Most people find talking about sex really difficult and embarrassing, and healthcare providers are no exception to the rule. It’s no surprise that we often avoid the subject entirely, as it is considered to be a sensitive and potentially awkward conversation – especially if you don’t know the person you’re talking to, as is the case with healthcare providers. But learning about the sexual behaviour of patients is becoming a vital part of the process now, as part of creating a high quality, patient-focussed and more efficient form of health care. In a survey of 500 men and women over the age of 25, 85 per cent of the participants expressed an interest in discussing sexual topics with their doctor, although 71 per cent stated that their GP would most likely dismiss their concerns. The knowledge a GP has of their patient’s sexual history gives them the opportunity to educate and counsel them about STDs, HIV and viral hepatitis. But without this knowledge, they’re unable to know which tests and vaccinations are needed. Such diseases are mostly ‘silent’ and unnoticed so they can lead to more serious illnesses, as well as spreading to partners which increases the prevalence of the disease within the community. So when a GP doesn’t ask the question about sex, they aren’t just affecting the patient themselves – they’re also affecting the health of the people in the wider community as well. The new initiatives aim to greatly lower the risk of HIV and other sexually transmitted diseases, which have risen significantly in recent years.
Studies show that gathering information about a patient’s’ sexual behaviour can be done in a very simple and effective way by asking three basic sexually-related questions regarding ones behaviour and risk:
- Have you been sexually active in the last year?
- Do you have sex with men only, women only, or both?
- How many sexual partners have you had in the last six months?
These questions help to give a really broad sense of a person’s sexual behaviour and their level of risk, which makes it easier for a GP to tailor a deeper discussion about their needs. It’s vital that GPs ensure that they assure their patients that this is something that they do with all their patients so that the individual doesn’t feel as though they are being singled out for their behaviour. This is especially the case for high-risk populations who have been marginalised or oppressed historically, such as transgender men or women, homosexual men and women, groups at high risk for HIV and STDs, and viral hepatitis. In order to help these groups, it’s important that their sexual history is described to their GP. This means asking questions such as:
- How often should people be tested for HIV and STDs?
- What vaccinations should be offered to whom?
- Why are some MSM at higher risk for HIV and STDs?
It may take time for GPs to feel comfortable speaking to their patients about sexual matters, their health, identities and desires. But once this becomes more routine, the stigma surrounding sex and sexual behaviour will also become less of an issue. This is important both in and out of a health care setting to make honest conversations about sex a more common occurrence. There are plenty of services available to provide education and help to people who need advice on sexual matters, as well as STD testing and advice on unplanned pregnancies – if you’re concerned, you should speak to your GP who can offer more information on the services in your local area.