Comprehensive STI Risk Assessment for Male Patients

Introduction to STI Risk Assessment

The Centers for Disease Control and Prevention recommends using the "Five P's" approach for comprehensive STI risk assessment in male patients, which includes Partners, Practices, Prevention of Pregnancy, Protection from STDs, and Past History of STDs 1

Healthcare providers should ask male patients if they have sex with men, women, or both, to assess their risk of STI transmission 1
Male patients should be asked about the number of partners they have had sex with in the past 2 months and 12 months to determine their risk of STI transmission 1
Healthcare providers should also ask if it is possible that any of the patient's sex partners in the past 12 months had sex with someone else while they were still in a sexual relationship with the patient 1

Healthcare providers should ask male patients about the kind of sex they have had recently to understand their risks for STDs 1
Male patients should be asked if they have had vaginal sex, anal sex, or oral sex, and if they use condoms never, sometimes, or always 1
If male patients report not using condoms, healthcare providers should ask why they do not use condoms, and if they use condoms sometimes, they should ask in what situations they use condoms 1

Healthcare providers should ask heterosexually active male patients what they and their partner(s) are doing to prevent pregnancy 1

Male patients should be asked what they do to protect themselves from STDs and HIV 1

Healthcare providers should ask male patients if they have ever had an STD, and if any of their partners have had an STD 1

Male patients should be asked if they or any of their partners have ever injected drugs, or exchanged money or drugs for sex 1
Healthcare providers should ask male patients in what situations or locations they typically meet their sexual partners 2

The American Academy of Pediatrics recommends that sexually active men who have sex with men be screened for STIs at least annually, or every 3-6 months if they have multiple or anonymous partners, use illicit drugs during sex, or have partners who engage in these activities 3
The American Academy of Family Physicians recommends that screening frequency for heterosexual men be based on individual risk factors and local prevalence rates 4, 5

Healthcare providers should reassure male patients about confidentiality to encourage disclosure of sensitive information 6