title: Patient-provider communication about sexual health among unmarried middle-aged and older women.
abstract: BACKGROUND
  Although past studies have highlighted the importance of patient-provider communication about sexual health and intimate relationships (SHIR), much of the research has focused on young women's or married women's experiences when discussing SHIR with their providers.
  
  
  OBJECTIVE
  To describe experiences of unmarried, middle-aged and older women in communicating about SHIR with their health care providers.
  
  
  METHODS
  Qualitative interviews were conducted with 40 unmarried women aged 40-75 years. We compared the responses of 19 sexual minority (lesbian and bisexual) women and 21 heterosexual women.
  
  
  RESULTS
  Women varied in their definitions of intimate relationships. Not all women thought providers should ask about SHIR unless questions were directly related to a health problem, and most were not satisfied with questions about SHIR on medical intake forms. However, the themes women considered to be important in communication about SHIR were remarkably consistent across subgroups (e.g. previously married or never married; sexual minority or heterosexual). Sexual minority women were more hesitant to share information about SHIR because they had had prior negative experiences when disclosing their sexual orientation or perceived that clinicians were not informed about relevant issues.
  
  
  CONCLUSIONS
  Some women felt that providers should ask about SHIR only if questions relate to an associated health problem (e.g. sexually transmitted infection). When providers do ask questions about SHIR, they should do so in ways that can be answered by all women regardless of partnering status, and follow questions with non-judgmental discussions.
authors.affiliation: Center for Behavioral Medicine, The Miriam Hospital, Brown Medical School, CORO Building, Suite 500, One Hoppin St, Providence, RI 02903, USA. Mary_Politi@Brown.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: Politi
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.forename: Gene
authors.initials: G
authors.lastname: Armstrong
authors.forename: Kelly A
authors.initials: KA
authors.lastname: McGarry
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Sciamanna
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D003142:Communication; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010817:Physician-Patient Relations; D012650:Self Disclosure; D012725:Sexual Behavior; D012847:Single Person