- Wash hands and introduce yourself
- Confirm the name and DOB of the patient
- Ask if you can talk to the patient about their sexual history
- Inform the patient that your conversation is confidential
Presenting complaint/reason for attendance
- Exacerbating/relieving factors
- Associated factors:
- Pelvic pain
- Ask if they have had these symptoms before
- Ask about previous STIs
- Where treated
- Test of cure?
Past medical history
- Any relevant conditions
- Any past surgery
- Affects reliability of microbial tests
- Over the counter medication
- Recreational drugs/chemsex
- What method
- Reliability (if relevant)
- LMP (first day)
- Cycle length, bleeding length
- Menstrual abnormalities
- Chance of pregnancy
Smear history (if >25 and <65)
- When was their last smear and result
- Any abnormal results in the past?
- Have they been pregnant before?
- How many pregnancies?
- How many deliveries?
- How many children?
- Method of delivery
- “I’m going to ask some personal questions that we ask everyone, just to help understand what’s going on.”
- Last sexual intercourse:
- When was it?
- Regular or casual partner?
- Length of relationship
- “Do you feel safe in this relationship?”
- Sex of partner?
- “Did you have vaginal sex? Oral sex? Anal sex?”
- “Receptive or insertive?”
- “Did you use condoms or no condoms?”
- Consistency of condom use
- Nationality of partner
- Repeat for previous sexual partners for the past 3 months
- Combine if there are many
Last passed urine
- How long since they passed urine?
- Needs to be several hours since passed urine for some tests to be accurate
HIV risk assessment
- Have you had an HIV test before?
- When was most recent?
- Have you had a partner known to be HIV positive?
- IV drug use or sex with an IV drug user
- Have you had sex with a man (men) or have any of your partners had sex with a man (women)
- Sexual partners outside Europe
- Have you ever paid for or been paid for sex?
- Medical treatment or blood transfusions abroad?
- Tattoos or piercings abroad?
- Drug use