Sexual History Taking in Clinical Settings: A Narrative Review

Brookmeyer, Kathryn A.; Coor, Alexandra; Kachur, Rachel; Beltran, Oscar; Reno, Hilary; Dittus, Patricia

doi:10.1097/olq.0000000000001319

Cited by 22 publications

(18 citation statements)

References 32 publications

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“…Providers who take a sexual history are more likely to provide sexual health care. 17 Yet only a minority of residents in this study took a routine sexual history. More studies elucidating best-practices within medical education for population-specific sexual history taking are needed.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and Perceived Barriers to Sexually Transmitted Infection Screening Among Graduate Medical Trainees

et al. 2021

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Graduate medical training is an opportune time to improve provider delivery of sexually transmitted infection (STI) screening. A survey of trainees found that the majority feel STI screening is their job but identified barriers to successful screening. Training that intentionally address service-specific barriers will be valuable in ending the STI epidemic.R ates of sexually transmitted infections (STIs) in the United States and New York City (NYC) have been increasing since 2014. 1,2 Untreated STIs account for substantial healthcare costs and may lead to further health complications; some, such as syphilis and gonorrhea, are a reliable marker of human immunodeficiency virus (HIV) acquisition. [3][4][5] Currently, the United States Preventive Services Task Force recommends routine gonorrhea and chlamydia screening for sexually active women 24 years or younger and older women who are at increased risk of HIV. 6 The United States Centers for Disease Control and Prevention recommend broader routine screening for gonorrhea and chlamydia, including in men who have sex with men, individuals on pre-exposure prophylaxis, persons living with HIV, and young men in high prevalence clinical settings. 7 Sexually transmitted infections are frequently asymptomatic; consequentially, risk-based screening can limit the clinical and public health impact of STI screening. 8,9 Additionally, patient stigma may affect STI risk factor disclosure, and provider stigma and discomfort may result in incomplete sexual history-taking, STI testing and treatment. 10,11 Strategies to reverse STI trends will require expansion of routine STI testing and treatment beyond sexual health service platforms and integration into other health services. 12 Integrating sexual and reproductive health (SRH) into other health services poses challenges at many health-system levels including the provider level. 10,11,13 Graduate medical education, in which resident physicians complete mentored-training, is an opportunity to improve provider delivery of STI screening and treatment as physicians establish medical practices that continue throughout their professional careers. 14,15 Because residents are "durably imprinted" during this training period, incorporating STI screening and treatment into the training curriculum can support future practices like the identification, management, and prevention of STIs, their sequelae, and other coinfections like HIV.

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Section: Discussionmentioning

confidence: 99%

Attitudes and Perceived Barriers to Sexually Transmitted Infection Screening Among Graduate Medical Trainees

et al. 2021

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“…The Centers for Disease Control and Prevention (CDC) in the United States recommends that a sexual history and STI risk assessment should be made at every initial comprehensive visit and at each visit concerning reproductive, genital, and urologic issues in primary care [62]. Unfortunately, research suggests that opportunities to screen for STIs [63] and take sexual histories are often missed by providers [64,65]. Most primary health care providers obtain a sexual history only if it is related to the patient complaint, but seldom do this routinely [62,66].…”

Section: Sexual Risk Assessmentsmentioning

confidence: 99%

“…Most primary health care providers obtain a sexual history only if it is related to the patient complaint, but seldom do this routinely [62,66]. Lack of confidence, personal discomfort, sense of discomfort on the part of the patient or time constraints are possible explanations why healthcare professionals may forego enquiring about sexual health [64,67]. When sexual histories are obtained, they are usually not comprehensive, and providers may discuss sexual history differently based on the patients' demographic characteristics [64].…”

