5 P's
Sexual History
Five questions, normalized as routine — build comfort first.
The board-friendly take on sexual history is that you take it on every adult, you take it the same way every time, and the 5 P's give you the structure. Partners (number, gender), Practices (anal, oral, vaginal), Protection (condom use consistency), Past history of STIs, and Pregnancy intent or prevention. Normalizing the questions matters — frame them as routine, not as a probe — and document specifics rather than impressions. AANP exam vignettes use the 5 P's to test whether you ask the right follow-up question rather than ordering reflexive screening, and to confirm you don't skip the conversation in older or partnered adults.
- PPartnersNumber in last 12 months; gender(s); new partners recently.
- PPracticesOral, vaginal, anal; condom use consistency.
- PPrevention of pregnancyCurrent method; efficacy; intention.
- PProtection from STIsCondom use; PrEP; HPV and hepatitis vaccines.
- PPast STIsPrior diagnoses; last testing; partners notified/treated.
Clinical Context
CDC-endorsed structure for sexual history taking. Normalize the ask: "I ask all my patients these questions — they help me keep you healthy." Confidentiality matters especially for adolescents and young adults.
Answers drive STI screening priorities and risk-reduction counseling (HIV, hepatitis, syphilis, chlamydia, gonorrhea). Update annually in sexually active adults, more often with risk factors. AANP primary-care questions test the 5 P's as standard-of-care for routine visits.
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