Sexual history

There a times when a sexual history may be appropriate, its important to consider the following factors though when deciding to carry out this history taking in the pre-hospital environment:

• Relevance of asking the questions
• Privacy of the setting
• Whether knowing the answers to the questions will change your management at all

The following is taken from the fantastic STI Guidelines website produced by the Australasian Sexual Health Alliance (“Taking a sexual history & contact tracing,” n.d.)

Basic questions

• When was the last time you had sex?
• Who have you been having sex with?
  • [Prompt further if required. If they answer ‘my partner’ you can then ask] Other than your regular partner have you had sex with anyone else? [or] When was the last time you had sex with someone other than your regular partner?
• How did you have sex? Vaginal sex/oral sex/anal sex? Did you use a condom? [Repeat question to ask about all sexual contact/partners disclosed by Q.2]
• [If not obvious already] Have your partners been male or female?
• In the last 3 months, how many sexual partners have you had?
• Have you ever been diagnosed with (or thought you had) an STI?

Detailed questions

I’d like to ask you about some other activities that could increase someone’s risk of some sexually transmitted infections and blood-borne viruses, is that ok?

• [If the patient has had sex with men] Have any of your male partners ever had sex with men?
• [If the patient is a female] Have you had sex with other women?
• [If the patient is a female] Are you pregnant?
• Have you ever been paid to have sex? When?
• Have you ever paid for sex? When?
• Have you ever had any tattoos? If yes, was that here or overseas?
• Have you ever injected drugs? Have you ever shared needles or any of the equipment used for injecting?
• Have you ever been in gaol?
• Are you a refugee or a recent migrant?
• Do you identify as Aboriginal or Torres Strait Islander?
• Have you ever experienced violence from a partner?

1. Taking a sexual history & contact tracing. In How to take a sexual history - Australian STI Management Guidelines. Australasian Sexual Health Alliance. http://www.sti.guidelines.org.au/resources/how-to-take-a-sexual-history