An evidence-based, sex positive strategy to make sexual history conversations less awkward and more effective for providers and patients
Sexual history taking can be an onerous and awkward task that does not always provide accurate, complete, or useful information for patient care. Standard risk assessment questions may be alienating to patients, discourage honest disclosure, and communicate that the number of partners or acts is the only component of sexual risk and health.
Increase rates of routine HIV/STI screening
The GOALS Approach was designed to:
Increase patients’ motivation for and commitment to sexual health behavior
Increase rates of universal biomedical prevention and contraceptive education
Enhance the patient-care provider relationship
How was GOALS developed?
What are the 5 steps of the GOALS Approach?
Give
Give a preamble that emphasizes sexual health.
The healthcare provider briefly introduces the sexual history in a way that de-emphasizes risk, normalizes sexuality as part of routine healthcare, and opens the door for the patient’s questions.
Objectives
Clear targets and key results to track progress.
Action
Executing daily tasks with intent and consistency.
Leadership
Guiding others and taking ownership of outcomes.
Suggest
Suggest a course of action.
Consistent with opt-out testing, the healthcare provider offers all patients HIV testing, 3-site STI testing, PrEP education, and contraceptive counseling, unless any of this testing is specifically contraindicated by the sexual history. Rather than focusing on any risk behaviors the patient may be engaging in, this step focuses specifically on the benefits of engaging in prevention behaviors, such as exerting greater control over one’s sex life and sexual health and decreasing anxiety about potential transmission.