Teaching the art of trauma informed, comprehensive sexual health history

Title : Teaching the art of trauma informed, comprehensive sexual health history

Abstract:

STI’s affect certain patient populations at a disproportional rate due to health disparities. According to the Centers for Disease Control and Prevention (CDC), syphilis has made a resurgence in the past five years in the United States, rates having risen a drastic 80% since 2018 in the United States (CDC, 2024). Non-Hispanic Black or African American people accounted for a rate of almost 32 % of new cases of primary and secondary syphilis in 2022 (HHS, 2024). Syphilis rates increased 4% between 2021 and 2022 in MSM (men who have sex with men) population. MSM living with HIV accounted for 36.4% of syphilis cases in 2022. The rate of congenital syphilis has also increased dramatically with over 3,700 cases of infants born with syphilis in 2022- a rise of 32% from 2021 (CDC, 2023). It is imperative that nursing education remain current with evidence-based practice guidelines to meet the changing demands related to sexual healthcare. Conversations related to this topic can often feel awkward or intrusive and learning the art of asking sensitive questions will enhance the students’ ability to provide, trauma-informed care. Identifying high risk behaviors through the comprehensive sexual health history leads to the discovery of appropriate STI screening. Patients with history of sexual abuse, trauma or violence may have special needs related to sexual health that should be addressed (CDC, 2024). Providing positive, affirming sexual health care includes providing a safe environment and a non-judgmental approach (Savoy, et al., 2020).  The CDC’s 5 P’s model is one example of a trauma-informed approach to obtaining the sexual health history (CDC, 2024). This model looks at the partners, sexual practices, protection against STI’s, past STI history and pregnancy intention through a comprehensive lens. As STI’s continue to be a common clinical problem, focusing on prevention, identification, and treatment of STI’s is necessary both at the individual level and with the population as a whole.

Audience Take Away:

• Demonstrate the need for current evidence-based education related to sexual health, highlighting healthcare disparities among certain populations.
• Apply trauma informed approaches to collecting a comprehensive sexual health history.
• Identify high risk behaviors and appropriate screening for STI’s.
• Recommend practice changes to better patient-centered outcomes when approaching sexual healthcare.

Biography:

Dr. McKimmy has been in the field of nursing for over twenty-five years, and in academia since 2006. She is a graduate of The University of Texas Medical Branch where she earned her BSN in 2000 and her MSN in the Family Nurse Practitioner Track in 2003. She completed her DNP at the University of Alabama in 2013, focusing on pediatric development/autism. She began her teaching career at UTMB in undergraduate studies and taught for over 10 years at Oregon Health & Science University in the FNP/DNP program, across all graduate programs, and served as the Post-Master's DNP Lead. While at OHSU, Dr. McKimmy served as chair to over 40 DNP students, successfully completing their doctoral projects. She actively served on the board of Nurse Practitioners of Oregon and was the state representative for the American Association of Nurse Practitioners for 4 years. Clinically, she has worked primarily in family practice, pediatrics, and school/college-based health and served as Medical Director for an FQHC look-alike in Portland, Oregon specializing in primary care, HIV and sexual health. Dr. McKimmy is an Associate Professor at Texas Tech Health Sciences University School of Nursing teaching in the BSN-DNP programs. She maintains her clinical practice in Pediatric Urgent Care.