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Institute of Epidemiology & Health Care

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International Visitor 20th June 2017

Title: Facilitating sexual health discussions in primary care with older Australians: Health practitioner perspectives

Speaker
Professor Meredith Temple-Smith

Abstract
: Sexual activity enhances physical and mental health during ageing. However, older Australians (aged 60+) are often left out of sexual health discussions owing to a false presumption that they are not, or do not want to be, sexually active. Many barriers prevent both older people and their General Practitioners (GPs) from initiating such discussions. Practice nurses (PNs) may provide an alternative as they already provide other sexual health services. Practice Managers (PMs) may have the ability to highlight opportunity for sexual health communication as part of their role as agents of change. What kind of facilitation might assist sexual health discussion between patient and practitioner?

In this pilot study, semi-structured interviews were conducted with 15 GPs, 6PNs and 6 PMs from rural and urban GP clinics, plus 10 key informants with experience in either current digital and online interventions, or sexual health. Interviews were transcribed and analysed thematically.

Whilst the majority of GPs believed it was part of their role to discuss sexual health with patients they did not routinely do so with older adults. Most GPs would only discuss sexual health with an older patient if it is deemed relevant to the complaint the patient brought into the consultation. Many PNs were already initiating discussions in the context of well women's checks, 75+ health assessments, and chronic disease management plans. The main barrier to PN led discussion was lack of support and follow up from GPs. Most GPs and PMs believed that a poster in the waiting room was the best way to increase the frequency and quality of sexual health discussions with older patients. Key informants believed digital and online interventions can provide a non-judgmental way for patients to disclose information about sensitive topics such as sexual health.