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Sexual history-taking among primary care physicians.
Journal of the National Medical Association 2006; 98(12);1924-1929.
Wimberly YH, Hogben M, Moore-Ruffin J, Moore SE, Fry-Johnson Y.
Abstract
BACKGROUND: Because many people seek sexual healthcare in settings where they
seek primary healthcare, the extent to which primary care physicians take
sexual histories is important. We surveyed Atlanta-area primary care physicians
to estimate the extent to which they take sexual histories as well as the
components of those histories and the circumstances under which they are
taken. METHODS: Four-hundred-sixteen physicians in four specialties (obstetrics/gynecology,
internal medicine, general/family practice, pediatrics) responded to a mail
survey conducted during 2003-2004. Respondents answered whether they asked
about sexual activity at all, including specific components of a comprehensive
sexual history such as sexual as sexual orientation, numbers of partners
and types of sexual activity, during routine exams, initial exams, complaint-based
visits or never. Respondents also reported their opinions on whether they
felt trained and comfortable taking sexual histories. RESULTS: Respondents
(51% male, 58% white) saw an average of 94 patients per week. A majority
(56%) felt adequately trained, while 79% felt comfortable taking sexual histories.
Almost three in five (58%) asked about sexual activity at a routine visit,
but much smaller proportions (12-34%) asked about the components of a sexual
history. However, 76% of physicians reported asking about sexual history
(61-75% for various components) if they felt it would be relevant to the
chief complaint. CONCLUSIONS: Most physicians report feeling comfortable
taking sexual histories and will do so if the patient's apparent complaint
is related to sexual health. But sexual histories as part of routine and
preventive healthcare are less common, and many physicians miss essential
components of a comprehensive sexual history. Structural changes and suggestions
for training to enhance sexual history-taking are discussed.