Sexual history is taken prior to pre test counseling that will help in accessing the clients high risk behaviour and all his knowledge, attitude, perception and behaviour.

• A sexual health history is a vital part of assessing a patient's sexual health
• Taking a sexual health history is essentially no different from taking a history relevant to any other aspect of health
• A sexual health history is really an essential part of any full & complete medical history
• Doctors should practice taking sexual health histories opportunistically from any sexually active patients (and especially young people) when they are dealing with something else minor (like suturing a wound, removing a skin lesion, checking a plaster, giving vaccinations etc)
• Ask about use and knowledge of safer sex practices and use this as an educative opportunity
• Create an environment in which the patient feels safe to talk about sexual behaviour and sexuality
• Give assurance of confidentiality
• Explain why you are asking for this information
• Use appropriate language - avoid jargon and technical terms
• Make no assumptions about the patient's sexual orientation or sexual practices
• Start with less threatening questions before progressing to more sensitive questions
• Recognise your own biases and then do not let them intrude
• Questioning about the partner's sexual health and risk factors is always necessary
• Ask about use and knowledge of safer sex practices and use this as an educative opportunity

• Assess risk
• Potential for exposure to HIV, other STIs
• Determine when exposure to risk occurred
• Previous testing
• When, where
• Is result available?
• Explain test
• Why the test is done (treatment, improve outcomes, reduce risk of transmission)
• How the test is done
• For infections with window periods, discuss implications, advise if and when repeat testing will be necessary
• Confidentiality issues: how confidentiality will be ensured by the health service, how the patient should protect their own confidentiality (eg carefully consider who they will tell)
• Inform regarding legal requirements for and mechanisms of notification
• Obtain informed consent
• Discuss how and when to obtain results
• It is particularly recommended all HIV (and probably Hepatitis B and Hep- atitis C) results are given in person by medical practitioners

• Demographic information
• Age: young age is a risk factor both for physiological reasons (cervical ectopy, less immunity) and behavioural reasons (more partners, rapid partner change, less condom use)
• Gender
• Area of residence
• Partnership status (don't assume partnership status reflects level of risk)
• Assessment of sexual function/dysfunction
• Is the problem primary or secondary?
• At what stage of the sexual response cycle does the problem occur? Drive (libido), arousal (erection, lubrication), release (orgasm, ejaculation), resolution (refractory period)
• Is the problem related to context (work stress, financial worries, occurs with spouse but not with lover etc)?
• What has happened to precipitate the consultation?
• Relationship issues
• Cultural factors
• Knowledge and experience of sex
• Personality factors
• Beliefs surrounding sex
• Infidelity

• Providing a safe, non-judgmental environment enables the patient divulge their sexual history
• Demonstrate interest and understanding
• Most people will talk freely about their sexual history if the above two points are practiced - many seem to welcome the opportunity, especially if the practitioner seems quite at ease and non-threatened by sexual matters
• Be respectful
• Discuss confidentiality
• Explain why you are asking the questions you ask
• Start with less-threatening open ended questions before progressing to more specific sensitive questions
• Make no assumptions about the persons sexual orientation, sexual behaviour

• Avoid technical language
• Use clear and simple words
• Check that the patient understands, adapt to the patient's level of understanding
• Identify what the patient means if he/she uses slang
• Ask specific questions
• Use visual aids to discuss anatomy and function of the sexual organs