Young Australians’ receptiveness to discussing sexual health with a general practitioner
Helen Bittleston
A * , Jane S. Hocking A , Jacqueline Coombe A , Meredith Temple-Smith B and Jane L. Goller A
+ Author Affiliations
- Author Affiliations
A Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Vic. 3010, Australia.
B Department of General Practice, The University of Melbourne, Carlton, Vic. 3010, Australia.
* Correspondence to: helen.bittleston@unimelb.edu.au
Australian Journal of Primary Health - https://doi.org/10.1071/PY23083
Submitted: 1 May 2023 Accepted: 24 July 2023 Published online: 24 August 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Most sexual health care in Australia is provided through general practice. However, many young Australians experience barriers to accessing sexual health care. This research examines young Australians’ receptiveness to discussing sexual health with a general practitioner (GP).
Methods: We conducted an anonymous online sexual health survey (open 2 May to 21 June 2022). Anyone living in Australia aged 16–29 years was eligible to participate. Participants were recruited via social media and asked whether they agreed with five statements exploring their receptivity to discussing sexual health with GPs. We explored characteristics associated with responses using multivariable logistic regression.
Results: Among 1915 participants, 69.3% were cisgender women, with a median age of 20 years; 48.5% were heterosexual. Approximately one-fifth agreed they might not tell a GP the whole truth about their sexual history, would be worried about confidentiality when discussing their sexual history and would be too embarrassed to see their usual GP if they thought they had a sexually transmitted infection. Over half (55.8%) agreed they would be comfortable with a GP bringing up sexual health in an unrelated consultation, but 39.6% would be nervous to bring up sexual health in case they needed an intimate examination. Multivariate regression identified several characteristics associated with responses. Notably, having a school-based sex education and a usual GP were factors associated with increased receptivity to discussing sexual health.
Conclusions: Young Australians were generally open to discussing sexual health with a GP. School-based sex education and GP–patient relationships are key to promoting sexual health among young people.
Keywords: access to health care, general practice, online survey, primary health care, quantitative research, sexual health, sexually transmissible infections, young people.
References
Adam PCG, de Wit JBF, Ketsuwan I, Treloar C (2019) Sexual health-related knowledge, attitudes and practices of young people in Australia. Results from the 2018 Debrief Survey among heterosexual and non-heterosexual respondents. Centre for Social Research in Health, UNSW Sydney, Sydney.Alencar Albuquerque G, de Lima Garcia C, da Silva Quirino G, Alves MJH, Belém JM, dos Santos Figueiredo FW, da Silva Paiva L, do Nascimento VB, da Silva Maciel É, Valenti VE, de Abreu LC, Adami F (2016) Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC International Health and Human Rights 16, 2
| Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review.Crossref | GoogleScholarGoogle Scholar |
Australian Curriculum Assessment and Reporting Authority (ACARA) (n.d.) Health and physical education. Sydney, Australia. Available at https://www.australiancurriculum.edu.au/f-10-curriculum/health-and-physical-education/ [Accessed 16 March 2023]
Australian Institute of Health and Welfare (AIHW) (2022) General practice, allied health, and other primary care services. Available at https://www.aihw.gov.au/reports/health-care-quality-performance/general-practice-allied-health-and-other-primary-c [Accessed 30 January 2023]
Australasian Sexual Health Alliance (2022) Australian STI management guidelines for use in primary care. ASHM. Available at https://sti.guidelines.org.au/standard-asymptomatic-checkup/ [Accessed 18 May 2023]
Ayhan CHB, Bilgin H, Uluman OT, Sukut O, Yilmaz S, Buzlu S (2020) A Systematic review of the discrimination against sexual and gender minority in health care settings. International Journal of Health Services 50, 44–61.
| A Systematic review of the discrimination against sexual and gender minority in health care settings.Crossref | GoogleScholarGoogle Scholar |
Baker JR, Arnold-Reed DE, Brett T, Hince DA, O’Ferrall I, Bulsara MK (2013) Perceptions of barriers to discussing and testing for sexually transmitted infections in a convenience sample of general practice patients. Australian Journal of Primary Health 19, 98–101.
| Perceptions of barriers to discussing and testing for sexually transmitted infections in a convenience sample of general practice patients.Crossref | GoogleScholarGoogle Scholar |
Bateson D, Edmiston N (2016) Pelvic inflammatory disease: management of new-onset low abdominal pain in young women. Medicine Today 17, 14–22.
