Taking a Sexual History

1. Taking a Sexual History Pavan K. Guram

2. 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

3. 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

4. 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.

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

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

7. 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

8. Chi chi man - a homosexual. • Cho-mo - a child molester. • Crime scene sex - sexual intercourse with a woman who is menstruating. • DATY - dining at the Y; cunnilingus. • Do-me queen - a selfish, submissive sexual partner, especially in a male homosexual relationship. • Drab - wearing men’s clothing; dressed as aboy. • 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.

9. 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.

10. 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.