taking a sexual history

department of health and human services

centers for disease control and prevention

taking a sexual history

a guide to
For a more complete picture of your patient’s

health, the following guide offers parameters

for discussion of sexual health issues. A sexual

history needs to be taken during a patient’s 

initial visit, during routine preventive exams,

and when you see signs of sexually transmitted

diseases (STDs). The dialogue lends itself to the

opportunity for risk-reduction counseling and

sharing information about behaviors that may

place your patient at risk of contracting STDs.

A sexual history allows you to identify those

individuals at risk for syphilis and other STDs,

including HIV, and to identify appropriate

anatomical sites for certain STD tests.
Please note:

As part of the Syphilis Elimination Effort 

(SEE), this guide was created to help you 

determine the risk of syphilis and other STDs

among your patients. The impact of STDs on 

a patient’s health can range from irritating 

to life threatening. Sexual health can greatly

impact overall quality of life.

This guide is meant to provide you with a 

sample of the discussion points and questions

that may be asked. It is not meant to 

be a standard for diagnosis or a complete 

reference for sexual history taking. This guide

may need to be modified to be culturally 

appropriate for some patients based on 

culture or gender dynamics.
Some patients may not be comfortable

talking about their sexual history, sex

partners, or sexual practices. Try to put

patients at ease and let them know 

that taking a sexual history is an important part of a regular medical exam or 

physical history.

taking a sexual history
Taking a 

Sexual History

dialogue with patient

> I am going to ask you a few questions 

about your sexual health and sexual 

practices. I understand that these 

questions are very personal, but they 

are important for your overall health.

> Just so you know, I ask these questions 

to all of my adult patients, regardless 

of age, gender, or marital status. These 

questions are as important as the 

questions about other areas of your 

physical and mental health. Like the 

rest of our visits, this information is 

kept in strict confidence. Do you have 

any questions before we get started?
the 5 

“

p

”

s of sexual healthThe five “P”s stand for:

• Partners

• Practices

• Protection from STDs

• Past history of STDs

• Prevention of pregnancy

These are the areas that you should

openly discuss with your patients. 

You probably will need to ask 

additional questions that are 

appropriate to each patient’s 

special situation or circumstances.
The 5 “P”s
Partners 1

To assess the risk of contracting an 

STD, it is important to determine the

number and gender of your patient’s 

sex partners. Remember: Never make

assumptions about the patient’s 

sexual orientation. 

If only one sex partner is noted over 

the last 12 months, be certain to inquire

about the length of the relationship. 

Ask about the partner’s risk factors, 

such as current or past sex partners 

or drug use. 

If more than one partner is noted in 

the last 12 months, be certain to explore

for more specific risk factors, such as

condom use (or non-use) and partner

risk factors.
1. Partners

dialogue with patient

> Are you currently sexually active? 

(Are you having sex?)

If no, have you ever been sexually active?

> In recent months, how many sex partners

have you had?

> In the past 12 months, how many sex 

partners have you had?

> Are your sex partners men, women, 

or both?

If a patient answers “both” repeat first 

two questions for each specific gender.

If a patient has been sexually active in the

past, but is not currently active, it is still

important to take a sexual history.
Practices 2

If a patient has had more than one 

sex partner in the past 12 months or has

had sex with a partner who has other

sex partners, you may want to explore

further his or her sexual practices and

condom use. 

Asking about other sex practices will

guide the assessment of patient risk,

risk-reduction strategies, the determination of necessary testing, and the 

identification of anatomical sites from

which to collect specimens for syphilis

and other STD testing.
2. Practices

dialogue with patient

> I am going to be more explicit here 

about the kind of sex you’ve had over the

last 12 months to better understand if

you are at risk for STDs.

> What kind of sexual contact do you have

or have you had? Genital (penis in the

vagina)? Anal (penis in the anus)? Oral

(mouth on penis, vagina, or anus)?
Protection from STDs

3

To learn more about the patient’s sexual

practices, use open-ended questions.

Based on the answers, you may discern

which direction to take the dialogue.

You will need to determine the appropriate level of risk-reduction counseling

for each patient. 

If a patient is in a monogamous relationship that has lasted for more than 12

months, risk-reduction counseling may

not be needed. 

However, in other situations, you may

need to explore the subjects of abstinence, monogamy, condom use, the

patient’s perception of his or her own

risk and his or her partner’s risk, and 

the issue of testing for STDs.
3. Protection

from STDs

dialogue with patient

> Do you and your partner(s) use any 

protection against STDs?

If not, could you tell me the reason?

> If so, what kind of protection do you use?

> How often do you use this protection?

If “sometimes,” in what situations or 

with whom do you use protection?

> Do you have any other questions, or are

there other forms of protection from STDs

that you would like to discuss today?
Past History of STDs

4

A history of prior STDs may place your

patient at greater risk now.
4. Past History 

of STDs

dialogue with patient

> Have you ever been diagnosed with an 

STD? When? How were you treated?

> Have you had any recurring symptoms 

or diagnoses?

> Have you ever been tested for syphilis, 

HIV, or other STDs? Would you like to be

tested?

> Has your current partner or any former

partners ever been diagnosed or treated 

for an STD? Were you tested for the 

same STD(s)?

If yes, when were you tested? What was

the diagnosis? How was it treated?
Prevention of Pregnancy

5

Based on partner information from 

the prior section, you may determine

that the patient is at risk of becoming

pregnant or of fathering a child. If so,

first determine if a pregnancy is desired.

Questions should be gender 

appropriate.
of Pregnancy

5. Prevention 

dialogue with patient

> Are you currently trying to conceive or

father a child?

> Are you concerned about getting pregnant

or getting your partner pregnant?

> Are you using contraception or practicing

any form of birth control? Do you need

any information on birth control?
completing the history dialogue with patient

> What other things about your sexual

health and sexual practices should 

we discuss to help ensure your good

health?

> What other concerns or questions

regarding your sexual health or 

sexual practices would you like 

to discuss? 

By the end of the interview session, 

the patient may have come up with

information or questions that he or 

she was not ready to discuss earlier.
the History

Completing 

At this point, thank the patient for being

open and honest and praise any protective

practices.

For patients at risk for syphilis and other

STDs, be certain to encourage testing 

and offer praise for protective practices.

Explain that syphilis prevention methods 

(or strategies) can include abstinence,

monogamy, i.e., being faithful to a single 

sex partner, or using condoms consistently

and correctly. These approaches can avoid

risk (abstinence) or effectively reduce risk 

for getting syphilis (monogamy, consistent

and correct condom use).

After reinforcing positive behavior, it is

appropriate to specifically address concerns

regarding high-risk practices. Your expression

of concern may help the patient accept a

counseling referral, if one is recommended.

Notes

Notes
Notes

Notes

information

For more information, please visit: 

www.cdc.gov/std/see/