ID – age, occupation
CC
Permission – I have some routine questions.
Partners
- Sexual activity
- Currently
- Total number of partners
- Risk behaviour of partners
- Orientation – men, women, or both
Practices
- Anal, oral, vaginal
- Use of protection
- Consistency of use
ROS
- Discharge, bleeding
- Pain with intercourse, on urination
- Sores, lumps
- Itching, genital warts
Risks
- Have you or your current partner . . .
- Have or ever had an STD
- Diagnosis, treatment
- Tested for HIV
- Blood transfusion (between 1978-1985)
- Multiple partners
- Impaired judgement from EtOH or drugs
- Sexual contacts during travel
- Pay for sex or receive money for sex
- Have or ever had an STD
Street Drugs
- Type, route
- Needle care
Miscellaneous
- Needle stick injury (HCW, dentists, dental hygienists)
- Tattoo
- Sexual abuse