JACKSONVILLE, FLA. — Pediatricians were the specialists most likely to ask patients about sexual history—followed by obstetricians and gynecologists, family physicians, and internists, according to a survey of physicians in the Atlanta metropolitan area.
The results, presented in a poster at a conference on STD prevention sponsored by the Centers for Disease Control and Prevention, came as a surprise to investigator Dr. Yolanda Wimberly.
“In most other studies, obstetrician-gynecologists are number one. This is part of what they do,” she said in an interview.
Respondents were primary care physicians; 51% were men, and the mean age was 44 years. Being black, female, and a pediatrician were the demographic factors most often associated with taking a sexual history.
There appears to be a disconnect between beliefs and practices, said Dr. Wimberly, of Morehouse School of Medicine in Atlanta. Most of the 414 primary care physicians rated sexual history taking as important, relevant, and something they were comfortable discussing with a patient. A majority, 77%, rated sexual history taking as fairly or extremely important; 85% said it was fairly or extremely relevant to medical care; and 79% indicated they were fairly or extremely comfortable with the practice.
Yet only 55% reported routinely asking patients.
Most of the metropolitan Atlanta physicians surveyed do not take a comprehensive history, but simply ask patients if they are sexually active, Dr. Wimberly said. “Instead of just asking: 'Do you take a sexual history?' we broke it down into components of a complete sexual history.”
Although 55% of respondents ask at the time of an annual exam about sexual history, “the numbers go down for the other components,” Dr. Wimberly said. For example, only 11% of physicians ask about sexual abuse and only 12% ask about sexual orientation. The findings suggest primary care physicians could benefit from additional training or use of a standardized questionnaire about sexual history, she added.
A total of 56% of physicians reported adequate or more than adequate training for sexual history taking. The practice rarely or never takes too much time, according to 57% of respondents.