How can we reimagine the sexual history to make it easier and better for providers and patients?
The GOALS Approach is an evidence-based, sex-positive strategy for making sexual history conversations less awkward and more effective.
What are the 5 steps of the GOALS Approach?
Give a preamble that emphasizes sexual health
Offer opt-out HIV/STI testing and information
Ask an open-ended question
Listen for relevant information and probe to fill in the blanks
Suggest a course of action
Why Use the GOALS Approach?
Sexual history taking can be an onerous and awkward task that does not always provide accurate or useful information for patient care. Standard risk assessment questions (e.g., How many partners have you had sex within the last 6 months?; How many times did you have receptive anal sex with a man when he did not use a condom?) 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.
The GOALS framework is designed to streamline sexual history conversations and elicit information most useful for identifying an appropriate clinical course of action. The “goal” of the GOALS framework is to reimagine the sexual history to make it easier and better for providers and patients.
Additional Resources
Self-Paced Training
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”I’ve incorporated the GOALS Framework into my clinic visits and I can say that I’m having more patient-centered interactions overall. It [GOALS] helps me to have a more positive footing with my patients and avoids some of the shaming questions that we once used. Patients are able to be more honest about their sex lives and I can better help them stay safe in their practices.”
— Caroline Carnevale, FNP, MPH, AAHIVS