Experts say we can only meet sexual health challenges by shifting away from the current focus on diseases and moving towards a perspective that promotes health and wellness. In a Journal of the American Medical Association (JAMA) Viewpoint published online June 18, 2015, Sexual Health in America: Improving Patient Care and Public Health, former Surgeon General David Satcher, MD, PhD, former ASHA Board Chair Edward W. Hook III, MD, and current ASHA Board member Eli Coleman, PhD, say we can move towards solutions by embracing a comprehensive sexual health framework that looks towards the promotion of health and wellness rather than a narrow fixation on diseases. Read the Viewpoint here.
While talking to patients about sexual health is important, it can be a difficult task. Many patients are uncomfortable asking questions or sharing concerns, and providers themselves often address the topic too quickly or not at all. As an illustration, 2012 national survey of U.S. OB-GYNs revealed that only 40 percent of those surveyed routinely ask questions to assess for sexual problems or dysfunction and only 29 percent routinely ask patients about satisfaction with their sexual lives. Fewer than a third—28 percent—routinely confirm a patient’s sexual orientation.
Part of the problem is starting the conversation. A 2009 poll of 304 US healthcare providers by the Association of Reproductive Health Professionals (ARHP) and HealthyWomen found that 74 percent of providers rely on their patients to initiate a discussion about sexual health. A survey that same year by the Women’s Sexual Health Foundation found that approximately the same amount of patients—73 percent preferred—that the healthcare provider brings up the topic of sexual health.
Communicating with patients about their sexual health is an essential part of patient care. After all, sexual health is an important part of overall health and routinely addressing sexual health issues can help destigmatize the subject of sex and sexual behavior and help increase patients’ comfort level in seeking care.
Below are selected resources to help improve communication with patients around sexual health.
- Developed by the National Association of Community Health Centers and the Fenway Institute’s National LGBT Health Education Center, the toolkit Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers facilitates the taking of routine sexual health histories as part of primary care visits. Key components of the toolkit are available as Word documents so that they can easily be customized and branded for your organization.
- “The Proactive Sexual Health History”: This article from American Family Physician discusses a routine way to elicit the patient’s sexual history that avoids judgmental attitudes and asks the patient for permission to discuss sexual function.
- The Centers for Disease Control and Prevention (CDC) offers A Guide to Taking a Sexual Health History, a printable 24-page booklet on discussing sexual health issues with patients, with a specific focus on sexually transmitted infections (STI). The guide includes sample dialogue to use to assess a patient’s risk for sexually transmitted infections.
- The National Coalition for Sexual Health offers Sexual Health and Your Patients, a provider’s guide created to help primary care providers learn how to better incorporate sexual health discussions and recommended preventive sexual health services into an adult or adolescent wellness visit.
Talking to Young Patients about Sexual Health
This video from CDC looks discusses the importance of a healthy dialogue between providers and young patients concerning their sexual health and features CDC Epidemiologist, Elizabeth Torrone, Ph.D. MSPH.