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Barriers to sexual history taking in general practice
M Temple-Smith1, J Hammond, P Pyett
1Centre for the Study of Sexually Transmissible Diseases, La Trobe University, Victoria.
Objective:
The aim of this pilot study was to identify barriers to the taking of a sexual history in general practice.
Method:
In order to canvass the widest range of opinion on this sensitive issue, focus groups of 4-8 general practitioners (GPs) were conducted using a GP facilitator. Groups shared one of the following common interests - considerable experience in sexual history taking, an interest in sexuality, large numbers of patients from a non-English speaking background, rural practice, Family Medicine Program trainee-ship or employment in a 24 hour clinic.
Results:
GPs identified a range of barriers including lack of time, fear of intrusion, age and sex of both GP and patient, fear of inadequacy, patient's offending behaviours, cultural differences (ethnic, gay and youth) and the presence of a third party.
Conclusion:
To improve sexual history taking GPs may need assistance in the following areas: education about the range of sexual practices; initiation of a sexual history with both old and new patients; understanding how to deal with their own discomfort and in the use of appropriate and non-judgmental language. GPs need knowledge of resources for further information and referral. Recommendations regarding the minimum strategy for inclusion of a sexual history as part of a standard consultation are made.