title: Recording the sexual orientation of male patients attending general practice.
abstract: BACKGROUND
  Determination of a patient's sexual orientation is important to guide appropriate health care. We assessed how frequently sexual orientation is included in the health records of men attending general practice and factors associated with its recording.
  
  
  METHODS
  Routine consultation data were extracted from seven Australian general practices in a 2-year period (2011-12) as part of a sexual health testing intervention for gay and bisexual men. We calculated the proportion of male patients with sexual orientation recorded and used logistic regression to determine patient, provider, clinic and community factors associated with recording.
  
  
  RESULTS
  There were 12475 men who attended the clinics in the study period and sexual orientation was recorded for 42%, of whom 67% were identified as homosexual, 3% bisexual and 30% heterosexual. Recording ranged from 3% to 81% between clinics. Patient factors independently associated with recording of sexual orientation were: being HIV-positive [adjusted odds ratio (AOR) = 1.2, 95% CI: 1.1-1.4], previous sexually transmissible infection/HIV testing at the clinic (AOR = 1.8, 95% CI: 1.6-2.0), and ≥6 previous clinic visits (AOR =1 .1, 95% CI: 1.0-1.1). Provider, clinic and community factors independently associated with sexual orientation recording were: regularly attending a female GP (AOR = 1.3, 95% CI: 1.1-1.4), ≥4 previous consults with a particular GP (AOR = 1.4, 95% CI: 1.2-1.7), attending a clinic with a high caseload of gay/bisexual patients (AOR = 8.8, 95% CI: 1.6-48.1), and the patient residing in a community with ≥10% same-sex partner households (AOR = 1.2, 95% CI: 1.0-1.3).
  
  
  CONCLUSIONS
  Sexual orientation was incomplete for more than half of male patients. Initiatives targeting both the patients and providers need to be considered to improve recording.
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia, d.callander@unsw.edu.au.
authors.forename: Denton
authors.initials: D
authors.lastname: Callander
authors.affiliation: Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Bourne
authors.affiliation: Taylor Square Private Clinic, Sydney, Australia.
authors.forename: Cathy
authors.initials: C
authors.lastname: Pell
authors.affiliation: Taylor Square Private Clinic, Sydney, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Finlayson
authors.affiliation: Fountain Street General Practice, Sydney, Australia.
authors.forename: Bradley
authors.initials: B
authors.lastname: Forssman
authors.affiliation: East Sydney Doctors, Sydney, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Baker
authors.affiliation: Centre for Social Research in Health, UNSW Australia, Sydney, Australia.
authors.forename: John
authors.initials: J
authors.lastname: de Wit
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
authors.affiliation: Burnet Institute, Melbourne, VIC, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Stoové
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia, Sydney Sexual Health Centre, Sydney Hospital, Sydney, Australia.
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Kaldor
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia; D003430:Cross-Sectional Studies; D004282:Documentation / Q000706:statistics & numerical data*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019529:Sexuality / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: data quality; general practice; primary health care; sexual orientation; sexuality.