Discussing STIs: doctors are from Mars, patients from Venus

Area of Science:

• Public Health
• General Practice
• Sexual Health

Background:

• Primary care settings are vital for sexual health promotion.
• Counselling on sexually transmitted infections (STIs) is infrequently provided and often insufficient in primary care.

Purpose of the Study:

• To identify and quantify the barriers encountered by primary care physicians when discussing STIs with patients.
• To understand the challenges in integrating STI prevention into routine primary care.

Main Methods:

• A postal questionnaire survey was distributed to a random sample of 200 primary care physicians in Antwerp, Belgium.
• A response rate of 68% was achieved, with 122 physicians completing the survey.

Main Results:

• Only 44.3% of responding physicians regularly counselled on STIs, safe sex, or sexual history.
• Key barriers included language/comprehension issues (74.2%), ethnic differences (68.4%), insufficient training (69.4%), time constraints (60.8%), patient's companion presence (up to 94.2%), and treating asymptomatic patients (71.4%).
• Approximately 50% of physicians failed to counsel at-risk asymptomatic patients or provide safe sex advice during initial contraception consultations.

Conclusions:

• Physicians encounter diverse and significant barriers to discussing STIs in primary care.
• Current STI counselling practices are suboptimal, necessitating targeted interventions.
• Prioritizing education and training for healthcare providers is essential to improve STI prevention and management in primary care settings.