title: Sexual history taking and sexually transmissible infection screening practices among men who have sex with men: a survey of Victorian general practitioners.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A cross-sectional survey of 354 Victorian GP to investigate attitudes and practices regarding sexual history taking and screening for HIV in MSM.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Alfred Hospital, Commercial Road, Prahan, Vic. 3181, Australia. bidgetbarber@hotmail.com
authors.forename: Bridget
authors.initials: B
authors.lastname: Barber
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jenkinson
authors.forename: Tim
authors.initials: T
authors.lastname: Spelman
authors.forename: Mark
authors.initials: M
authors.lastname: Stoove
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003625:Data Collection; D018563:Disease Notification / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008487:Medical History Taking; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D014739:Victoria