Sexual History Explained: Its Impact and Significance
Discussing sexual history with a healthcare provider is a crucial aspect of holistic medical care, providing valuable insights into a patient's sexual health risks, behaviors, and needs. This discussion enables more personalized, effective care and preventive services, helping to uncover factors that patients may not volunteer unless asked[1][2][4].
The Discussion Process
Healthcare providers typically engage in a structured, respectful dialogue with patients, using evidence-based frameworks like the CDC’s "5 Ps":
- Partners: This involves discussing the number, gender(s), and orientation of a patient's sexual partners.
- Practices: Providers delve into the types of sexual behaviors a patient engages in.
- Past History: They inquire about a patient's history of sexually transmitted infections (STIs).
- Protection: Providers ask about the protection methods used, such as condoms.
- Pregnancy Prevention or Reproductive Life Plans: This covers discussions about a patient's intentions regarding pregnancy.
The conversation can be expanded to include:
- Pleasure: Exploring sexual satisfaction and function.
- Pain: Addressing unwanted pain during sexual activity[1][2].
Patients can expect their providers to ask nonjudgmental, specific questions about these areas to offer appropriate care and screening. Providers aim to create a safe, confidential environment, emphasizing that questions are clinical, not personal judgments[3]. Patients are encouraged to answer honestly but can decline to answer anything they’re uncomfortable with.
Special Considerations for LGBTQ Patients
For LGBTQ patients, sexual history taking helps reveal important aspects like sexual orientation and gender identity, guiding affirming and relevant care[4]. The American Medical Association provides educational resources to help providers adopt best practices that respect and address the needs of these populations.
The Role of Healthcare Providers
In the context of discussing sexual history, healthcare providers play a critical role in screening for and treating STIs, identifying high-risk behaviors, sharing information and resources related to safer sex practices, addressing any sexual health concerns, and getting an overall picture of the patient's mental, emotional, and physical health[5].
Normalizing Open Communication
Normalizing open communication with healthcare providers about sexual health can lead to better health and safety outcomes. Discussing sexual history with a healthcare provider allows for the creation of a safe space where patients can confidently broach sexual health topics without fear of judgment or criticism[6].
Resources for Support
In case of domestic or sexual violence, resources such as the U.S. national suicide and crisis lifeline (988) offer 24/7 counseling support, while the National Domestic Violence Hotline (800.799.SAFE) provides resources for planning safety and connecting with online representatives[7]. Local and state resources, as well as international directories, are available for help with domestic and sexual violence.
[1] Centers for Disease Control and Prevention. (2021). Sexual history taking. Retrieved from https://www.cdc.gov/std/hiv/risk/sexual-history-taking/index.htm
[2] American College of Obstetricians and Gynecologists. (2020). Sexual history taking. Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/sexual-history-taking-in-obstetrics-and-gynecology
[3] American Medical Association. (2021). Sexual orientation and gender identity. Retrieved from https://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-of-scientific-affairs/sexual-orientation-and-gender-identity
[4] American Medical Association. (2021). LGBTQIA+ health. Retrieved from https://www.ama-assn.org/ama/pub/about-ama/our-people/ama-councils/council-on-ethical-and-judicial-affairs/lgbtqia+-health
[5] U.S. Department of Health and Human Services. (2021). Sexual health. Retrieved from https://www.hhs.gov/healthcare/prevention-and-wellness/sexual-health/index.html
[6] American Psychological Association. (2021). Sexual health. Retrieved from https://www.apa.org/topics/sexual-health
[7] National Domestic Violence Hotline. (2021). The National Domestic Violence Hotline. Retrieved from https://www.thehotline.org/
[8] Substance Abuse and Mental Health Services Administration. (2021). National Helpline. Retrieved from https://www.samhsa.gov/find-help/national-helpline
- The structured, respectful dialogue between healthcare providers and patients, called the CDC’s "5 Ps", involves discussing the number, gender(s), and orientation of a patient's sexual partners (Partners) as part of understanding their relationships.
- Besides the CDC’s "5 Ps", the conversation can be expanded to include exploring sexual satisfaction and function (Pleasure) and addressing unwanted pain during sexual activity (Pain).
- For LGBTQ patients, discussing sexual history with a healthcare provider is crucial as it helps reveal important aspects like sexual orientation and gender identity, guiding affirming and relevant care, aligning with the importance given to culture and personal lifestyle in medical care.
- Healthcare providers aim to create a safe, confidential environment and play a critical role in screening for and treating STIs, identifying high-risk behaviors, sharing information and resources related to safer sex practices, addressing any sexual health concerns, and getting an overall picture of the patient's mental, emotional, and physical health, highlighting the relationship between health and wellness.
- In the context of mental health, normalizing open communication with healthcare providers about sexual health can lead to better health and safety outcomes, fostering a culture where patients feel comfortable discussing personal matters like sexual history.
