What are the 5 P’s of sexual health?

A lot of people hear about “the 5 P’s” at a doctor’s visit and are not quite sure what that means. If you have ever wondered what are the 5 Ps of sexual health, you are not alone. This simple framework helps your health care provider understand your sexual life in a respectful and organized way so you can get the care, testing, and support you need.

The 5 Ps come from guidance by the Centers for Disease Control and Prevention (CDC) and focus on five key areas: Partners, Practices, Protection from STIs, Past history of STIs, and Pregnancy intention (CDC). You can also use these same five areas to check in with yourself and make more informed decisions about your sexual health.

Below, you will learn what each “P” means, what your clinician is really asking, and how you can prepare to talk about them comfortably.

Why the 5 Ps matter for your health

Sexual health is about much more than avoiding infections or pregnancy. It includes safety, consent, pleasure, identity, and your long term wellbeing. That said, many health visits still focus most on infection risk, which is where the 5 Ps originally came from (NCBI – PMC).

When your doctor or nurse uses the 5 Ps, they are trying to:

Understand your actual risks, not just your identity or relationship label
Decide which STI tests you may need and from which body sites
Offer protection options that match your life
Talk with you about pregnancy plans and contraception if that is relevant

Using the 5 Ps should be as routine as taking your blood pressure, for both adults and teens (Sermo). In fact, survey data suggest that about 71% of patients think primary care doctors should ask all patients about sexual health, which shows that most people are open to these conversations when they are handled respectfully (Sermo).

Partners: Who you are sexually active with

The first “P”, Partners, looks at who you are having sex with and a few basic details about those relationships. This gives your provider a clearer picture of your possible exposure to STIs.

They may ask:

How many sexual partners you have now
How many partners you have had in the past 12 months
The genders of your partners
Whether your partners might have other partners
Whether any partners inject drugs or have known STIs

According to CDC guidance, these questions help assess your risk and decide if you need testing or preventive medication like PrEP for HIV (CDC).

You can make this part of the conversation easier by:

Keeping a rough sense of your number of partners over the last year
Being honest, even if the answer feels awkward or you think you might be judged
Saying when you are not sure about something, like whether a partner has other partners

Some updated approaches suggest that it can be more helpful to ask about a partner’s body parts rather than only gender, since that is more medically relevant for STI testing and prevention (NCBI – PMC).

Practices: What types of sex you are having

The second “P”, Practices, focuses on how you are having sex. Different sexual activities carry different levels of risk for different infections, so your provider needs to know the specifics to offer accurate advice and testing.

They may ask open ended questions like:

“What kind of sexual activity do you have with your partners?”
“Which body parts are involved when you have sex?”

This could include:

Oral sex
Vaginal sex
Anal sex
Use of sex toys, and whether they are shared
Use of fingers or hands during sex

The CDC recommends that providers tailor questions to your situation and use neutral, nonjudgmental language so you feel safe being honest (CDC). This information guides which tests you may need and from which sites, such as throat, genitals, or rectum.

If you feel shy about describing what you do, you can:

Use simple words like “oral”, “vaginal”, and “anal”
Say “I use toys” or “We mostly have oral sex” if you do not want to go into detail
Let your provider know if there is anything you feel uncomfortable talking about

The goal is not to pry into your private life for no reason. The goal is to protect your health with accurate information.

Protection from STIs: How you reduce risk

The third “P”, Protection from STIs, looks at how you currently protect yourself against sexually transmitted infections, or if you are interested in changing your approach. This is where you talk about condoms, testing, vaccines, and other prevention tools.

Your provider might ask:

How often you use condoms or other barriers, like dental dams
Whether you or your partners have been tested recently
If you are vaccinated against HPV or hepatitis B
Whether you have ever taken PrEP for HIV or are interested in it
If you have periods of abstinence or monogamy and how that works for you

The CDC emphasizes that these questions should be free of assumptions. Not using condoms every time does not mean you are irresponsible. Using condoms every time does not always mean your risk is zero (CDC). The point is to explore what you are already doing and what might help you feel even safer.

You can use this P to:

Ask about better condoms if you have had discomfort or breakage
Learn about regular screening schedules, especially if you have multiple partners
Discuss PrEP or PEP for HIV if that fits your risk level
Talk about HPV vaccination, which is often available up to age 26, and sometimes beyond

This is also a good moment to mention if you are worried that a partner might not be honest about their status. Your provider can help you plan next steps that do not rely only on trust.

