title: Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections.
abstract: BACKGROUND
  Primary care providers are well placed to control the spread of sexually transmitted infections (STI); however, care is likely to be influenced by their attitudes and beliefs. The present study investigates the relationship between general practitioner's (GP) self-reported level of comfort in dealing with patients with STI and the care they deliver.
  
  
  METHODS
  A postal survey was conducted using a stratified random sample of 15% of GPs practising in New South Wales, Australia, to assess practitioners' management of STI. A total of 409 GPs participated in the study yielding a response rate of 45.4%.
  
  
  RESULTS
  Although over two-thirds (69-72%) of GPs were comfortable in managing STI in heterosexual or young patients, fewer than half (40-46%) felt comfortable caring for patients who were sex workers, indigenous, people who inject drugs, gay or lesbian. Practitioners who were comfortable were more likely to offer sexual risk assessment, safe-sex counselling, and were less likely to report limited ability to influence patients' risk behaviours. Practitioner discomfort was positively associated with reporting constraints in sexual history-taking and the need for training in sexual health.
  
  
  CONCLUSIONS
  Practitioners' care and support for patients with STI are influenced by their inexperience, lack of skills and/or attitudes. The reasons for GP discomfort in managing STI patients need further exploration as does its impact on patient care.
authors.affiliation: Social Research Centre, The University of Queensland, St Lucia, Qld 4072, Australia. a.khan2@uq.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.forename: D
authors.initials: D
authors.lastname: Plummer
authors.forename: R
authors.initials: R
authors.lastname: Hussain
authors.forename: V
authors.initials: V
authors.lastname: Minichiello
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005260:Female; D020010:Heterosexuality / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011287:Prejudice; D011787:Quality of Health Care / Q000592:standards*; D011477:Sex Work / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000523:psychology / Q000628:therapy*; D015819:Substance Abuse, Intravenous / Q000523:psychology