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Sexual history taking in primary care

02 August 2021
8 min read
Volume 32 · Issue 8

Abstract

Sexual history can be neglected in a routine nursing or medical assessment. Sarah Kipps gives tips to assist in making a sexual history taking session as comfortable as possible for both health professional and patient

Practitioners in primary care are in a unique position to improve the sexual health of men and women. They can do this by introducing the topic of sexual health into their everyday consultations and thereby normalising the subject as part of routine health for the patient. There is evidence that health professionals find sexual history taking to be one of the more challenging aspects of a consultation. There are a number of different reasons for this: feeling not equipped to ask questions of such a sensitive nature; fear of opening a ‘can of worms’ which cannot be dealt with; and the general social embarrassment and difficulties experienced talking about sex in general. This article will give health professionals some tips and guides to assist in making a sexual history taking session as comfortable as possible for both health professional and patient.

Sexual health is a multi-faceted, broad concept which is not just narrowly defined by issues such as sexually transmitted infections (STIs), pregnancy and contraception but is a ‘state of physical, emotional and social well-being in relation to sexuality’ (World Health Organization [WHO], 2006). Physical sexual health does not just imply the absence of disease but being enabled to make positive health choices and being able to access services when needed.

Positive sexual health outcomes are seen as important to individuals and they have also been recognised by the government as a major public health issue.

There have been some achievements in public heath targets set by government, namely a decline in teenage pregnancy and more high risk groups being offered and accepting HIV tests (Department of Health, 2013). But there are still major challenges: there were approximately 468 342 sexually transmitted infection diagnoses made in England in 2019 (Public Health England, 2020); up to 50% of pregnancies were unplanned; and almost half of adults newly diagnosed with HIV were diagnosed after the point where they should have started treatment (Department of Health, 2013).

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