title: A national survey of clinic sexual histories for sexually transmitted infection and HIV screening.
abstract: BACKGROUND
  Optimal elements of a sexual history for sexually transmitted infection (STI) and HIV risk assessment remain undefined.
  
  
  OBJECTIVE
  The goal of this study was to describe sexual histories in use at STI clinics across the United States.
  
  
  METHODS
  This study consisted of a cross-sectional survey of facilities in cities with populations >200,000 (n = 65). Within each city, a public health STI clinic (71% of the sample) or other STI care facility (29%) was randomly selected and sexual history forms were requested. Information was obtained from 48 clinics (74% response).
  
  
  RESULTS
  Most forms recorded information on symptoms and prior STI (96%), condom use (88%), other contraception (85%), and numbers and gender (83%) of sex partners. Common HIV risk questions were injecting drug use (IDU; 94%), sex for drugs or money (58%), and sex with an HIV-positive or IDU partner (52%). Ascertainment of time during which risks occurred (contact periods) varied from the past 14 days to the past 12 months, with only 38% of clinics using any 1 time period. Few histories (17%) incorporated questions for men who have sex with men (MSM). Only 2 (4%) had space to record information about sexual behaviors by the HIV status of the sex partner. Condom use was infrequently assessed specifically for vaginal and anal sex (13%), and condom use problems were rarely explored (10%). Most forms documented STI/HIV counseling, although few (25%) included specific risk reduction plans.
  
  
  CONCLUSIONS
  Sexual histories are highly variable. Although challenging to accomplish, STI/HIV care, surveillance, and prevention may be improved by developing consensus on core questions to be used in sexual histories.
authors.affiliation: Biobehavioral Nursing and Health Systems, University of Washington (UW) School of Nursing, Seattle, Washington 98195-7266, USA. akurth@u.washington.edu
authors.forename: Ann E
authors.initials: AE
authors.lastname: Kurth
authors.forename: King K
authors.initials: KK
authors.lastname: Holmes
authors.forename: Renee
authors.initials: R
authors.lastname: Hawkins
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
mesh_terms: D000554:Ambulatory Care Facilities; D015982:Bias; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008487:Medical History Taking; D018570:Risk Assessment; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology