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Consultation and clinical assessment for advanced clinical practitioners in sexual health

12 May 2022
11 min read
Volume 31 · Issue 9

Abstract

Sexual health is a very important aspect of patient wellbeing, but it is a topic health professionals still find challenging within patient consultations. The incidence of sexually transmitted infections (STIs) continues to rise, highlighting the need for all advanced clinical practitioners (ACPs) to understand the principles of a sexual health consultation as they may have to support patients who present with a sexual health concern, not purely those in specialist clinics and roles. This article provides a comprehensive overview of key points to include as part of a consultation and assessment within this area of specialist practice. Effective communication is a key skill for obtaining a thorough, clear history, allowing for more accurate differentials and a smoother patient journey. The environment and body language are two other considerations when undertaking a sexual health consultation. As with all histories, a systematic approach is essential and having a solid knowledge of the foundations of sexual health will enable the ACP to focus this history to obtain pertinent information.

Sexual health is an important aspect of patient wellbeing, and is just as important as physical or mental health. It is therefore a key element for all advanced clinical practitioners (ACPs) to consider within their practice. Sexual health, according to the World Health Organization (WHO) (2022), ‘requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled’. Despite sexual health being such an important aspect of wellbeing, health professionals still find the topic challenging to address within a consultation (Dyer and das Nair, 2013).

Sexual ill health has an impact not only in a social context but also in terms of financial resources, with an increasing number of sexually transmitted infections (STIs) placing increasing stress on the health service. Iacobucci (2020) reported that, in the past decade in England, there has been a 249% increase in cases of gonorrhoea and a 165% increase in cases of syphilis. The incidence of STIs in England has risen from 425 933 in 2017 to 468 342 in 2019 (Mitchell et al, 2020). These numbers highlight the need for all ACPs, whether or not in specialist sexual health roles, to understand the principles of a sexual health consultation as they may have to support patients who present with a sexual health concern outside purely specialist clinics.

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