(P180) SEXUAL HISTORY TAKING: PROVIDER-REPORTED PRACTICES, COMFORT, AND BARRIERS

Background:
Evidence suggests that sexual history taking is an important practice that improves patient outcomes and perceived quality of sexual health care; however, many providers do not report sexual history taking as a routine practice. Therefore, the purpose of this study was to explore provider-reported comfort, barriers, and needs related to patient-provider sexual health conversations.

Methods:
Remesh, an anonymous and interactive focus group platform, was used to engage healthcare providers. Using a mixed-methods approach, providers were asked about sexual health conversation frequency, barriers, and comfort-level during patient appointments. Providers were asked to share personal, training/education, and system/process barriers to sexual health conversations they encounter. Topics and patient populations where discomfort was heightened were also explored. Data were analyzed using the Remesh platform and included descriptive statistics for closed-ended questions and inductive thematic analysis of open-ended questions.

Results:
Participants (n=41) were primarily male (63%), physicians (75%), non-sexual health providers (59%), and specialized in general/family or internal medicine (83%). Less than half reported sexual health history taking as routine practice. Most felt moderately comfortable (60%), but 73% reported they sometimes worry they will offend patients when talking about sexual health. Across all barrier types, time, and competing priorities most heavily influenced discussion likelihood. Over half (60%) identified transgender individuals as patients for which sexual health discussions are uncomfortable. Most reported being uncomfortable discussing sexual assault/abuse (58%) and sexual pleasure (55%).

Conclusion:
Overall, providers were not highly comfortable discussing sexual health with patients and reported time and competing priorities as the most pervasive barrier. A variety of sexual health topics and patient populations were identified as uncomfortable, primarily due to fear of offending patients. While keeping barriers in mind, future efforts should develop and evaluate materials that aim to support patient-provider conversations, particularly with populations and across topics where discomfort is elevated.