Collecting and registering sexual health information in the context of HIV risk in the electronic medical record of general practitioners: a qualitative exploration of the preference of general practitioners in urban communities in Flanders (Belgium)

Abstract

Background and aim: Current health-care delivery requires increasingly proactive and inter-professional work. Therefore, collecting patient information and knowledge management is of paramount importance. General practitioners (GPs) are well placed to lead these evolving models of care delivery. However, it is unclear how they are handling these changes. To gain an insight into this matter, the HIV epidemic was chosen as a test case. Methods: Data were collected and analysed from 13 semi-structured interviews with GPs, working in urban communities in Flanders. Findings: GPs use various types of patient information to estimate patients' risk of HIV. The way in which sexual health information is collected and registered, depends on the type of information under discussion. General patient information and medical history data are often automatically collected and registered. Proactively collecting sexual health information is uncommon. Moreover, the registration of the latter is not obvious, mostly owing to insufficient space in the electronic medical record (EMR). Conclusions: GPs seem willing to systematically collect and register sexual health information, in particular about HIV-risk factors. They expressed a need for guidance together with practical adjustments of the EMR to adequately capture and share this information.

Four sexually transmitted infections (STIs) in Belgian general practice: first results (2013–2014) of a nationwide continuing surveillance study

“…As described before, the reluctance of Belgian GPs to openly discuss sexual issues with patients was evidenced. 6 8 10 Our study suggests that this is more difficult when patients are older or (co-)infected with syphilis or gonorrhoea, maybe even more marked by shame and stigma than other STIs. Recently, a practical tool was developed in Flanders to support GPs in disclosing (deviant) sexual practices of their patients with STI.…”

How Do Family Physicians Perceive Their Role in Providing Pre-exposure Prophylaxis for HIV Prevention?–An Online Qualitative Study in Flanders, Belgium

“…Besides issues of time and a lack of guidelines, this finding could also be linked to FPs' discomfort to inquire sexual behavior in clients. As shown in previous studies, FPs often lacked the confidence to discuss sexual health in the absence of an obvious entry point ( 20 , 44 , 45 ). If unaddressed, these practical challenges could undermine FPs' potential to identify suitable PrEP candidates among their clients.…”

HIV testing within general practices in Europe: a mixed-methods systematic review

“…Sexual behaviour was hardly ever discussed except in cases of genital complaint. Instead, assumptions about HIV risk were based on certain patient characteristics such as country of origin, past STI episodes and sexual orientation [ 31 ]. A cross-sectional survey among newly diagnosed HIV patients ( N = 111) in Amsterdam (Netherlands) revealed that sexual orientation was registered in the patients’ record in 34% of the men having sex with men (MSM) cases.…”

“… Trienekens, 2013 [ 46 ] Netherlands Prospective observational patient survey within the representative Dutch sentinel GP network, 2008–2011 43 general practices; 2111 new episodes concerning STI/HIV issues No HIV tests were carried out for 64% of the STI-related consultations involving patients at higher risk for HIV. Vos, 2016 [ 31 ] Belgium Qualitative study making use of in-depth interviews, 2011 13 GPs in urban areas in Flanders No inclination to routinely collect and register sexual health information. Assumptions on HIV risk based on country of origin, past STI episodes and sexual orientation.…”