Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections.
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.
Khan
A
A
Social Research Centre, The University of Queensland, St Lucia, Qld 4072, Australia. a.khan2@uq.edu.au
Plummer
D
D
Hussain
R
R
Minichiello
V
V
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