Sexual History Elicitation Practices Among Providers of STD Services in Florida

Background: 

In the United States an estimated 1 million sexually transmitted diseases (STDS) are reported annually. The state of Florida has some of the highest STD rates in the country. STDs are a particular problem for minorities, women, and adolescents. If left untreated STDs can cause serious health problems including infertility, increased risk for certain types of cancer, and increased risk for HIV transmission.Sexual history elicitation is a tool available to clinicians to assess patients’ sexual risk behaviors and to counsel, test, and treat STDs. 

Objectives:  The purpose of this research was to examine the sexual history elicitation practices among providers of STD services: obstetricians and gynecologist, family practitioners, internal medicine physicians, pediatricians, nurse practitioners, and physician assistants in Florida.   

Methods: Random stratified samples of 2338 primary care providers in Florida were mailed an anonymous pencil-and-paper, self-administered survey. The survey instrument was constructed and tested to measure primary care provider sexual elicitation practices. The survey was also available online. Data from the survey was analyzed with SPSS 18.0 a series of one way ANOVAs, multiple linear regression, Person correlation, and factor analysis was performed.

Results:  This study found that sexual history elicitation practices did differ across specialties and fields. Sixty-seven percent of PCPs were likely to take a sexual history. Female (gender), PCPs  that listed obstetrics and gynecologist as their specialty area, and PCP that diagnosed numerous STDs were found to be significantly associated with likelihood to take a sexual history.

Conclusions:  Sexual history taking was highly variable. Targeted interventions are needed to increase sexual history elicitation practices among Florida PCPs in family medicine, internal medicine and pediatrics.

Implications for Programs, Policy, and Research:  This research will help increase awareness of provider barriers to effective STD screening and thus inform the development of organizational expectations, training curricula, and clinical practice guidelines in Florida.