an STI?
    • When was your last STI screening?
    • Have you ever had any symptoms or concerns about STIs?
  6. Vaccinations:
    • Have you been vaccinated against HPV (human papillomavirus)?
    • Have you been vaccinated against hepatitis B?
    • For MSM we have HAV, HBV, HPV, meningococcal vaccinations to suggest.
  7. Behavioral and Social History:
    • Have you ever exchanged sex for money, drugs, or other goods/services?
    • Have you ever used IV drugs?
    • Do you have a history of sexual trauma or assault?
  8. Relationship Status and Practices:
    • Are you currently in a relationship? If so, how long has it been?
    • Do you or your partner(s) have other concurrent partners?
  9. Menstrual and Reproductive History:
    • When was your last menstrual period?
    • How regular are your periods?
    • Do you have any pain or discomfort with intercourse?
  10. Screening and Prevention:
    • Would you like information about STI prevention?
    • Would you like information about pregnancy prevention or fertility?
  11. Closing:
    • Is there anything else you’d like to discuss regarding your sexual health or any other concerns?

Remember, the sexual history should be adapted based on the patient’s age, gender, cultural background, and specific medical needs. It’s essential for the healthcare provider to be respectful, non-judgmental, and to ensure the patient’s privacy and confidentiality.