Practice patterns for the elicitation of sexual history, education, and counseling among providers of STD services: Results from the Gonorrhea Community Action Project (GCAP)

被引:51
作者
Bull, SS
Rietmeijer, C
Fortenberry, JD
Stoner, B
Malotte, K
Vandevanter, N
Middlestadt, SE
Hook, EW
机构
[1] Denver Hlth & Hosp Author, Dept Publ Hlth, Denver, CO USA
[2] Univ Colorado, Hlth & Behav Sci Program, Denver, CO 80202 USA
[3] Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA
[4] Indiana Univ, Sch Med, Bloomington, IN 47405 USA
[5] Washington Univ, Sch Med, Div Infect Dis, St Louis, MO 63110 USA
[6] Calif State Univ Long Beach, Long Beach, CA 90840 USA
[7] Columbia Univ, Sch Publ Hlth, Div Sociomed Sci, New York, NY USA
[8] Acad Educ Dev, Washington, DC USA
[9] Jefferson Cty Dept Hlth, Birmingham, AL USA
[10] Univ Alabama, Dept Med, Div Infect Dis, Birmingham, AL 35294 USA
关键词
D O I
10.1097/00007435-199911000-00008
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: The frequently asymptomatic nature and high incidence of severe complications of sexually transmitted diseases (STD) calls for targeted efforts to identify those at greatest risk. Earlier studies have shown inconsistencies regarding STD evaluation by primary care chinicians and physicians. However, the literature regarding the consistency of practice patterns regarding elicitation of sexual history is limited. We examined practice patterns for the elicitation of sexual history among providers across seven sites nationwide. Methods: As part of a multisite study to encourage health seeking for populations specifically at risk for gonorrhea (GC) and other STDs, semistructured interviews that included questions regarding sexual history elicitation were conducted with 208 service providers in a total of 121 publicly and privately funded clinics, managed care organizations (MCOs), hospital clinics, community- and school-based clinics in Denver, New York, Los Angeles, Birmingham, St. Louis, Indianapolis, and Prince Georges County, MD. Results: Among the providers interviewed, practice patterns for the elicitation of sexual history were inconsistent. Sexual histories mere described as routine (i.e., solicited from every client regardless of reason for visit) in 57% of sites. Providers most frequently asked clients their number of sex partners (57%), their contraceptive history (55%), and STD history (34%). Client discomfort among 46% and provider discomfort among 13% was cited as barriers to the elicitation of sexual history. A quarter (26%) of providers agreed that the elicitation of sexual history can be fostered by improved provider communication skills and 16% agreed increasing training and experience for providers is needed. Conclusions: These findings suggest that interventions with providers to standardize sexual history elicitation can help to reduce barriers to prevention, diagnosis, and treatment of STD.
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收藏
页码:584 / 589
页数:6
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