Reimagine the sexual history to make it less awkward and more effective 

Patient Education         Staff Training           Injectable PrEP         Sexual History         Program Development         Buy-in

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. The “goal” is to reimagine the sexual history to make it easier and better for providers and patients.

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

Patients want their healthcare providers to ask them about sexual health

85% of patients say they want to talk about sexual health with their provider, but only 6% of providers take a sexual history at every visit

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.

The GOALS Approach has been adopted or endorsed by:

And others!