Routine Healthcare Provider Sexual History Taking Among National Medical Association Physicians and African American Male Patients

Background:African-American men who have sex with men are disproportionately impacted by HIV and other STDs.  Data suggest missed opportunities for HIV/ STD prevention and screening among African-American men who have visited healthcare providers in the year prior to a new HIV diagnosis. National Medical Association (NMA) providers recently described discomfort with discussing sexual health with male patients as a barrier to offering routine HIV testing.

Objectives:Describe facilitators and barriers of routine HIV screening between NMA physicians and African-American male patients; Discuss preliminary results of an evaluation of routine sexual history discussions in clinical settings.

Methods:From 2006-2009, fourteen training sessions were held at regional and national NMA conferences with over 2,000 NMA physicians regarding the implementation of routine HIV screening in their practices.  Concerns expressed by NMA physicians about facilitators and barriers of routine HIV screening were transcribed, reviewed for common themes and summarized in a final report.

Results:The majority of participating NMA physicians expressed hesitancy with initiating sexual health discussions, particularly with male patients, as a barrier to offering routine HIV screenings.  They suggested a routine, basic sexual health discussion that could occur during a clinical encounter could facilitate screenings.

Conclusions:NMA physicians are willing to explore methods to increase routine sexual histories and HIV/STD screenings during clinical encounters. 

Implications for Programs, Policy, and/or Research: Implementing tools that support routine sexual history discussions for providers and patients represents an important step in combating the HIV and STD epidemics.  A standard sexual history instrument will be introduced to NMA physicians who are serving African-American men in 10-12 high HIV and STD prevalence areas in the United States.  Pre- and post-intervention evaluation tools will be used to measure the documented number of sexual histories and HIV/STD screenings at baseline and 3-months post-intervention.