A new chapter unveiled at the 2025 Argentine Society of Infectious Diseases (SADI) Congress updates evidence-based guidelines for sexual health histories. The seven core question areas are designed to guide patient-centered conversations and reduce stigma in clinical settings. Thailand’s healthcare community can apply these insights to improve trust, confidentiality, and access across public and private sectors.
In Thai culture, discussions about sexual health can be sensitive and stigmatized. The adapted framework reflects a global effort to destigmatize services and improve care. Data from Thailand’s Ministry of Public Health shows ongoing gaps in STI screening and patient trust, underscoring the need for clearer communication tools and empathetic clinical approaches. The guidelines offer a pragmatic model for Thai practitioners to foster confidentiality, trust, and patient-centered care within local contexts.
Clinicians note that starting conversations about intimate topics is a common barrier. An outpatient physician at a major metropolitan hospital and a researcher at a medical university emphasize creating a comfortable environment before discussing sexual practices. Empathy, privacy, and inclusivity are foundational for accurate diagnoses and effective STI prevention.
The seven domains structure a comprehensive sexual health history:
- Reason for Consultation: Explore motivation for the visit and presenting symptoms to guide testing and examinations.
- History of STIs: Inquire about prior infections, risk perceptions, and prior HIV or hepatitis screenings to clarify current vulnerabilities.
- Sexual Partners: Respectfully ask about the number and gender of partners, timing of last contact, and relationship status or orientation.
- Sexual Practices: Discuss activities and contexts that influence risk, including group or transactional sex, sex toy use, and related substance use.
- STI Protection: Assess condom use, vaccination status for hepatitis A/B and HPV to tailor prevention and referrals.
- Pregnancy Prevention: Discuss contraception, pregnancy plans, and access to safe abortion services in a nonjudgmental manner.
- Other Sexual Health Issues: Screen for sexual satisfaction, function, psychological well-being, and potential gender-based violence to ensure holistic care.
A notable feature is attention to the initial clinical interaction—greetings, eye contact, and supportive body language—to reduce anxiety and build rapport. Questions should use simple, clear language with space for patient explanations and sensitivity to nonverbal distress cues.
Experts involved highlight that local epidemiology, diagnostic options, and region-specific treatments should inform guidelines. This locally attuned approach resonates in Thailand, where STI patterns and healthcare access differ from Western contexts. Data from Thai health authorities supports tailoring guidelines to national realities.
The guidance calls for heightened sensitivity toward higher-risk populations, including transgender individuals, sex workers, men who have sex with men, adolescents, prisoners, people who inject drugs, and migrants. In Thai society, stigma remains a barrier. The recommendations encourage flexible clinic hours, nonassumptive language, and gender-neutral terminology. Training on personal biases for all healthcare staff is essential.
Thailand has progressed in integrating sexual health education, especially in urban centers. Rural areas and conservative communities often lack access and confidence to seek care. The seven-question framework can be adapted to Thailand’s social and linguistic landscape, with practical supports such as scripted introductions and partnerships with local non-governmental organizations to reach vulnerable groups who may avoid state facilities. Delivery enhancements, including evening clinics and mobile outreach, are encouraged to reach factory workers and sex workers who struggle to visit clinics during regular hours.
Internationally, the guidelines align with best practices endorsed by leading health organizations. Advancing stigma-free, patient-centered consultations is increasingly recognized as vital for preventing STI transmission and strengthening trust in the healthcare system. Telemedicine and digital tools are expected to play larger roles in sexual health care, with confidential online consultations, home testing options, and decision-support technologies being explored in several Thai cities.
For Thai readers, the core message is clear: open communication, mutual respect, and nonjudgmental care are fundamental. Patients should expect inclusive, confidential services tailored to their needs. Healthcare providers are urged to pursue ongoing training and familiarize themselves with updated guidelines that balance technical precision with compassionate care.
As Thailand modernizes public health and moves toward broader universal health coverage, policymakers and clinicians can adapt these seven questions to local realities. By fostering open, holistic sexual health conversations, Thailand can reduce STI burden and set a regional standard for patient-centered care.
Practical steps for readers include advocating for respectful consultations, seeking clinics with trained and empathetic providers, and encouraging friends and family to prioritize regular sexual health checkups. Health professionals are encouraged to pursue continuing education, use culturally appropriate resources, and collaborate with community organizations to broaden reach and impact.