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The transgender five P's: Partners, prevention of pregnancy, protection from STIs, practices, and past history of STIs

The transgender five P's: Partners, prevention of pregnancy, protection from STIs, practices, and past history of STIs
Partners
Do you have sex with men, women, or both? Are any of them transgender?
In the past two months, how many partners have you had sex with?
In the past 12 months, how many partners have you had sex with?
Is it possible that any of your sex partners in the past 12 months had sex with someone else while they were still in a sexual relationship with you?
Prevention of pregnancy
What are you doing to prevent pregnancy?
Protection from STIs
What do you do to protect yourself from STIs and HIV?
Practices
To understand your risks for STIs, I need to understand the kind of sex you have had recently.
Have you had vaginal sex, meaning "penis-in-vagina" sex?*
If yes:
Do you use condoms: never, sometimes, or always?
Have you had anal sex, meaning "penis-in-rectum/anus" sex?
If yes:
Do you use condoms: never, sometimes, or always?
Have you had oral sex, meaning "mouth-on-penis/vagina"?
For condom answers:
If never:
Why do you not use condoms?
If sometimes:
In what situations (or with whom) do you not use condoms?
Past history of STIs
Have you ever had an STI?
Have any of your partners had an STI?
Additional questions to identify HIV and viral hepatitis risk:
Have you or any of your partners ever injected drugs?
Have you or any of your partners exchanged money or drugs for sex?
Is there anything else about your sexual practices that I need to know about?
STI: sexually transmitted infection; HIV: human immunodeficiency virus.
* Some transgender men (female to male) do not use the term "vagina" and may prefer to refer to the vagina as "front hole." It is generally best for the provider to ask patients what their preferred term for their genitals is.
Adapted from: Workowski KA, Berman SM. Sexually transmitted diseases guidelines, 2010. MMWR Recomm Rep 2010; 59 (No.RR-12): 3.
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