General practitioners' approach to young women's sexual health

Maxime Pautrat

Keywords: Sexuality ; Health communication ; General practitioners

Background:

THE WHO defines sexual health (SH) as a positive and respectful respectful approach. The news about sexual violence, access to pornography or recommendations on STIs screening for people under 25 are a reminder of the role of primary care prevention role of primary care professionals. However, talking about sexuality with the youngest patients remains a difficulty for GPs during consultations.

Research questions:

What do GPs think about their role in talking to women aged between 15 and 25 about their sexual health?

Method:

Qualitative study
Inclusion criteria: active general practitioners.
Participants: initially recruited from GP close to the investigators, then by a snowball effect to ensure diversity of profiles.
Data collection: Semi-structured individual interviews at the place of practice
Analysis: inspired by grounded theory

Results:

16 GPs included (average length of interviews: 30 minutes). The GPs recalled their key role in tackling SH "Because if it's not us, who's going to do it?" but declared that their practice was rather opportunistic: "I bring it up when I feel there's something not quite right". The fear of being intrusive or of being "accused of something" was expressed: "As a male doctor, asking all the young teenagers the question 'have you had sexual relations' after getting the mother out of the house means risking ending up in the police straight away". An empathetic attitude and adapting to the patient's time frame seem to be the key: "You have to leave the door open to discussion, and when they're ready to talk about it, you have to be there to listen".

Conclusions:

This study explains GPs' apprehensions and the tricks they use in their day-to-day practice to talk about sexuality with their youngest patients. The short duration of the interviews was possibly due to the inexperience of the investigators.

Points for discussion:

Free STIs screening without a prescription for people under the age of 25 has recently been allowed in France: is this a way for GPs to take ownership of their SH, or is it one less opportunity for them to talk about sexuality?

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