Let's Talk Sex: A Pilot Study of Sexual History Elicitation by Providers of STD Services in Leon County, Florida

Tuesday, September 20, 2016
Florida Public Health Review

A new article, Let's Talk Sex: A Pilot Study of Sexual History Elicitation by Providers of STD Services in Leon County, Florida, by Salimah El-Amin, Senior Research Associate and Director of the Global Inequality Initiative at the Samuel DuBois Cook Center on Social Equity and Khai Zaw, Statistical Research Associate for Cook Center, was published in the August, 2016, volume of the Florida Public Health Review (13, 64-72).

This pilot study was designed to test a survey questionnaire that measures primary care provider (PCP) sexual elicitation practices. PCPs included obstetricians and gynecologists, family practitioners, internal medicine physicians, pediatricians, nurse practitioners, and physician assistants in Leon County Florida. Between January 2010 and March 2010, a convenience sample of 50 PCPs in Florida were administered a pencil-and-paper survey. The survey instrument was constructed and tested to measure PCP sexual elicitation practices. The survey instrument was found to be an internally consistent and reliable assessment tool for sexual history elicitation. These preliminary pilot study findings warrant a larger study. 

An estimated one million sexually transmitted diseases (STDs) are reported annually in the United States. Florida has some of the highest HIV and STD rates in the country. STDs are a particular problem for minorities, women, and adolescents. Sexual history elicitation is a tool available to clinicians to assess patients’ sexual risk behaviors and to counsel, test, and treat STDs. Previous barriers to sexual history elicitation include subject matter, patient –physician communications, provider training, and physician perceptions.

Table 5 (above) shows that most respondents reported likelihood of asking patients about their number of sex partners (73%), sexual orientation (66%), history of STDs (88%), condom use (92%), and injection drug use (83%). However, participants were not as likely to currently ask patients about their engagement in oral (63%) and anal sex (59%). This finding is important because STDs can also be acquired via oral and anal sex. Anal sex is considered a high risk sexual behavior because the lining of the rectum is thin and may allow viruses and bacteria to enter the body during anal sex. There have been misconceptions about the risk of oral sex and STD. However, HIV, herpes, syphilis, gonorrhea, genital warts and hepatitis A can all be transmitted through oral sex (CDC, 2015b).

Thirsty-six percent of PCPs reported receiving additional STD training beyond their degree. This is an important finding. A disconnect exists between the PCP education curriculum and sexual health education. Education is clearly essential to improving the skills, knowledge and ability of PCP to offer patients holistic care that includes a focus on sexual health (Sung, 2013).

Read the full pilot study: goo.gl/2biIBW

Read the Florida Public Health Review, Vol. 13 (August, 2016): www.ut.edu/floridapublichealthreview/current/