1 Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
AIDS Patient Care STDS. 2014 Mar;28(3):113-20. doi: 10.1089/apc.2013.0328. Epub 2014 Feb 24.
Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts.
临床医生在常规问诊中，有机会评估患者感染性传播疾病（STDs）的风险，包括人类免疫缺陷病毒（HIV），并为常规 HIV/STD 筛查提供适当建议。然而，只有不到 40%的医生会向患者询问性史，而且许多人在学校并没有接受过正式的性史培训。在与一家全国性的医生专业组织合作后，我们使用面授和网络研讨会的方式，对 26 名（来自美国和美国领土的）执业医生（58%为女性；中位数年龄=48 岁）进行了性史采集培训。培训在 6 小时的现场或 2 小时的网络研讨会中进行。我们评估了他们在常规医疗就诊中整合性史的培训后体验。我们评估了性史的使用情况和常规 HIV/STD 筛查情况。所有参与的医生都报告说，他们在性史采集方面有所改善，记录的性史和常规 HIV/STD 筛查数量有所增加。从定性评估中出现了四个主题：（1）需要更多的性史培训；（2）提供中性别的性史工具的重要性；（3）存在常规性史/检测的障碍；（4）对进行常规性史的医生来说存在意外的好处。这些发现被用于开发一个简短的、中性别的性史工具，用于临床使用。这项试点评估表明，医生愿意在临床实践中使用性史工具，以支持 HIV/STD 预防工作。
