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Teaching
Sexual Health and Responsibility – Every
Practitioner’s Responsibility
By
Maureen N. Letts
4th
year medical student
Univ.
of Cincinnati College of Medicine
After
spending the month of February working at the
Cincinnati Health Department’s Sexually
Transmitted Diseases (STD) Clinic, my eyes were
opened to some of the challenges and barriers
that arise when educating patients about sexual
health. It
is typically a host of poor choices lead many
patients to the STD Clinic.
Embarrassment, fear of being judged, and
ignorance of the facts make many hesitant to
disclose the truth of their behavior once they
arrive. The
fact is, the rate of HIV/AIDS continues to rise
in the African-American community, and yet many
patients’ attitudes and practices are
unchanged.
Many of these clinic patients, who range
in age from early teens to middle- and
older-aged adults, take comfort in the fact that
most sexually transmitted infections (STIs) can
be treated with an injection or short course of
antibiotic pills.
They neglect to see the potential
long-term consequences of STIs and the serious
threat of HIV.
To my surprise, however, the majority of
patients are willing to listen, talk
realistically about their practices, and ask
questions when they have a non-judgmental and
receptive health care provider with whom they
can interact. For these very reasons, it is the responsibility of every
practitioner to break down these barriers by
providing a safe haven for discussion,
initiating dialogue, and providing the hard-core
facts related to patient sexual health and
responsibility with every patient encounter.
In
order to approach sensitive issues related to
sexual health with patients, one must first
facilitate an environment where open discussion
can take place.
Many physicians display patient
information pamphlets in their waiting areas or
posters in examination rooms that address health
topics. By
including information on topics such as safe
sex, HIV, birth control, and abstinence,
patients become aware that these issues are of
concern to their doctor, and thus, should be
their concern too.
Furthermore, health care providers should
regularly ask questions related to sexual health
as a part of a comprehensive interview.
Although some patients may be hesitant to
respond initially, addressing these issues shows
the physician’s interest in the patient’s
overall well-being.
Patients should be made aware that
questions regarding sexual health are not
specifically directed towards them, but instead
that the physician discusses such issues with
all patients.
When the health care provider creates a
safe haven for discussion of sexual health early
in the doctor-patient relationship, it opens the
door for honest dialogue in the future.
It
is vital that health care providers initiate
this dialogue with all of their patients,
regardless of age, cultural difference, or
sexual preference.
Although teenagers and young adults are
statistically shown to participate in more risky
sexual behavior, adults and elderly patients are
not immune to the consequences of unsafe sexual
activities.
Discussions with teenage patients should
encompass body image and self –esteem, as well
as making mature and responsible decisions about
engaging in sexual activity, birth control, and
protection from STIs.
Adults should be counseled on responsible
sexuality, birth control, and sexual
dysfunction.
Additionally, they should be encouraged
to have open and honest discussions with their
adolescent and teenage children at home.
Finally, all patients should be screened
for sexual abuse and intimate partner violence.
Although
most people will respond to these types of open
discussions, the occasional patient will be
apathetic or obstinate to your advice.
When this type of situation arises, it is
time to give them the cold, hard facts and ask
the tough questions. “Did you know that
HIV/AIDS is the leading cause of death in
African-Americans from ages 25-44?”
“Are you ready to be a father?”
“Do you realize that you are putting
your unborn child at risk?” When
patients understand the impact of a single poor
choice in the present on their future health and
wellness, they often become more attentive and
willing to heed a physician’s advice.
This is when effective patient education
can take place.
By
creating a setting conducive to the discussion
of sexual health and responsibility with
patients, and providing pertinent factual
information, health care providers form an
important partnership with their patients.
When the physician takes responsibility
for allowing issues of sexual health to be
addressed and engages the patient in the
discussion, it empowers them to take more
responsibility for their care as well.
There are no easy answers, and many
challenges remain, but influencing a change, one
patient at a time, is a success indeed! |
