Taking a sexual history and educating clients about safe sex.

The importance for taking a sexual history cannot be overstated. In the general patient population, the goal of the history is to assess the impact of illness on a client's sexual health. This information provides the nurse with a baseline for educating the client about his or her sexual adaptation to illness or surgery. Further, the sexual history is a part of the holistic nursing framework for patient care. Nurses working in settings in which they routinely care for clients with STDs have the additional responsibility of utilizing data from the history to educate clients regarding risk factors, re-evaluation of lifestyle behaviors, and preventative measures. Education of clients is crucial to decreasing the incidence of STDs. Nurses need to confront their own values and attitudes regarding sexuality as the first step to overcoming barriers in discussing sexuality with their clients. Additionally, education regarding human sexual behavior is important in expanding nurses' knowledge in this area. I have outlined interview techniques that can be helpful in eliciting the sexual history, emphasizing open-ended questions and ubiquitous statements. These techniques can be useful in both ambulatory and in-patient settings. The format for taking a sexual history has been addressed, with specific questions relevant to clients exposed to STDs. I have pointed to the need for considering the sexual history within the context of the client's life situation and suggested that information regarding sexuality be thoughtfully gathered, taking into account variables such as culture and sexual preference. Finally, this article addresses educating clients for safe sexual practices and emphasizes the need for nurses to counsel all sexually active clients concerning the risk factors for STDs. As the incidence of STDs continue to increase, and particularly as AIDS becomes increasingly widespread, nurses must be in the forefront of educating the public. As a health care profession advocating caring and commitment to holistic care, nursing can contribute to health promotion activities through addressing clients' sexual health.