Sexual history-taking among primary care physicians

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.