Sexual healthcare knowledge, attitudes, and practices among primary care physicians in Trinidad and Tobago

Abstract

Background:Our understanding of healthcare professionals’ competence level in both their sexual history taking practices and their attitudes in addressing sexual health concerns of patients in middle and old age is lacking. This research aimed to assess primary care physicians’ (PCPs) knowledge, attitudes, and sexual healthcare practices toward patients who are ≥45 years in Trinidad and Tobago.Materials and Methods:A self-reported survey instrument assessing clinical sexual health knowledge, attitudes, and practices was administered nationwide to all registered PCPs (n = 155) in the public healthcare service. Descriptive and inferential statistical analyses were conducted using STATA.Results:PCPs, who were foreign medical graduates, middle-aged, male, and worked in urban centers, had improved odds of discussing sexual health with middle-aged and older patients. PCPs with any training in sexual health communication or sexual history taking were three times more likely to initiate a sexual health discussion or take a sexual history. Over 90% of physicians reported taking a sexual history only if the discussion was patient initiated and over 50% of PCPs indicated they will not ask these older patients about their sexual orientation, sexual partners, sexual abuse, or violence.Conclusions:Even though PCPs reported having a positive willing attitude toward offering sexual health care to these patients, they had a low level of knowledge of sexual function in later life and inconsistent sexual history taking practices. There is a great need for training physicians’ on sexual health communication and history taking and on sexual function in older adults.

Patients with chronic diseases: Is sexual health brought up by general practitioners during appointments? A web-based study

“…This confirmed some earlier results regarding the preference for same-gender GPs in appointments concerning sexual health [5,25]. A UK study with 22 GPs [5], a US study with 78 physicians [25], and a study in Trinidad and Tobago [26] with 155 primary care physicians showed that female physicians were more comfortable bringing up sexual health issues with female patients and male physicians with male patients. Furthermore, a US study [27] with 416 physicians found that female physicians took sexual histories more often than male physicians.…”

“…Of note is that a majority of the patients with chronic diseases are presumably middle-aged or older, and are thus considerably older than the GPs in our youngest age group. Previous studies have proposed that a large age difference between the GP and the patient may hinder sexual history taking [6,26]. Furthermore, it could be hypothesized that in addition to sexual medicine education, both professional and personal life experiences could provide more understanding of the existence of sexual problems.…”

Sex education and Afghan migrant adolescent women

“…[ 30 53 ] The use of various health promotion strategies such as multimedia and educational materials in clinics and by primary care physicians, can reduce sexual taboos in developing societies. [ 54 ]…”

Competence and Attitude of Family Physicians towards Sexuality Regarding Their Sexual Orientation, Age, or Having a Partner—Survey Study and Validation

“…Family physicians have an essential role in this regard, being the first to be consulted on these issues and being able to detect problems in the sexual sphere of their patients [ 2 , 5 , 6 ]. Elements such as longitudinally in time allow an approach based on greater confidence [ 2 , 7 , 8 ].…”

“…In addition, they have patients in consultation who associate various types of pathologies, from diabetes to cardiovascular diseases, which affect the sexual sphere to a different extent, making difficulties in this matter more prevalent [ 9 , 10 , 11 ]. They generally have a good predisposition to attend to the sexuality of their patients, but there are several clear barriers to overcome [ 5 ]. Physicians’ attitudes are influenced by various factors, such as patients’ age, health status, or socioeconomic status, as well as their usual focus on family planning and sexually transmitted infections [ 5 , 6 , 11 ].…”