A pioneering chapter presented at the 2025 Argentine Society of Infectious Diseases (SADI) Congress introduces updated, evidence-based guidelines aimed at transforming how doctors worldwide—including in Thailand—approach sexual health histories in patient care. The guidelines, published and discussed by the HIV and STI Commission and developed with input from leading infectious disease specialists, offer clinicians seven core question areas essential for comprehensive sexual health consultations. Their adoption marks a significant shift toward more inclusive, respectful, and effective patient interactions, with important lessons for Thai healthcare providers and the wider community.
In Thai culture, where conversations about sexual health remain taboo in many settings, the introduction of such structured guidelines reflects growing international calls to destigmatize and improve access to sexual health services. According to the latest Global AIDS Update by UNAIDS, and Thailand’s Ministry of Public Health data, continued gaps in STI screening and patient trust persist—often due to discomfort and lack of openness during medical consultations (UNAIDS, Thai MOPH). By equipping practitioners with concrete recommendations and clear communication tools, the Argentine guidelines offer Thai healthcare providers a model for fostering empathy, confidentiality, and patient-centered care.
The new recommendations begin by addressing a long-standing barrier in sexual health practice: the difficulty patients and doctors often experience when discussing intimate topics. As one of the guideline authors, an outpatient physician at Hospital de Infecciosas F.J. Muñiz and a researcher at ISALUD University, stated, “You cannot rush into conversations about sexual practices without creating a comfortable environment. A lack of empathy is often the first barrier to timely and appropriate care.” This approach, grounded in values of respect, privacy, and inclusion, provides a roadmap for clinicians to build trust with patients—crucial for accurate diagnoses and effective STI prevention.
Central to the guidelines are seven domains that form the backbone of a thorough sexual health history:
Reason for Consultation: Clinicians are advised to start by understanding a patient’s motivation for the visit and reviewing any relevant symptoms, guiding both examination and diagnostic testing.
History of STIs: Detailed questions about previous infections, risk perceptions, and past HIV or hepatitis screenings help clarify current vulnerabilities—a step often missed in rushed or uncomfortable consultations.
Sexual Partners: Rather than making assumptions, clinicians are urged to respectfully inquire about the number and gender of partners, time since last sexual contact, and any relevant details about relationship status or sexual orientation.
Sexual Practices: Recognizing that risks can vary by practice and setting, the updated guidelines emphasize exploring the types of sexual activities patients engage in—including group or transactional sex, sex toy use, and related substance use.
STI Protection: Evaluating frequency of condom use and vaccination status (including hepatitis A, hepatitis B, and HPV) allows clinicians to tailor prevention strategies and referrals.
Pregnancy Prevention: The guidelines call for open, nonjudgmental discussions around contraceptive use, pregnancy plans, and access to safe abortion services—a sensitive topic in both Argentine and Thai healthcare contexts.
Other Sexual Health Issues: Screening for sexual satisfaction, function, psychological concerns, and potential gender-based violence ensures that services are holistic and responsive to broader health needs.
A notable feature of the chapter, missing from many international protocols, is its focus on the initial interaction in the clinical setting. Experts emphasize the importance of greetings, eye contact, and supportive body language in reducing anxiety and building rapport. Questions are to be presented in simple, clear language, always allowing for patient explanations and signs of distress.
A member of the recommendation coordination team, an infectious-disease specialist at Hospital de Clínicas José de San Martín and professor at Buenos Aires University, told Medscape: “Instead of just copying the international guidelines, this version includes local epidemiology, available diagnostic methods, and treatments tailored to the regional context.” This approach, directly relevant to Thailand, where local patterns of STI prevalence and healthcare access differ from Western countries, emphasizes the importance of context-specific responses (Medscape).
For populations at higher risk—such as transgender individuals, sex workers, men who have sex with men, adolescents, prisoners, people who inject drugs, and migrants—the guide calls for even greater sensitivity and flexibility. In Thai society, some of these groups continue to face significant stigma and barriers to care, as documented in the recent National Strategy to End AIDS reports (Thai Red Cross AIDS Research Centre, WHO Thailand). The guidelines recommend offering clinic hours outside the standard schedule, avoiding assumptions about sexual activity or orientation, and using gender-neutral language whenever possible.
Expert voices behind the guidelines stress that the responsibility for improving sexual health consultations lies not only with doctors, but with the whole healthcare team. Training on personal biases—cultural or religious—should be mandatory, as even administrative staff can inadvertently discourage patients from seeking or returning for care.
Thailand has made progress in normalizing sexual health education, particularly in urban centers such as Bangkok and Chiang Mai. Still, rural communities and conservative segments often lack the resources or confidence to address sexual health needs openly. The seven-question approach, adapted creatively to Thailand’s social, educational, and linguistic circumstances, could serve as an effective, culturally sensitive framework. For example, many Thai providers may benefit from scripted introductions or communication guides when broaching difficult subjects, and from partnerships with local NGOs to support vulnerable groups who feel alienated in state facilities (Bangkok Post).
Importantly, the new guidelines also discourage unnecessary genital examinations and recommend delaying such steps until sufficient trust has been established. This is particularly meaningful for Thai patients, for whom modesty and privacy are culturally significant. Flexibility in service delivery, including evenings or mobile clinics, is further encouraged—a practice being piloted in some parts of Thailand to reach factory workers and sex workers who cannot easily visit clinics during the day (ILO Thailand).
On a broader scale, the research behind these guidelines echoes international best practices endorsed by UNAIDS, the World Health Organization, and leading sexual health advocacy groups. Creating stigma-free, patient-centered consultations is increasingly recognized as a best practice not only in preventing STI spread but also in building overall trust in the healthcare system.
Looking to the future, technology and telemedicine are poised to play a greater role in sexual health care delivery, potentially breaking down some of the remaining barriers for Thai youth and marginalized populations. Apps for confidential consultations, home testing kits, and AI-driven decision support for clinicians are all emerging as global trends, and pilot projects are underway in Bangkok and other cities (WHO Telemedicine Guidelines).
For Thai readers, the message is clear: effective sexual health care begins with open communication, mutual respect, and an environment free from judgment. Patients should feel empowered to expect inclusive, confidential services that focus on their needs—not stereotypes or assumptions. Healthcare providers, in turn, should seek ongoing training and familiarize themselves with updated guidelines that stress both technical skill and human compassion.
As Thailand continues its public health modernization and strengthens its commitments under the Universal Coverage Scheme, policymakers and practitioners alike should consider adapting these seven key questions for the local context. By fostering a culture in which sexual health is openly discussed and holistically addressed, Thailand can further reduce its STI burden and set a region-leading example in patient-centered care.
Practical recommendations for readers include advocating for patient rights during consultations, seeking out clinics staffed by trained and empathetic providers, and urging friends and family to prioritize regular sexual health checkups. Healthcare professionals are encouraged to participate in ongoing education, utilize culturally appropriate resources, and collaborate with community-based organizations to expand the reach and impact of these life-changing guidelines.
For more detailed information, consult reputable sources including the original Medscape article, the Thai Ministry of Public Health, and UNAIDS Thailand.