Sexual risk assessment in general practice: evidence from a New South Wales survey
Asaduzzaman Khan A D E , David Plummer B , Rafat Hussain C and Victor Minichiello CA Department of Statistics, University of Dhaka, Dhaka 1000, Bangladesh.
B School of Education, University of the West Indies, Port of Spain, Trinidad.
C School of Health, University of New England, Armidale, NSW 2351, Australia.
D Present address: Social Research Centre, The University of Queensland, St Lucia, Qld 4072, Australia.
E Corresponding author. Email: a.khan2@uq.edu.au
Sexual Health 4(1) 1-8 https://doi.org/10.1071/SH06012
Submitted: 16 February 2006 Accepted: 14 July 2006 Published: 26 February 2007
Abstract
Background: Physicians’ inadequate involvement in sexual risk assessment has the potential to miss many asymptomatic cases. The present study was conducted to explore sexual risk assessment by physicians in clinical practice and to identify barriers in eliciting sexual histories from patients. Methods: A stratified random sample of 15% of general practitioners (GP) from New South Wales was surveyed to assess their management of sexually transmissible infections (STI). In total, 409 GP participated in the survey with a response rate of 45.4%. Results: Although nearly 70% of GP regularly elicited a sexual history from commercial sex workers whose presenting complaint was not an STI, this history taking was much lower (<10%) among GP for patients who were young or heterosexual. About 23% never took a sexual history from Indigenous patients and 19% never elicited this history from lesbian patients. Lack of time was the most commonly cited barrier in sexual history taking (55%), followed by a concern that patients might feel uncomfortable if a sexual history was taken (49%). Other constraints were presence of another person (39%) and physician’s embarrassment (15%). About 19% of GP indicated that further training in sexual history taking could improve their practice. Conclusions: The present study identifies inconsistent involvement by GP in taking sexual histories, which can result in missed opportunities for early detection of many STI. Options for overcoming barriers to taking sexual histories by GP are discussed.
Acknowledgements
We are indebted to Dr David Bradford, Past President of the Australasian College of Sexual Health Physicians for his ongoing support and valuable advice during the study. Our thanks also go to Drs Suzanne Robertson, Elizabeth Pringle, Miriam Grotowski and Jan Browne for their valuable input in developing the study instruments. We are very grateful to all GP who participated in the study. An Institutional Research Grant from the University of New England supported the study.
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