Section: Sexual Risk Assessmentsmentioning

confidence: 99%

“…Lack of confidence, personal discomfort, sense of discomfort on the part of the patient or time constraints are possible explanations why healthcare professionals may forego enquiring about sexual health [64,67]. When sexual histories are obtained, they are usually not comprehensive, and providers may discuss sexual history differently based on the patients' demographic characteristics [64]. Young patients in particular agree that primary care providers should ask frequently about sexual health and that sexual health is an important part of well-being, but they also report that it is uncommon to have those conversations [68].…”

Section: Sexual Risk Assessmentsmentioning

confidence: 99%

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Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics

Hammarström

2021

Linköping University Medical Dissertations

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There were all my answers, I had been honest. I used to do drugs, so we talked about that and how guys treated me and things like that. So, yes, we started talking more after that piece of paper. I wouldn't have opened up otherwise, sure if she would have asked, but I still wouldn't have told as much without that paper. So, we had a conversation, it went well."Lisa, 17 years, interviewed for Study III Contents

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“…Notably, prevalence estimates show a great variance and are further complicated by the fact that in the health care system SDs are commonly not inquired for Brookmeyer et al ( 14 ). In primary care, only 10–16% of general practitioners actively ask for sexual concerns ( 15 ) and the rate of sexual history taking in urologists and gynecologists was found to be 23 and 8%, respectively ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Sexual Dysfunctions in Patients Receiving Opioid Agonist Treatment and Heroin-Assisted Treatment Compared to Patients in Private Practice—Identifying Group Differences and Predictors

et al. 2022

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Background and AimsSexual dysfunctions (SDs) show a marked impact on a person’s general wellbeing. Several risk-factors like physical and mental illnesses as well as alcohol and tobacco use have to date been identified to contribute to the occurrence of SDs. The impact of opioid-agonist treatment (OAT) on SDs remains unclear, with some studies demonstrating an improvement after methadone maintenance treatment (MMT) initiation. However, no studies on the prevalence and predictors of SDs in heroin-assisted treatment (HAT) exist to date.MethodsA cross-sectional study was conducted with patients from a MMT center (n = 57) and a center specializing in HAT (n = 47). A control group of patients with mild transient illnesses (n = 67) was recruited from a general practitioner (GP). The International Index of Erectile Function, the Female Sexual Function Index, as well as measurements for psychological distress, depressive state, nicotine dependence, and high-risk alcohol use were employed. Patients also completed a self-designed questionnaire on help-seeking behavior regarding sexual health. Mann-Whitney-U tests and chi-square tests were performed for group comparisons and binary logistic regression models were calculated.ResultsTwenty-five percent of the GP sample (n = 17), 70.2% (n = 40) of the MMT sample, and 57.4% (n = 27) of the HAT sample suffered from SDs at the time of study conduction. OAT patients differed significantly from GP patients in depressive state, high-risk alcohol use, nicotine dependence, and psychological distress. Age, depressive state, and opioid dependence predicted the occurrence of SDs in the total sample. No differences between OAT and GP patients were found regarding help-seeking behavior.DiscussionAge, depressive state, and opioid dependence predicted the occurrence of SDs in the total sample. It remains unclear whether SDs are caused by opioid intake itself or result from other substance-use related lifestyle factors, that were not controlled for in this study. A lack of help-seeking behavior was observed in our sample, underlining the importance of clinicians proactively inquiring about the sexual health of their patients.ConclusionThe high prevalence of SDs observed in MMT does not differ from the prevalence in HAT. Clinicians should actively inquire about their patients’ sexual health in GP and OAT centers alike.

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Sexual History Taking in Clinical Settings: A Narrative Review

Cited by 22 publications

References 32 publications

Attitudes and Perceived Barriers to Sexually Transmitted Infection Screening Among Graduate Medical Trainees

Attitudes and Perceived Barriers to Sexually Transmitted Infection Screening Among Graduate Medical Trainees

Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics

Sexual Dysfunctions in Patients Receiving Opioid Agonist Treatment and Heroin-Assisted Treatment Compared to Patients in Private Practice—Identifying Group Differences and Predictors

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