Approach to the Sexual History and Physical Exam
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Taking a sexual history is an important facet of adolescent health that can be challenging for healthcare providers. Adolescents and young adults aged 13–24 are at increased risk for sexually transmitted infections (STIs) due to risky sexual behaviors. Many of these high-risk behaviors are influenced by related risk behaviors such as drug and alcohol intake, peer norms, and sexual health education (or lack thereof). The long-term consequences of STIs can include fertility problems and maternal-fetal transmission of infections, in addition to the obvious public health risks of continued transmission in the community. For these reasons, it is essential to take a thorough sexual history using the methods outlined below. Providers should aim to make the patient feel comfortable by reinforcing normalcy and maintaining confidentiality in their interaction. Finally, the physical exam is crucial in forming a differential diagnosis of any symptoms that a patient might be experiencing. This chapter will provide insight into methods of obtaining a sexual history from a patient in a professional, comfortable, and efficient manner.
KeywordsSexual history Confidentiality Sexual behaviors Risk
- 1.Kalmuss D, Davidsson A, Cohall A, Laraque D, Cassell C. Preventing sexual risk behaviors and pregnancy among teenagers: linking research and programs; 2016. Retrieved April 25, 2017, from https://www.guttmacher.org/journals/psrh/2003/03/preventing-sexual-risk-behaviors-and-pregnancy-among-teenagers-linking.
- 2.Institute of Medicine (US) Committee on Prevention and Control of Sexually Transmitted Diseases; Eng TR, Butler WT, editors. The hidden epidemic: confronting sexually transmitted diseases: summary. Washington, DC: National Academies Press (US); 1997. Broad Scope and Impact of STIS. Available from: http://www.ncbi.nlm.nih.gov/books/NBK233449/.
- 3.“Meeting the health care needs for adolescents in managed care”. J Adolesc Health, April 1998. Web. 13 Aug 2016.Google Scholar
- 5.“Youth risk behavior surveillance – United States, 2015”. Morbidity and mortality weekly report. CDC, 10 June 2016. Web. 13 Aug 2016.Google Scholar
- 6.“Trends in the prevalence of sexual behaviors and HIV …” CDC. N.p., n.d. Web. 13 Aug 2016.Google Scholar
- 7.Perrin J, Guyer B, Lawrence JM. Health care services for children and adolescents. Princeton Brookings, Winter 2002. Web. 13 Aug 2016.Google Scholar
- 8.“Conversations on sex lacking between doctors and teens”. Duke Medicine. Duke Medicine News and Communications, n.d. Web. 13 Aug 2016.Google Scholar
- 9.Pakpreo P. AMA J Ethics®. VM AMA J Ethics, October 2005. Web. 13 Aug 2016.Google Scholar
- 11.Protecting confidentiality for individuals insured as dependents. 2016, August 1. Retrieved August 22, 2016, from https://www.guttmacher.org/state-policy/explore/protecting-confidentiality-individuals-insured-dependents.
- 12.“Sexually Transmitted Infections (STIs) fact sheet”. World Health Organization. N.p., n.d. Web. 13 Aug 2016.Google Scholar
- 14.David Klein, J. G., and William Adelman (2014). “HEEADSSS 3.0 The psychosocial interview for adolescents updated for a new century fueled by media.” Contemporary Pediatrics: 16–28.Google Scholar
- 16.Taking routine histories of sexual health: a system-wide approach for health centers. 2015, November. Retrieved September, 2016, from http://www.lgbthealtheducation.org/wp-content/uploads/COM-827-sexual-history_toolkit_2015.pdf.
- 17.Parent-child communication: promoting sexually healthy youth. 2009, November. Retrieved September 05, 2016, from http://www.advocatesforyouth.org/the-facts-parent-child-communication.
- 18.Neinstein LS, Neinstein LS. Adolescent health care: a practical guide. Philadelphia: Lippincott Williams & Wilkins; 2008.Google Scholar
- 19.CDC, editors. A guide to taking a sexual history; 2005. Retrieved September 05, 2016, from https://www.cdc.gov/STD/treatment/sexualhistory.pdf.