Other Key Aspects to Remember
Besides the "Five P's," screening for sexual assault and intimate partner violence is recommended by the US Preventive Services Task Force for all women of childbearing age (grade B). Other patients may benefit, although the USPSTF has not explicitly recommended screening.
Asking whether patients' medical conditions or treatments affect their sexual functioning is also helpful. Patients may privately weigh perceived benefits of medication against the sexual side effects but not feel a need to discuss it. Asking not only provides an opportunity to discuss that potential concern, but it also communicates that you are considering the quality of their life and not simply the blunt measurements reported through lab results and imaging.
Alternatives to Discussions
Given time constraints and competing priorities, some clinics use self-reporting tools that a patient fills out prior to seeing the provider. This may be preferable for patients who are uncomfortable talking openly about their sexual practices but still want to communicate the information to their provider. Some tools are written questionnaires or even dry-erase boards with boxes to check. Mobile apps such as the Tablet Sexual Health App (TaSHA) are also options. Some tablet-based apps use a HIPAA-compliant server and cue the clinician about any risk-related responses that need further discussion.
Additional Resources
The importance of sexuality and sexual health is self-evident, especially in primary care and reproductive health settings. For more information about sexual health, check out these great resources:
The National STD Curriculum: This is a fantastic online learning module, complete with a boardlike review question bank (CME credits available).
The National STD Clinical Consultation Network: For any nonurgent, difficult STD cases, this can be used to consult national STD experts.
The American Academy of Family Physicians' Guide to Sexual History Taking: This resource is specific to the primary health setting.
The Association of Reproductive Health Professionals Guide: This resource includes a list of screening tools for female patients.
Sexuality in Older Age: Essential Considerations for Healthcare Professionals: This academic article by Taylor and Gosney provides incredibly important perspective.
Sexual Health Online Learning Module: This resource was developed through a partnership between the Denver Prevention Training Center and the National LGBT Health Education Training Center (which is another wonderful resource).
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Let's Talk About Sex: Tips for How to Take a Sexual History - Medscape - Jan 11, 2018.
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