Brief Sexual Histories and Routine HIV/STD Testing by Medical Providers

Abstract

Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts.

Access to post-exposure prophylaxis following sexual exposure for men who have sex with men in an Irish healthcare setting

“…We hypothesise factors including departmental pressures including staff availability, unawareness of PEP indications and unfamiliarity with sexual history taking. Lanier et al 29 demonstrate less than half of healthcare providers conduct sexual history taking with patients. 29 We identified a disparity in access to PEP for MSM, representing missed opportunities to utilise a targeted intervention known to reduce HIV transmission in MSM.…”

“…Lanier et al 29 demonstrate less than half of healthcare providers conduct sexual history taking with patients. 29 We identified a disparity in access to PEP for MSM, representing missed opportunities to utilise a targeted intervention known to reduce HIV transmission in MSM. Possible reasons include poor knowledge of PEP indication, availability and administration for UPSI.…”

Antiretrovirals for Primary HIV Prevention: the Current Status of Pre- and Post-exposure Prophylaxis

“…Patient-provider discussions about sexual orientation and HIV risk behaviors are infrequent in primary care settings due in part to patient and provider discomfort with discussing sensitive topics and lack of provider training [92–94], so novel approaches to facilitating these discussions are needed. In-person or webinar trainings to enhance providers’ interviewing skills, structured questionnaires that practitioners can utilize to elicit comprehensive sexual histories [95], routine collection of sexual orientation and gender identity (“SOGI”) data by clinics [96], and algorithms that incorporate patient-reported data to generate personal estimates of risk [97, 98] have been explored to enhance risk assessments, though the effectiveness of these interventions requires further evaluation.…”

The Importance of Sexual History Taking for PrEP Comprehension Among Young People of Color

“…37,38 Furthermore, personal relevance of information may be critical to message “involvement,” which has significant impacts on cognitive processes that govern message comprehension, including attention and elaboration. 39 Finally, despite evidence which highlights the importance of sexual history taking in clinical settings, 40 research has yet to examine whether engaging in discussion about one’s own risk behavior prior to learning about PrEP impacts comprehension.…”