Kurth Ann E, Holmes King K, Hawkins Renee, Golden Matthew R
Biobehavioral Nursing and Health Systems, University of Washington (UW) School of Nursing, Seattle, Washington 98195-7266, USA.
Sex Transm Dis. 2005 Jun;32(6):370-6. doi: 10.1097/01.olq.0000154499.17511.0a.
Optimal elements of a sexual history for sexually transmitted infection (STI) and HIV risk assessment remain undefined.
The goal of this study was to describe sexual histories in use at STI clinics across the United States.
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).
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.
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.
用于性传播感染（STI）和HIV风险评估的性史最佳要素尚未明确。
本研究的目的是描述美国各地性传播感染诊所使用的性史情况。
本研究包括对人口超过20万的城市中的机构进行横断面调查（n = 65）。在每个城市中，随机选择一家公共卫生性传播感染诊所（占样本的71%）或其他性传播感染护理机构（29%），并索要性史表格。从48家诊所获得了信息（回复率为74%）。
大多数表格记录了症状和既往性传播感染（96%）、避孕套使用情况（88%）、其他避孕措施（85%）以及性伴侣数量和性别（83%）等信息。常见的HIV风险问题包括注射吸毒（IDU；94%）、以性换毒品或金钱（58%）以及与HIV阳性或注射吸毒者性伴侣发生性行为（52%）。对风险发生时间（接触期）的确定从过去14天到过去12个月不等，只有38%的诊所使用任何一个特定时间段。很少有性史（17%）纳入了针对男男性行为者（MSM）的问题。只有2家（4%）有空间记录性伴侣HIV状况的性行为信息。很少专门评估阴道和肛交时的避孕套使用情况（13%），也很少探讨避孕套使用问题（10%）。大多数表格记录了性传播感染/艾滋病咨询情况，尽管很少（25%）包括具体的风险降低计划。
性史差异很大。尽管难以实现，但通过就性史中使用的核心问题达成共识，可能会改善性传播感染/艾滋病的护理、监测和预防工作。