Past history of STIs: What has happened before

The fourth “P”, Past history of STIs, covers your previous infections and treatments. If you have had an STI before, you are not alone. Many infections are common and treatable, but they can increase your risk of future infections or complications if they are not carefully managed.

Your clinician may ask:

If you have ever been diagnosed with an STI, such as chlamydia, gonorrhea, syphilis, herpes, HPV, or HIV
When that happened and how it was treated
Whether your partners were treated at the time
If you have had any recurring symptoms, like pain, discharge, or sores

The CDC notes that understanding your past STI history helps identify whether you are at higher risk now and whether you may need more frequent testing or follow up (CDC).

If you are not sure of the names of past infections, you can:

Say where the infection was (for example, “I had something in my throat in 2022 that needed antibiotics”)
Mention if you received a shot or pills, and for how long
Share any lab results you might have in an online portal or on your phone

Having had an STI in the past should not be a source of shame. Instead, it is an important part of your health story that helps your provider keep you well now.

Pregnancy intention: If and when you want to get pregnant

The fifth “P”, Pregnancy intention, is about your plans, hopes, or concerns regarding pregnancy. This part is relevant if you or your partner has the capacity to become pregnant.

Your provider might ask:

Whether you are trying to get pregnant now, open to it, or trying to avoid it
If you might want children in the future
Which contraception, if any, you are currently using
Whether you have had any past pregnancies, miscarriages, or abortions

According to CDC guidance, discussing pregnancy intention helps your provider offer the right mix of contraception, fertility information, and preconception care when needed (CDC). For example, you might need different advice if you are trying to avoid pregnancy for several years compared to if you might want to conceive in the next year.

You can use this P to:

Clarify what you actually want, even if you feel uncertain
Ask about birth control options that fit your body and lifestyle
Talk about how pregnancy would affect your health conditions or medications
Explore how to prepare your body if you hope to conceive soon

If you are not sure what you want, it is okay to say that. Your provider can still help you think through options that give you time and flexibility.

You do not have to have all the answers about your sexual life before you walk into a clinic. The 5 Ps are there to guide the conversation, not to test you.

Newer expansions: Pleasure, problems, and pride

You might also hear about an expanded version of the 5 Ps that includes three more: pleasure, problems, and pride. The National Coalition for Sexual Health, with support from the CDC, recommends this broader, more patient centered framework (NCBI – PMC).

These additions recognize that:

Pleasure matters. Feeling good, comfortable, and satisfied is a key part of sexual health.
Problems such as pain, low desire, difficulty with arousal or orgasm, or past trauma deserve attention and support.
Pride in your sexual orientation, gender identity, and relationships can protect your mental health and help you feel more confident seeking care.

This expanded “8 Ps” approach encourages a trauma informed, respectful conversation that sees you as a whole person, not just a set of risks for infection (NCBI – PMC).

If your provider does not bring up pleasure, problems, or pride, you can still mention them yourself. You might say:

“Sex has been painful, can we talk about that?”
“I am not really enjoying sex lately and I am not sure why.”
“I want to make sure this space is safe to talk about my gender identity.”

Your experiences and feelings are just as important as lab results.

How you can prepare for a 5 Ps conversation

Knowing what the 5 Ps of sexual health are can make your next health visit feel more relaxed and productive. Before your appointment, you can:

Jot down notes about:

Recent partners and types of sex
Any protection methods you use
Past STIs or symptoms
Your current thoughts about pregnancy

Decide your comfort level. Think about how much detail you are willing to share and what words you prefer to use.
Plan a phrase to start the conversation, such as:

“I want to talk about STI testing.”
“Can we go over my birth control options?”
“I have questions about how to stay safe with new partners.”

Remember you can ask for privacy or boundaries, like asking a parent or partner to step out of the room, or saying you do not want to discuss a particular topic right now.

Health care teams are increasingly trained to use frameworks like the 5 Ps in a respectful, inclusive way. Programs like the CDC’s virtual patient simulation on sexual health aim to help providers get better at these conversations in real life (Sermo).

Putting the 5 Ps into your own life

You do not have to wait for a doctor’s visit to use the 5 Ps. You can ask yourself these five questions regularly:

Partners: Who am I having sex with, and what do I know about their health?
Practices: What types of sex am I having, and what does that mean for my risk?
Protection from STIs: How am I protecting myself, and is that still working for me?
Past STIs: What has happened before, and what did I learn from it?
Pregnancy intention: Do I want to avoid, achieve, or simply not worry about pregnancy right now?

By revisiting these areas, you give yourself a clearer view of your sexual health so you can ask for the care and support that truly fits your life.