The sexual history-taking and counseling practices of primary care physicians

As part of a statewide survey of experiences related to the acquired immunodeficiency syndrome and competencies of a random sample of primary care physicians in California done in early 1986, we interviewed 1,000 internists, family and general practitioners about their sexual history-taking and counseling practices. Less than 4% have patients complete a history form that includes questions about sexual orientation or practices, and only 10% ask new patients questions specific enough to identify those at high risk of exposure to the human immunodeficiency virus. Internists, women and younger physicians and those expressing little discomfort in dealing with gay men more often took adequate sexual histories and gave appropriate advice. Among those physicians with patients at risk of becoming infected, only half recommended the use of condoms and 60% advised a reduction in the number of partners. More than 15% recommended abstention from sexual intercourse, and 8% suggested these patients should switch to a heterosexual life-style.