November 22, 2011
Recent increases in HIV notifications have been seen among men who have sex with men in Victoria. Early diagnosis as an HIV prevention strategy requires that general practitioners (GPs) recognize at-risk individuals and perform screening, the authors wrote, and taking a sexual history is a part of this process. To investigate attitudes and practices about sexual history taking and HIV screening in MSM, the team conducted a cross-sectional survey of 354 GPs in Victoria.
Among respondents, 185 GPs (53 percent, 95 percent confidence interval: 47 percent-58 percent) said they were "very likely" to take a sexual history from MSM who presented for a routine check-up, although 161 (46 percent, 95 percent CI: 40 percent-51 percent) said they would not do so during the initial consultation.
The GPs cited barriers to sexual history taking that included time constraints (28 percent, 95 percent CI: 24 percent-36 percent); feeling inadequately trained (25 percent, 95 percent CI: 21 percent-30 percent); discomfort discussing sex (24 percent, 95 percent CI: 20 percent-29 percent); and fear of embarrassing the patient (24 percent, 95 percent CI: 20 percent-29 percent). Factors that were associated with a reduced likelihood of taking a sexual history included being male, time constraints, fear of patient embarrassment, and moral or religious views.
Sixty-three percent of the GPs (95 percent CI: 58 percent-68 percent) said they would offer HIV testing 3-6 monthly for MSM with casual partners. Sixteen percent of the GPs (95 percent CI: 12 percent-20 percent) (n=54) said they would offer screening on request only.
"Being unlikely to take a sexual history and fear of patient embarrassment were associated with a decreased likelihood of offering an HIV test," the authors found. "GPs often fail to take a sexual history from MSM, limiting opportunities to offer HIV screening. Strategies are required to increase GPs' awareness of sexual health as a priority for MSM."