Sexual history taking

Question 1

What should you include in a sexual health history?

Answer 1

Presenting complaint

History of presenting complaint

Previous medical history inc previous STIs

Drugs/allergies

Additional for ♀:
Cervical smears, contraception, pregnancy and gynaecological history, LMP

Sexual behaviours

May include enquiry about intimate partner violence and alcohol / recreational drug use

Question 2

What are common presenting complaints in men (re. sexual health)?

Answer 2

Dysuria

Discharge

Testicular pain/ swelling

Skin changes – rashes, lumps, sores, blisters

Question 3

What are common presenting complaints in women (re. sexual health)?

Answer 3

Dysuria

Vaginal discharge

Intermenstrual / postcoital bleeding

Lower abdominal pain

Dyspareunia

Skin changes – rashes, lumps, sores, blisters

Question 4

What questions should be asked about last sexual contact?

Answer 4

When?

With whom?

Is that a regular partner?

Together how long?

From where?

Are they known or unknown to patient?

Type of sex – vaginal? oral? anal? Given or received?

Were condoms used? (for each sexual method)

Any condom accidents?

In the last 3 months anyone else? Ask all above again

Question 5

what questions might you want to ask about to asses for blood-borne virus risk?

Answer 5

partner with known HIV

IVDU

MSM (men who have sex with men)

Non-UK partner

CSW (commercial sex worker)