Sexual history taking Flashcards
Whats the HEAD-ASS exam?
Used for younger persons
● Home → who lives at home with you?
● Education and/or employment
● Eating
● Activities
● Drugs
● Sexuality → important to ask about age of partner if a young person
● Suicide & depression
● Safety
Why ask about sex?
- Most patients are sexually active
- Assessing STI risk
- Assess related issues i.e GU
- Sexual functionality
- Risk of sexual abuse or past abuse
- Build sexual wellbeing and knowledge in pt.
What are the barriers to discussing sexual health for the medical professional?
■ EMBARRASSMENT
■ Sexual health history-taking poorly taught.
■ Fear of offending or intruding
■ Often overlooked in GP land.
■ Fear of disclosures of sexual abuse
■ medico legal fears
What are barriers to asking about sexual health for the patient?
■ EMBARRASSMENT
■ Lack of privacy
■ Fear of losing confidentiality
■ Social, cultural, religious factors
■ Poor past experiences/lack of
trust
■ Feels unrelated/unnecessary to
presentation
When is it appropriate to ask about sexual health?
■ If someone requests an sexual health check
■ if someone is a contact of an STI
■ If someone presents with related symptoms:
- genital symptoms
- urinary symptoms
- lower abdominal pain
- ano-rectal symptoms
- unusual rash or other illness
● Also - as part of a regular consultation
What are the opportunistic possibilities for asking about sexual health?
Opportunistic screening:
■ aged under 30y
■ MSM
■ during a consult for contraception or cervical smear
■ antenatal consultation
How do you take a sexual history?
■ Introduction & scene-setting
■ Normalisation & explanation
■ Presenting complaint
■ Symptoms (SOCRATES)
■ Sexual history; what, where, when & with who
■ Medical history, medications and allergies
■ Social history
■ Sexual abuse, intimate partner violence
Special considerations:
- adolescents & young people
- sex, gender and sexuality
