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I would like to commend the authors for their informative review, “A practical approach to the diagnosis and management of chlamydia and gonorrhea.” I plan to distribute this article to colleagues and learners as a helpful practice tool.
As a reproductive and sexual health-focused family physician, medical educator, and advocate, I also firmly believe in the importance of conducting a thorough sexual health history. However, I respectfully disagree with the suggested approach to taking a sexual history based on the 5 Ps outlined by the Centers for Disease Control and Prevention (CDC), as it fails to facilitate a comprehensive assessment. While the CDC's guide primarily aims to assist healthcare providers in assessing a patient's infection risk, I propose following an alternative approach put forth by the National Coalition for Sexual Health, and supported by the CDC, in which the 5 Ps are modified and expanded to include the 3 additional Ps: pleasure, problems, and pride. Incorporating these components into a sexual history ensures a more comprehensive, patient-centred, and trauma-informed approach and communicates to the patient that their provider cares about their sexual health beyond solely assessing their infection risk.
Furthermore, when asking about a patient's partners, Table 1 suggests the questions, "What is/are the genders of your sexual partners?" and "Do your partners have other sexual partners? What is/are their gen...
Show MoreCompeting Interests: None declared.References
- 1. Altarum Institute. Sexual Health and Your Patients: A Provider’s Guide. Washington, DC: Altarum Institute; 2016. Updated 2022. Available: https://nationalcoalitionforsexualhealth.org/tools/for-healthcare-providers/asset/Provider-Guide_May-2022.pdf (ac
- 2. Canada Institutes of Health Research. What is gender? What is sex? Ottawa: Government of Canada. 2023. Available: https://cihr-irsc.gc.ca/e/48642.html (accessed 2023 June 19)