Taking a Sexual History Pavan K. Guram

Overview of How to take a Sexual History Reasons for attendance Symptoms review Last sexual intercourse – date, patient gender, sites of exposure, condom use Previous sexual partners Previous STIs Women – LMP, contraception and cytology history HIV & Hep B&C risk Establish method of testing/giving results Establish competency/child protection if <16y/o

Initial Assessment Presenting complaint  Check the patient's reason for attending.  They may require advice or a check up or they may have a specific symptom. Symptom Review  Women Change in vaginal discharge Vulval skin problems Lower abdo pain Dysuria Changes in menstrual cycle/irregular bleeding  Men Urethral discharge Dysuria Genital skin problems

Partners Check the relationship of symptoms to LSI or to intercourse with a particular partner. Condom use - always, sometimes or never. Type of sex - e.g. oral, vaginal, anal. Symptoms or diagnosis of partner(s). Sex with same or opposite sex partners - check directly "Have you ever had sex with another man?" Sex work - "Have you ever been paid for sex?" Partners from overseas in the last year.

Menstrual History & Contraception What contraception is used? Is it used correctly? LMP – is there any chance of pregnancy? Menstrual problems eg IMB/PCB

Previous STIs Previous diagnoses Previous treatment Previous COMPLIANCE Treatment of partner(s) – consider re-infection

Other essentials… Past medical/surgical history Current medication inc. recreational drugs Allergies Smoking & alcohol use iv drug use with needle sharing (ever?) HIV/HepB&C risk

Chi chi man - a homosexual. Cho-mo - a child molester. Crime scene sex - sexual intercourse with a woman who is menstruating. DATY - d ining a t t he Y ; cunnilingus. Do-me queen - a selfish, submissive sexual partner, especially in a male homosexual relationship. Drab - wearing men’s clothing; dr essed as a b oy. Eve-teasing - harassment of, or sexually aggressive behavior toward, women or girls. Feederism - a fetish in which pleasure or sexual gratification is taken from the overfeeding or intentional fattening of one’s self or one’s partners. Fifi - a masturbatory substitute for a vagina. Fire crotch - a person with red (pubic) hair.

Freeball - to not wear underpants Get brain - to receive fellatio. Junk - the genitals or genital area; occasionally, the posterior. Lesbian bed death - the decline of sexual relations between a committed lesbian couple. Lolicon - the attraction of older men to girls or very young women. Pickle park - a public area, such as a park or roadside rest stop, where sexual liaisons between men are said to take place; in trucking, any roadside rest area. Piquerism - the derivation of pleasure, especially sexual gratification, from stabbing another person. Reflectoporn - a sexual fetish involving the display of nudity in reflective surfaces. Roasting - group sex involving one woman and more than one man.

Shrimp - to suck toes. Spermarche - a man’s first ever ejaculation of sexual fluids. Sticky rice - an East Asian who prefers romantic partners of the same race. Swardspeak - spoken by Filipino gay and transvestite men. Sweet in the pants - effeminate or homosexual. Tip drill - an unattractive person, male or female, esp. one who is used for sex or money. Tumpsy - a woman’s genitals. Two-spirited - homosexual, transgendered, or transsexual. Va-jay-jay - the vagina. Waps - a woman’s breasts.