Sexual history taking and sexually transmissible infection screening practices among men who have sex with men: a survey of Victorian general practitioners

Abstract

HIV notifications among men who have sex with men (MSM) in Victoria, Australia, have increased recently. Early HIV diagnosis is a prevention strategy that requires general practitioners (GP) to recognise at-risk individuals and perform screening. Sexual history taking is part of this process. A cross-sectional survey of 354 Victorian GP to investigate attitudes and practices regarding sexual history taking and screening for HIV in MSM. In total, 185 (53%, 95% CI: 47-58%) GPs reported being 'very likely' to take a sexual history from MSM presenting for a routine check-up; however 161 (46%, 95% CI: 40-51%) would not do so during the initial consultation. Barriers to sexual history taking included time constraints (28%, 95% CI: 24-36%), feeling inadequately trained (25%, 95% CI: 21-30%), discomfort discussing sex (24%, 95% CI: 20-29%) and fear of patient embarrassment (24%, 95% CI: 20-29%). Factors associated with a reduced likelihood included being male, time constraints, fear of patient embarrassment, and moral or religious views. Most GP (63%, 95% CI: 58-68%) reported they would offer HIV screening 3-6 monthly for MSM with casual partners; 54 (16%, 95% CI: 12-20%) would offer screening only on request. Being unlikely to take a sexual history and fear of patient embarrassment were associated with a decreased likelihood of offering an HIV test. GP 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.