Sexual history taking: perspectives on doctor-patient interactions during routine consultations in rural primary care in South Africa

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dc.article.start-page100389en_ZA
dc.citation.doi10.1016/j.esxm.2021en_ZA
dc.contributor.authorPretorius, Deidre
dc.contributor.authorCouper, Ian
dc.contributor.authorMlambo, Motlatso
dc.date.accessioned2021-10-04T13:49:19Z
dc.date.available2021-10-04T13:49:19Z
dc.date.issued2021-05-03
dc.departmentFamily Medicine
dc.description.abstractBackground: Sexual history taking for risk behavior contributes to improving health outcomes in primary care. Giving the high numbers of people living with AIDS, every patient in South Africa should be offered an HIV test, which implies that a comprehensive sexual history must be taken. Aim: To describe the optimal consultation process, as well as associated factors and skills required to improve disclosure of sexual health issues during a clinical encounter with a doctor in primary health care settings in North West province, South Africa. Methods: This qualitative study, based on grounded theory, involved the video-recording of 151 consultations of adult patients living primarily with hypertension and diabetes. This article reports on the 5 consultations where some form of sexual history taking was observed. Patient consultations were analyzed thematically, which entailed open coding, followed by focused and verbatim coding using MaxQDA 2018 software. Confirmability was ensured by 2 generalist doctors, a public health specialist and the study supervisors. Main outcome measure: Sexual history was not taken and patients living with sexual dysfunction were missed. If patients understand how disease and medication contribute to their sexual wellbeing, this may change their perceptions of the illness and adherence patterns. Results: Sexual history was taken in 5 (3%) out of 151 consultations. Three themes emerged from these 5 consultations. In the patient-doctor relationship theme, patients experienced paternalism and a lack of warmth and respect. The consultation context theme included the seating arrangements, ineffective use of time, and privacy challenges due to interruptions and translators. Theme 3, consultation content, dealt with poor coverage of the components of the sexual health history. Conclusion: Overall, sexual dysfunction in patients was totally overlooked and risk for HIV was not explored, which had a negative effect on patients' quality of life and long-term health outcomes. The study provided detailed information on the complexity of sexual history taking during a routine consultation and is relevant to primary health care in a rural setting. Pretorius D, Couper I, Mlambo M. Sexual History Taking: Perspectives on Doctor-Patient Interactions During Routine Consultations in Rural Primary Care in South Africa. Sex Med 2021;9:100389.en_ZA
dc.description.librarianLTM2021en_ZA
dc.facultyFaculty of Health Sciencesen_ZA
dc.funderWits Open Access Publishing Funden_ZA
dc.identifier.citationPretorius D, Couper IP, Mlambo MD. Sexual history taking: perspectives on doctor-patient interactions during routine consultations in rural primary care in South Africa. Sex Med. 2021;9(4):100389. DOI: 10.1016/j.esxm.2021.en_ZA
dc.identifier.urihttps://hdl.handle.net/10539/31615
dc.journal.issue4en_ZA
dc.journal.linkhttps://doi.org/10.1016/j.esxm.2021.100389en_ZA
dc.journal.titleInternational Society for Sexual Medicineen_ZA
dc.journal.volume9en_ZA
dc.language.isoenen_ZA
dc.publisherElsevier Inc.en_ZA
dc.rights©2021 The Authorsen_ZA
dc.schoolSchool of Clinical Medicineen_ZA
dc.subjectCommunicationen_ZA
dc.subjectConsultationen_ZA
dc.subjectHIV Screeningen_ZA
dc.subjectPatient Centerednessen_ZA
dc.subjectSexual dysfunctionen_ZA
dc.subjectSexual Risk Screeningen_ZA
dc.titleSexual history taking: perspectives on doctor-patient interactions during routine consultations in rural primary care in South Africaen_ZA
dc.typeArticleen_ZA
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