sexual history

Question 1

how do you start

Answer 1

ask about reason for attendance

“I’ve been asked to take a sexual history from you, this is going to involve me asking some personal questions which you may find uncomfortable. Everything you tell me is confidential within the boundaries of the team looking after your care. If you would like to stop at any time, please let me know.”

Question 2

what are systems questions to ask

Answer 2

discharge
dysuria
swellings
growths
ulcers
pain 
PV bleeding 

systemic symptoms: rash, eye problems. joint pain

Question 3

what do you ask about partners

Answer 3

current and recent partners

dates
male or female
condom use
oral/vaginal/anal

abroad partners
bisexual partners

Question 4

what should you ask people with vaginas

Answer 4

menstrual history
contraceptives
vaginal discharge
vulval itching or soreness
abdominal pain 
pain during or after sex

Question 5

what should you ask in PMH

Answer 5

previous STIs
Hiv hepatitis
vaccines

Question 6

what should you ask in social history

Answer 6

alcohol
drugs
needle sharing

Question 7

what should you ask about periods

Answer 7

LMP
regularity
length of cycle
dysmenorrhoea 
post coital bleeding 
intermenstrual bleeding 
smears
previous gynaecological treatment 
any chance you could be pregnant

Question 8

what should people with penises

Answer 8

pain in testes
swellings
itching 
skin changes
discharge from the urethra 
dysuria 
systemic symptoms

Question 9

hiv questions

Answer 9

have you ever had a partner who is HIV positive

have you ever had sex with a MSM

have you ever had sex with someone abroad

have you injected drugs

have you ever slept with someone who injected drugs

have you ever paid or been paid for sex

Question 10

how should you finish

Answer 10

summarise

reaffirm confidentiality