Talking with Patients
Many emergency physicians cite discussions about sexual health as a barrier to effectively offering EPT.
Learn more about how destigmatizine sexual health conversations can help clinicians connect with their patients and counsel them on healthy behaviors, risk reduction and options for treatment.
Let’s Talk About Sexual Health
Talking with your patients about sexual health and taking a sexual history can be an important part of the ED encounter. This is especially true for younger patients, racial/ ethnic minorities, those with poor healthcare access because these groups are disproportionately impacted by sexually transmitted diseases (STDs). This video from the CDC discusses the importance of a healthy dialogue between youth and providers concerning their sexual health.
Counseling Guide for providers
This pdf is linked from the Essential Access Health website, a program in partnership with the California Department of Public Health, STD Control Branch. This guide was developed by these institutions with input from clinicians. The key counseling messages outlined in this guide are intended to be used as educational aids and can be tailored for use in various clinical settings.
Ask about "The Five P's"
The CDC recommneds considering these key elements of a patient's sexual history when considering risk factors for STIs and points for patient counseling.
The Five P's shown below are shared from the CDC's 2015 STD Guidelines: Partners, Practices, Prevention of Pregnancy, Protection from STDs, and Past History of STDs
"Do you have sex with men, women, or both?"
"In the past 2 months, how many partners have you had sex with?"
"In the past 12 months, how many partners have you had sex with?"
"Is it possible that any of your sex partners had sex with someone else while they were still in a sexual relationship with you?"
"To understand your risks for STDs, I need to understand the kind of sex you have had recently."
"Have you had vaginal sex, meaning 'penis in vagina sex'?" If yes, "Do you use condoms: never, sometimes, or always?"
"Have you had anal sex, meaning 'penis in rectum/anus sex'?" If yes, "Do you use condoms: never, sometimes, or always?"
"Have you had oral sex, meaning 'mouth on penis/vagina'?"
For condom answers:
If "never": "Why don't you use condoms?"
If "sometimes": "In what situations (or with whom) do you use condoms?"
3. Prevention of pregnancy
"What are you doing to prevent pregnancy?"
4. Protection from STDs
"What do you do to protect yourself from STDs and HIV?"
5. Past history of STDs
"Have you ever had an STD?"
"Have any of your partners had an STD?"
Additional questions to identify HIV and viral hepatitis risk include:
"Have you or any of your partners ever injected drugs?"
"Have your or any of your partners exchanged money or drugs for sex?"
"Is there anything else about your sexual practices that I need to know about?"