Bird S (2011) Consent to medical treatment: the mature minor. Australian Family Physician 40, 159–160.
Brooks H, Llewellyn CD, Nadarzynski T, Pelloso FC, De Souza Guilherme F, Pollard A, Jones CJ (2018) Sexual orientation disclosure in health care: a systematic review. British Journal of General Practice 68, e187–e196.
| Sexual orientation disclosure in health care: a systematic review.Crossref | GoogleScholarGoogle Scholar |
Caddy C, Temple-Smith M, Coombe J (2023) Who does what? Reproductive responsibilities between heterosexual partners. Culture, Health & Sexuality
| Who does what? Reproductive responsibilities between heterosexual partners.Crossref | GoogleScholarGoogle Scholar |
Collyer A, Bourke S, Temple-Smith M (2018) General practitioners’ perspectives on promoting sexual health to young men. Australian Journal for General Practitioners 47, 376–381.
| General practitioners’ perspectives on promoting sexual health to young men.Crossref | GoogleScholarGoogle Scholar |
Ezer P, Power J, Jones T, Fisher C (2020) 2nd National Survey of Australian Teachers of Sexuality Education 2018. (Australian Research Centre in Sex, Health & Society)
Fairley CK, Chow EPF, Simms I, Hocking JS, Ong JJ (2022) Accessible health care is critical to the effective control of sexually transmitted infections. Sexual Health 19, 255–264.
| Accessible health care is critical to the effective control of sexually transmitted infections.Crossref | GoogleScholarGoogle Scholar |
Genc M (2000) Syphilis in pregnancy. Sexually Transmitted Infections 76, 73–79.
| Syphilis in pregnancy.Crossref | GoogleScholarGoogle Scholar |
Gott M, Galena E, Hinchcliff S, Elford H (2004) “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Family Practice 21, 528–536.
| “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care.Crossref | GoogleScholarGoogle Scholar |
Harris ML, Coombe J, Forder PM, Lucke JC, Bateson D, Loxton D (2020) Young women’s complex patterns of contraceptive use: findings from an Australian Cohort Study. Perspectives on Sexual and Reproductive Health 52, 181–190.
| Young women’s complex patterns of contraceptive use: findings from an Australian Cohort Study.Crossref | GoogleScholarGoogle Scholar |
Hook EW (2017) Syphilis. The Lancet 389, 1550–1557.
| Syphilis.Crossref | GoogleScholarGoogle Scholar |
Hoopes AJ, Benson SK, Howard HB, Morrison DM, Ko LK, Shafii T (2017) Adolescent perspectives on patient-provider sexual health communication: a qualitative study. Journal of Primary Care & Community Health 8, 332–337.
| Adolescent perspectives on patient-provider sexual health communication: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
Jackson C, Ball L (2018) Continuity of care: vital, but how do we measure and promote it? Australian Journal for General Practitioners 47, 662–664.
| Continuity of care: vital, but how do we measure and promote it?Crossref | GoogleScholarGoogle Scholar |
Kang M, Rochford A, Skinner SR, Mindel A, Webb M, Peat J, Usherwood T (2014) Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial. BMC Public Health 14, 12
| Sexual behaviour, sexually transmitted infections and attitudes to chlamydia testing among a unique national sample of young Australians: baseline data from a randomised controlled trial.Crossref | GoogleScholarGoogle Scholar |
King J, McManus H, Kwon A, Gray R, Mcgregor S (2022) HIV, viral hepatitis and sexually transmissible infections in Australia: annual surveillance report 2022. The Kirby Institute, UNSW, Sydney, Australia.
