Facilitators and Barriers in Sexual History Taking

Abstract

Sexuality is a central part of human life and overall wellbeing. As awareness on issues of sexuality has been increasing, sexual health history is ever more thought of as an indispensable part of the general health assessment. The main purpose of taking a sexual history is to assess a patient’s sexual background and current functioning. The biopsychosocial model provides a comprehensive framework for this evaluation that takes into account medical, psychological, intrapsychic, interpersonal, social, cultural and ethnic variables. Although several strategies and skills can be used to enhance the efficiency and effectiveness of the process of sexual history taking, a number of barriers still impede the communication about sexual topics. The main objective of this work is to explore, integrate and summarize current knowledge on the perceived obstacles and facilitators for taking a sexual history encountered by health professionals in their clinical practice. A narrative review was conducted through a database search of scientific documents. Fifty six articles were included and analysed, being grouped into main research areas: sexual health education and promotion, sexual transmitted diseases, sexuality and disease, sexual dysfunction, lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ), and sexual violence. Deficiencies in sexual history taking education and training, reticence to take a history related to concerns about the acceptability of discussing sexuality with the patient and stigma and society’s attitudes towards sex came out as major cross-cutting themes. Barriers and facilitators operate at the individual, institutional and societal levels. Sexual history taking holds the key to the practice of sexual health and provides the basis for treatment, prevention, education and sexual health promotion.