Sexual History Taking Toolkit

SPNS Sexually Transmitted Infections Initiative

Tools to help clinics improve screening, testing, and treatment of common bacterial STIs among people with HIV or at risk for HIV.

STI Testing Best Practices for Health Clinics

Brief description of recommendations for clinics seeking to improve their STI testing. Show it at your next staff meeting!

Tools

These resources were developed under HRSA's Improving Sexually Transmitted Infection Screening and Treatment among People with or at Risk for HIV Project (a SPNS initiative), which implemented needs-based training and clinical and non-clinical interventions. Users are free to adapt these tools to their clinic needs.

This comprehensive sexual history template was created for use by clinicians to assess potential health risks associated with an individual’s sexual history and behavior. This template includes questions that are recommended at the initial patient visit for baseline, and some that should be asked at the initial visit as well as at follow-up visits for routine screening and testing of bacterial sexually transmitted infections (STIs). Users are free to modify the template for their own settings.

Download Template (MS Word)

Template for clinicians to assess potential STI risks associated with an individual’s sexual history and behavior. Includes questions recommended at each patient visit after the initial visit (when the more comprehensive sexual history is completed) for routine screening and testing of bacterial STIs.

Download Survey (MS Word)

Download Routine Clinic Visit STI Screening Flow (PDF)

  • Patient completes sexual history using ACASI
  • Clinical team member (RN, LPN, MA, NP, MD, DO, PA) reviews the ACASI sexual history summary page or answers to ACASI sexual history questions to identify needed GC/CT NAATs (oral, genital, rectal) & syphilis testing
  • MD/DO/NP/PA places order for needed tests OR RN/MA uses standing order to place order for needed tests
  • Patient counseled by RN/LPN/MA on GC/CT NAAT specimen self-collection at each needed anatomical site (throat swab, rectal swab, urine or genital swab) & given test kit(s), one for each anatomical site needed, for collection in bathroom or exam room OR if patient prefers provider to collect, RN/MA/LPN/MD/DO/NP/PA collects specimen
  • GC/CT specimens are labeled for site of swab, & either urine or site of swab (throat, rectal, urethral, vaginal, or cervical) is written on the lab request
  • If indicated in sexual history, blood for syphilis serology is collected along with any other needed blood specimens
  • REMEMBER, patients reporting ANY of the following since last clinic visit or sexual history:
    • condomless sex with ≥2 different sexual partners
    • exchange sex for commodities
    • using drug(s) or alcohol with sex
    • partner known by patient to be having sex with others
    • a new sexual partner (since last screening)
  • need to be tested for GC/CT at each site of reported intercourse (throat, genital, rectal) & syphilis every 3-6 months.
  • All pregnant women need vaginal GC/CT & syphilis testing in the 1st trimester & again in the 3rd trimester (as well as throat & rectal GC/CT NAAT if indicated by history).
  • All patients diagnosed with GC &/or CT need to be retested 3 months after treatment. People with HIV diagnosed with syphilis should be retested 3 months aftertreatment. For those without HIV, retest in 6months.

Abbreviations:

  • ACASI – audio computer-assisted self-interview
  • CT – chlamydia
  • GC – gonorrhea
  • NAAT – nucleic acid amplification test

Standing Orders for Ryan White HIV/AIDS Program Funded Clinics

Bacterial Sexually Transmitted Disease Screening and Testing Services for Patients Getting Lab Work Done Before HIV Monitoring Scheduled Appointment.

Download Standing Orders (MS Word)

Improving Routine STI Screening and Testing

Learn from participating Ryan White HIV/AIDS Program agencies in this initiative as they describe sexually transmitted infection screening and testing procedures, including risk assessments, and self-testing.

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