A sexual health visit covers sexual practices, protection, pregnancy plans and infection risk in a private, respectful conversation. It is a chance to test for infections, offer vaccines and prevention and answer questions without judgment.
Key symptoms
- Often no symptoms; the visit is for screening
- Genital discharge, sores, itching or pain
- Burning with urination
- Pain during sex or bleeding after sex
- Concerns about pregnancy, contraception or sexual function
What you find on exam
- Sexual history with the 5 Ps: partners, practices, protection, past STIs, pregnancy plans
- Inspect skin, mouth, lymph nodes and genitals
- Pelvic or genital exam when there are symptoms
- Respect privacy, offer a chaperone, use inclusive language
Tests
- NAAT for gonorrhea and chlamydia at each exposed site
- HIV and syphilis testing; hepatitis B and C as indicated
- Pregnancy test when relevant
- Cervical cancer screening if due
Treatment basics
- Treat infections and arrange partner treatment
- HIV pre-exposure prophylaxis (PrEP) for people at higher risk
- HPV and hepatitis B vaccines
- Condoms, contraception and doxycycline post-exposure prophylaxis for selected patients
Red flags
- Pelvic pain with fever or a positive pregnancy test
- Signs of coercion, abuse or trafficking
- Possible HIV exposure in the last 72 hours: start post-exposure prophylaxis
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.