Taking a Sexual History
A comprehensive sexual history is an essential part of the sexual health evaluation. All health care providers, whether they are caring for youth or older patients, should take a sexual history to assess risk and provide a basis for risk reduction through counseling. Ideally, this should be done at a new patient visit, an annual visit, or anytime a patient presents with symptoms or history suggesting an STD risk.
- State the parameters of confidentiality.
- Use a developmentally oriented approach.
- Use open ended questions.
- Be aware of judgmental questions.
- Try questioning in the third person if necessary.
- Ask adolescents for clarification of answers as needed.
- Use reflective listening.
- Don't make any assumptions.
- Always educate patients, including teens, about their options.
- Present clear information.
- Refer patients, including teens, to other resources as needed.
- Summarize your discussion at the end of the visit (it may be helpful to restate the confidentiality of the encounter at this time).
- Leave the patient with an open invitation for further discussion as needed.
- Partners (who, when, how many)
- Pregnancy Prevention (contraception, abstinence)
- Protection (barriers)
- Practices (what types of sex)
- Past history of STDs
The Teen Pregnancy Prevention Initiative of the Michigan Department of Health & Human Services recommends beginning to take an age appropriate sexual history at the first teen visit or age 12 years, whichever comes first. Of course, younger, even preteen children may need to be questioned regarding sexual issues if sexual abuse is suspected.
For more tips specific to youth, check out Taking a Youth Centered Sexual History