Let's Talk About Sex: A Survey of Patients' Preferences When Addressing Sexual Health Concerns in a Family Medicine Residency Program Office.

INTRODUCTION: Comprehensive medical care should embody the biopsychosocial care model and encompass all aspects of health. Sexual health topics may be overlooked or avoided because of patient and provider discomfort. Our purpose was to better understand patients' preferences about discussing sexual concerns in primary care. We hypothesized that most individuals have sexual concerns, but many barriers prevent them from seeking care.
METHOD: We surveyed patients at a family medicine residency program office. The survey explored whether patients had experienced sexual concerns, preferences for addressing concerns in the office, and barriers and facilitators to addressing concerns. Results were analyzed using counts and proportions. Pearson correlations, Pearson χ2 analyses, and independent samples t-tests were used to explore demographic differences in responses.
RESULTS: Most participants indicated that physicians should ask all patients about having sexual concerns and that physicians should initiate these conversations. Younger participants were more likely to have this preference. Participants identified embarrassment as the most common barrier to sexual health conversations. Participants indicated it was easier to discuss sexual concerns with physicians of the same gender and/or a physician they had seen before.
CONCLUSIONS: The majority of patients prefer active inquiry about sexual health concerns from primary care physicians. However, because a large minority prefer not to be asked about sexual health, physicians should inquire sensitively, particularly with older patients. Continuity of patient-physician relationship and allowing patients to choose their provider based on gender may also help facilitate these discussions.