Reimagine the sexual history to make it less awkward and more effective
The GOALS Approach is an evidence-based, sex-positive framework designed to streamline sexual history conversations and elicit the information most useful for identifying an appropriate course of clinician action.
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
The “GOAL” is to reimagine the sexual history to make it easier and better for providers and patients.
Patients want their healthcare providers to ask them about sexual health
But only
Emphasizing benefits—rather than risks—is more successful in motivating behavior
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 Approach is non-judgmental, puts the focus on the patient and their priorities, and normalizes universal testing.
Adopted or Endorsed by:
The AIDS Education and Training Center (AETC) National Coordinating Resource Center
The American Medical Association (AMA) Resource Library
And others!