Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic.


Journal

The journal of sexual medicine
ISSN: 1743-6109
Titre abrégé: J Sex Med
Pays: Netherlands
ID NLM: 101230693

Informations de publication

Date de publication:
08 2020
Historique:
received: 28 01 2020
revised: 31 03 2020
accepted: 03 05 2020
pubmed: 2 7 2020
medline: 22 12 2020
entrez: 2 7 2020
Statut: ppublish

Résumé

Surveys report low frequencies of sexual history (SH) obtained in primary care. Sexually transmitted infections incidence can be reduced with timely screening. It is important to determine whether providers obtain thorough SH and to identify needs for improvement. To evaluate the frequency and depth of SH taking in primary care. In this cross-sectional cohort study, 1,017 primary care visits were reviewed (1,017 adult patients, female 55.26%). 417 patients were seen by male providers and 600 patients were seen by female providers. Multivariate ordered and logit models were deployed. The primary outcome measures included SH taking rates and completeness based on the 5 P model as described by the Centers for Disease Control and Prevention. All components of SH were explored in 1.08% of visits. Partial SH was obtained in 33.92% of visits. No SH was taken in the majority of visits (65%). SH was more likely to be taken from female patients than from male patients (P < .001), and was less likely to be obtained from older patients as compared to younger individuals (P < .001). There was no significant difference in SH taking between male and female providers (P = .753). The provider title and the level of training were found to be independent predictors of SH taking (P < .001). The results of this study highlight an unmet need for more comprehensive and consistent SH taking amongst providers, particularly in high-risk settings, so that SH can be used as a valuable tool in preventive care. To the best of our knowledge, this is the largest study to date examining SH taking in the primary care setting. Limitations include the retrospective study design, lack of generalizability to other hospitals, and inconsistencies in available data. The SH taking rates in primary care clinics are globally low with a variation depending on the provider position or level of training, provider gender, and patient age. Palaiodimos L, Herman HS, Wood E, et al. Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic. J Sex Med 2020;17:1509-1519.

Sections du résumé

BACKGROUND
Surveys report low frequencies of sexual history (SH) obtained in primary care. Sexually transmitted infections incidence can be reduced with timely screening. It is important to determine whether providers obtain thorough SH and to identify needs for improvement.
AIM
To evaluate the frequency and depth of SH taking in primary care.
METHODS
In this cross-sectional cohort study, 1,017 primary care visits were reviewed (1,017 adult patients, female 55.26%). 417 patients were seen by male providers and 600 patients were seen by female providers. Multivariate ordered and logit models were deployed.
MAIN OUTCOME MEASURES
The primary outcome measures included SH taking rates and completeness based on the 5 P model as described by the Centers for Disease Control and Prevention.
RESULTS
All components of SH were explored in 1.08% of visits. Partial SH was obtained in 33.92% of visits. No SH was taken in the majority of visits (65%). SH was more likely to be taken from female patients than from male patients (P < .001), and was less likely to be obtained from older patients as compared to younger individuals (P < .001). There was no significant difference in SH taking between male and female providers (P = .753). The provider title and the level of training were found to be independent predictors of SH taking (P < .001).
CLINICAL IMPLICATIONS
The results of this study highlight an unmet need for more comprehensive and consistent SH taking amongst providers, particularly in high-risk settings, so that SH can be used as a valuable tool in preventive care.
STRENGTHS & LIMITATIONS
To the best of our knowledge, this is the largest study to date examining SH taking in the primary care setting. Limitations include the retrospective study design, lack of generalizability to other hospitals, and inconsistencies in available data.
CONCLUSION
The SH taking rates in primary care clinics are globally low with a variation depending on the provider position or level of training, provider gender, and patient age. Palaiodimos L, Herman HS, Wood E, et al. Practices and Barriers in Sexual History Taking: A Cross-Sectional Study in a Public Adult Primary Care Clinic. J Sex Med 2020;17:1509-1519.

Identifiants

pubmed: 32605821
pii: S1743-6095(20)30611-1
doi: 10.1016/j.jsxm.2020.05.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1509-1519

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Auteurs

Leonidas Palaiodimos (L)

Division of Hospital Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Heather S Herman (HS)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Erika Wood (E)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Dimitrios Karamanis (D)

Department of Economics, University of Piraeus, Attica, Greece.

Cesar Martinez-Rodriguez (C)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Alejandra Sanchez-Lopez (A)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Emma Ruderman (E)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Maximus Jang (M)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Daniel Fischer (D)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Hao Huang (H)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Uttara Gadde (U)

Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA. Electronic address: ug26@njms.rutgers.edu.

Jason Leider (J)

Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

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