Lecture 16 - Sexual History

Question 1

Main things we want to provide for sexual health care

Answer 1

• positive sexuality
• safe - no diseases, abuse
• healthy sexual relationships
• Contraception
• preventing and treating STIs.

assess risks of STIS, problems with sexual function, past sexual abus, past sexual partners, knoweldege and wellbeing

Question 2

Barriers to skillful and supportive talks about sex

Answer 2

Associated with embarrassment & negativity
 Sexual education is generally poor quality
 Fear of TMI (too much information)
 Fear of offending or intruding
 Often overlooked in general health care
 Fear of disclosures of sexual abuse
 Ethico-legal uncertainty

Question 3

Why, when what and how to ask sexuality

Answer 3

• silent infections
• preventability
• distressing impact - infertility, pain
• holsitic health and wellbeing
• screening and testing (prevention)
• sharing knowledge and health promotion

Question 4

When to ask

Answer 4

-Sexual health service - STI check, contraception request, smear test, fertility and pregnancy
-Symptoms presneted - discharge, pain, itch, diagnosis
-Social indication - sexual curosity, questiers, idenfifed sexual practieces
Opportunisitcally - life transiitons, travel, new patinet, wellbeing , general cehkcs
-Environment - privacy and quiet environemtn

Question 5

How to ask baout this

SNAPC

Answer 5

S - signpost - need to ask you some questions about..
Normalise - say you always ask all your pateitns about this
Acknowledge - this is personal, may be uncorfortable
P - permit - dont have to answer anythign, share paower
C - confidenceitallyity

Question 6

5Ps

Answer 6

-Past history (STIs, sexual health, functioning problems)
-Partners - gneder, no. past and current, relationships
-Pregnancy - contraception, fertilitym past nad preset
-P practices - types of sexual behaviorus and with whome
Prevention - sexual healht protection habits

Question 7

What to do and not to do

Answer 7

-make it clear what you are asking
-make sure you are not makign any assumptions
-set up boundaries that allow comfort
-use terms to invite people to describe ..
-use simple words
-dont be condecesig
-

Question 8

HEEADSSS assesment

Answer 8

Home
 Education and/or employment
 Eating
 Activities
 Drugs
 Sexuality
 Suicide & depression
 Safety

Question 9

How to respond to someone who has been sexually abused

Answer 9

Validate by saying“It’s not okay that that happened to you”; “I am very sorry that happened to you”.
Be utterly present (it is important to take a few minutes)
Stay calm, reinforce how common it is, don’t minimse
Normalise any traumatic responses and symptoms, e.g. “many people find….is that something that has affected you?”
Check out if they are currently safe (SAFETY protocols)
Offer opportunities for support and treatment
Check how they feel about reporting to the Police.