safe sexual practices

Every patient should be asked about his or her sexual practices during the PMH (past medical history)

It is important to determine which patient need counseling

1) sexually inactive patinet; may be rarely found on the exam, he she may need counseling for sexual problems. But it is not common

Tip: if a patient is not sexually active you should ask about the reason for that. There might be some medical/psychiatric problem for that

2) Low risk patinet; patient active only with one partner, eg with spouse or the one with multiple partners, but regualry using condoms is a low risk patient.

Counseling is generally not needed for this gourp

Tip: the later one should be aprreciated for obsrving safe sexual practices, you can say

I am glad to know that you are observing safe sexual practices and I hope that you will continue this in future.

3) High risk patinet; This group includes the patients having more than one partner with irregular condom use or male homosexual even with one partner.

Counsling is must for this gourp and they sould also be encouraged to take HIV test, if status is not known

Appropriate transition sentence should be used

You can ask the patient as follows

Mr XYZ now I am going to ask a few questions about your sexual practices, let me assure you its going to be strictly confidential between you and me; is it ok with you?

Pause and let the patient respond

Then proceed as

Are you sexually active?

if pt says yes, ask

who is your partner?

pt will tell you about his/her partners, then ask

any other partners

if the reply is yes, ask

do you relate sexually to males, females or both

then you should ask

do you use any method of contraception like condoms?

if the patient falls in the high risk group he should be counseled

Make an eye contact and say:

Mr XYZ being your physican i am much concerned about you health*. I need to warn you that you are not observing safe sexual practices
It puts you at risk of getting STDs (sexually transmitted disease) whicn include hepatitis and even aids

Pause to see the response, then continue

I would strongly recommend you to use condoms regularly. (If patinet or partner is on OCPs you can add) I would also like to tell you that Oral Contaceptive pills dont protect against sexually transmitted disease.

Pause to note response and then say

I would also like you to take a blood test for HIV

if you need any help dont hesitate to contact me. I am here to assist you


The patinet showing positvie response should be appreciated.


Tip: For unsafe sexual practices, you have to

1) ask screening questions

2) recognize the high risk patinet

3) show your concern

4) tell about the main health hazards

5) advise to use condoms

6) advise to take HIV test

7) encourage and appreciate positive response

8)offer help and assistance