Patient responses to generalized sexual history questions may not accurately estimate actual risky activities

Background – Clinicians frequently rely upon patient-provided information to determine an individual's risk of sexually transmitted disease and screening eligibility. However, general questions may be inadequate to elicit accurate risk estimation information.

Objective – To determine consistency of patient sexual history survey responses.

Methods – Emergency department patients aged 15-34 completed a history of sexual activity in the past year; subsequently analyzed for consistency between general and specific sexual activity questions.

Results (preliminary; will end at 300 each females/males; correlations will be calculated then) – Of 395 participants, mean age was 25.1 years, 65.6% were female, and 90.4% reported being sexually active (Sex12). Of 20 males reporting no Sex12, 5% reported providing male oral sex (mOS), 25% provided female OS (fOS), and 20% received fOS. Of 18 females reporting no Sex12, 11.1% reported providing mOS and 11.1% receiving mOS. Of all 117 males reporting no male partners, 1.7% reported providing mOS and receptive anal sex. Of all 230 females reporting no female partners, 0.9% reported providing fOS and 1.7% receiving fOS. Finally, of the 125 males stating they had sex with females (vs. ‘males', ‘both', ‘other'), 4.0% also reported >0 male partners, while 2.9% of 240 females similarly stating only opposite gender sex reported >0 female partners.

Conclusions –Preliminary analysis shows that patient responses to general questions regarding sexual activity (e.g. “Are you sexually active?”) are not necessarily sensitive enough to ascertain infection risk and screening eligibility. More direct questions, likely requiring increased clinician time and comfort, may be required.