Kularadhan V, Fairley CK, Chen M, Bilardi J, Fortune R, Chow EPF, Philips T, Ong JJ (2022) Optimising the delivery of sexual health services in Australia: a qualitative study. Sexual Health 19, 376–385.
| Optimising the delivery of sexual health services in Australia: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
Mitchell KR, Lewis R, O’Sullivan LF, Fortenberry JD (2021) What is sexual wellbeing and why does it matter for public health? The Lancet Public Health 6, e608–e613.
| What is sexual wellbeing and why does it matter for public health?Crossref | GoogleScholarGoogle Scholar |
Moreau C, Kågesten AE, Blum RW (2016) Sexual dysfunction among youth: an overlooked sexual health concern. BMC Public Health 16, 1170
| Sexual dysfunction among youth: an overlooked sexual health concern.Crossref | GoogleScholarGoogle Scholar |
Mursa R, Patterson C, Halcomb E (2022) Men’s help-seeking and engagement with general practice: An integrative review. Journal of Advanced Nursing 78, 1938–1953.
| Men’s help-seeking and engagement with general practice: An integrative review.Crossref | GoogleScholarGoogle Scholar |
North Western Melbourne Primary Health Network (NWMPHN) (n.d.) VHHITAL. Available at https://nwmphn.org.au/about/partnerships-collaborations/vhhital/ [Accessed 23 June 2023]
Ong JJ, Fairley CK, Fortune R, Bissessor M, Maloney C, Williams H, Castro A, Castro L, Wu J, Lee PS, Chow EPF, Chen MY (2022) Improving access to sexual health services in general practice using a hub-and-spoke model: a mixed-methods evaluation. International Journal of Environmental Research and Public Health 19, 3935
| Improving access to sexual health services in general practice using a hub-and-spoke model: a mixed-methods evaluation.Crossref | GoogleScholarGoogle Scholar |
Pavlin NL, Parker R, Fairley CK, Gunn JM, Hocking J (2008) Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice. BMC Infectious Diseases 8, 62
| Take the sex out of STI screening! Views of young women on implementing chlamydia screening in general practice.Crossref | GoogleScholarGoogle Scholar |
RACGP (2022) 2022 RACGP curriculum and syllabus for Australian general practice: sexual health and gender diversity. Royal Australian College of General Practitioners. Available at https://www.racgp.org.au/education/education-providers/curriculum/curriculum-and-syllabus/units/sexual-health-and-gender-diversity [Accessed 23 June 2023]
Rowe H, Holton S, Kirkman M, Bayly C, Jordan L, McNamee K, Mcbain J, Sinnott V, Fisher J (2016) Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey. Australian and New Zealand Journal of Public Health 40, 104–109.
| Prevalence and distribution of unintended pregnancy: the Understanding Fertility Management in Australia National Survey.Crossref | GoogleScholarGoogle Scholar |
Schlichthorst M, Sanci LA, Hocking JS (2016) Health and lifestyle factors associated with sexual difficulties in men – results from a study of Australian men aged 18 to 55 years. BMC Public Health 16, 1043
| Health and lifestyle factors associated with sexual difficulties in men – results from a study of Australian men aged 18 to 55 years.Crossref | GoogleScholarGoogle Scholar |
UNESCO (2016) Review of the evidence on sexuality education: report to inform the update of the UNESCO International Technical Guidance on Sexuality Education. UNESCO, Paris, France.
Waling A, Bellamy R, Ezer P, Kerr L, Lucke J, Fisher C (2020) ‘It’s kinda bad, honestly’: Australian students’ experiences of relationships and sexuality education. Health Education Research 35, 538–552.
| ‘It’s kinda bad, honestly’: Australian students’ experiences of relationships and sexuality education.Crossref | GoogleScholarGoogle Scholar |
Waling A, Fisher C, Ezer P, Kerr L, Bellamy R, Lucke J (2021) “Please teach students that sex is a healthy part of growing up”: Australian students’ desires for relationships and sexuality education. Sexuality Research and Social Policy 18, 1113–1128.
| “Please teach students that sex is a healthy part of growing up”: Australian students’ desires for relationships and sexuality education.Crossref | GoogleScholarGoogle Scholar |
WHO (2006) Sexual and reproductive health and research. World Health Organisation. Available at https://www.who.int/teams/sexual-and-reproductive-health-and-research/key-areas-of-work/sexual-health/defining-sexual-health [Accessed 18 May 2023]
Zannoni R, Dobberkau E, Kaduszkiewicz H, Stirn AV (2021) Addressing sexual problems in German primary care: a qualitative study. Journal of Primary Care & Community Health 12, 215013272110464
| Addressing sexual problems in German primary care: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
