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Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers

A Collaboration of the National Association of Community Health Centers (NACHC) and the National LGBT Health Education Center, The Fenway Institute, Fenway Health


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For patients and the health centers that serve them, sexual health care and prevention interventions mean routine screening of physical, behavioral, and social health factors and subsequent care management and coordination with public health through strong partnerships.  Skilled at patient engagement and proactive planned care, health centers can integrate a routine sexual health history as part of the overall health assessment, as well as routine screenings for HIV and hepatitis C based on the most current CDC recommendations.

Ultimately, health center attention to patient sexual health reflects a commitment to improved community health and patient-centered care.  In a health center that provides patient-centered care, the care team is prepared to:

  • Engage each patient in a discussion of his or her sexual health,
  • Collect data and information that guides clinical care decisions and goals of the care team and the patient regarding sexually transmitted infections (STIs) and sexual behaviors; and
  • Coordinate the sexual health preventive and treatment service needs of the patient.

To support health centers as they endeavor to better integrate sexual health into patient-centered care, we collaborated with the National Association of Community Health Centers (NACHC) to create Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers (Toolkit).  Designed specifically for use by health centers, but adaptable by other health care organizations, the Toolkit provides resources for establishing the routine collection of histories of sexual health within the primary care visit, including recommended screening questions and subsequent risk assessments; an algorithm; sample EMR templates, information on coding and billing; and working with special populations, including patients who are transgender and men who have sex with men.  Very importantly, the Toolkit provides contextual information to support integrating sexual health as a vital step for improved patient health and patient engagement, including a PowerPoint presentation that can be used for orienting staff to the key recommendations and concepts in the Toolkit.  The contents have been created so that they can be downloaded and adapted for individual health center use.

In addition to the toolkit, NACHC developed a companion video series entitled, HIV and Related Issues:  Engaging Patients and Communities.  This series of 4 short videos highlights health centers as an integral part of our nation’s response to the critical issues of HIV, hepatitis C, and sexual health.  Addressing these issues, often through active partnerships, is essential in a true Patient Centered Medical Home and in fully engaging our patients, families, and communities.

Education Center Director Harvey Makadon’s video Importance of Sexual Health in Primary Care can be seen below.  Click here to view the rest of the video series from NACHC.


View/Download the PDF Toolkit

View/Download the Staff Orientation PowerPoint presentation


E-mail Caryn Bernstein (NACHC) or Hilary Goldhammer (Fenway) with questions, suggestions or corrections.

In addition to the Toolkit, NACHC offers resources on Hepatitis C, HIV Screening, and LGBT Health as part of its sexual health framework.  The National LGBT Health Education Center offers additional resources on HIV prevention and other vital LGBT health issues.



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